Nodular acne is a severe type of inflammatory acne that causes firm, painful lumps to form under the skin and red bumps to appear on the skin's surface. It is caused by a bacteria called Cutibacterium acnes (C. acnes) becoming trapped under the skin in nodules, leading to infection and inflammation. Nodular acne requires treatment from a healthcare provider, and untreated, it can lead to severe scars. Prescription oral medications and topical creams can help. Unlike other types of acne, nodular acne cannot be cleared up with over-the- counter products alone.