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What Causes A Single Red Raised Nodule Along With Few Pustules On Face?

Posted on Wed, 20 Apr 2016

Question: I have an acne query & would like the assistance of a dermatologist please. Ideally I would prefer Dr. Kakkar S. as I consulted him a few times last year, however if he's not free I would be grateful for help from any dermatologist ASAP as I'd like some professional guidance today if possible, many thanks.

Dear dr

I am writing to you about a Largeish hormonal acne lesion i have - it is only one spot but more deep tender than the surface pimple which might be called a pustule, it is a tender lump but i do not know if it qualifies for nodule or cyst status

1) 5-6mm diameter
2) a red hard lump, elevated by 2-3 mm, now showing sign of pus in centre, its been there since sunday. The pus seems to be splitting into 2 heads
3) very tender to touch /wash
4) on me these type tend to linger- can scar, last one like this last year left 2 raised white bumps in the skin which haven't changed and might be a scar of some form.
5) feels like a button or half pea in the skin

The spot isnt throbbing but im aware of it all the time sort of growing and it feels like tingling etc

I Have kept big spots mainly at bay successfully using differin but i unfortunstely left it off for a week due to being very ill with an ear infection which coincided with being premenstrual.

I Am treating with daily differin and zindaclin gel, i have also atarted using blue/red light therapy, is that best & only treatment or
Should i request short course antibiotics from the gp and will it scar? I live in uk and its very difficult to get a Dr to visit (im housebound) or prescribe anything for a single spot. I would not be bothered about having a large spot if it wasnt for the risk of scarring which I am Prone to as i have a serious health condition.

I have just finished a 10 day course of flucloxellin for my severe ear infection.

Thanks for your help
XXXXXXX Newnham

Answered by Dr. Asmeet Kaur Sawhney (40 minutes later)

Brief Answer:
Case of nodular acne, consider taking oral antibiotics

Detailed Answer:
Hi
Thanks for being at healthcare magic

I have reviewed the attached photographs.

I can appreciate a single red raised nodule along with few pustules.

It seems case of nodular acne. I would recommend you to continue with differin gel and zindaclin gel.

In case a person is prone to scarring I do recommend them to take a short course of oral antibiotic like tablet Azithromycin 500 mg once daily for 3 consecutive days in a week for 2 weeks. This will hasten the resolution of the nodule.

This is a prescription drug and you need to see the doctor in person to get it.

I hope to have answered your query and would be happy to clarify any further doubts.

Regards
Dr Asmeet

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Asmeet Kaur Sawhney (18 hours later)

Hello

Thanks very much for your prompt help.

I'm afraid the uk GP I spoke to this morning was Not prepared to prescribe any antibiotics "for one spot" stating its something he wouldn't support as I've just finished another course of strong antibiotics.
Initially he recommended just Zindaclin gel, then he suggested fucidin as a stronger option. I can't go against his opinion as I am in uk and have to accept just one opinion when housebound and unable to travel, however I trust your opinion also. Would you please give me your advice/opinion regarding Zindaclin or fucidin for this type lesion? & is there anything else I can do to reduce scarring if antibiotics aren't an option for me - ie is the light therapy I'm using likely to help or make things worse?

Many thanks. XXXXXXX Newnham

Answered by Dr. Asmeet Kaur Sawhney (38 minutes later)

Brief Answer:
Use fucidin cream and blue light therapy

Detailed Answer:
Hi
You can use fucidin cream for that single nodular lesion. It is a better option than zindaclin gel but continue using differin gel at night.
You can use blue light therapy. Although it won't be drastically effective but will definitely show moderate benefits in inflammatory acne as in your case.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Asmeet Kaur Sawhney (4 hours later)

Hi,

thats really helpful
thanks s much,

Can /should fucidin go on top of differin gel as i have been appying zindaclin or is it best separately one applied at night, one during day?
Thats my final query, sorry to keep coming back.

Regards XXXXXXX Newnham o

Answered by Dr. Asmeet Kaur Sawhney (14 minutes later)

Brief Answer:
You can apply fucidin cream on top of differin gel.

Detailed Answer:
You can apply fucidin cream on top of differin gel.

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Naveen Kumar