Like all types of acne, it can be quite the mystery figuring out where it comes from if you’re not a pro. But Engelman says there are a few causes that are common like the combination of excess oil, dead skin cells and C. acne bacteria. “Nodular acne is more likely to form when there is an excess of these things, which can easily clog pores, get infected and lead to a nodular acne breakout,” she says. She also notes that the presence of C. acne bacteria is what causes the infection.
Another cause to consider is, you guessed it, hormones. “Hormones can cause oil production to increase which makes breakouts more likely,” Engelman says.
Maiman says when androgen (male) hormones increase, so does oil production. “Androgens also can change the chemical makeup of oil, making it thicker which is more likely to clog pores, as well as a more desirable environment for acne-causing bacteria,” Maiman explains.
But when it comes to discerning why some people are more likely to develop nodular acne over others, Maiman says it’s still a mystery. “There does appear to be a genetic component, meaning that, if your parents or sibling had nodular acne, you’re more likely to get it, too.”
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