Isotretinoin is indicated for nodular acne or severe acne that is unresponsive to conventional therapies. The usual dose is 0.5 to 1.0 mg/kg/day for 20 weeks, or a cumulative dose of 120 mg/kg.

Topical clindamycin is a first-line treatment for a severe type ... be used to treat very inflamed forms of severe acne, including cystic and nodular acne. It can also be used on inflamed pimples ...

In 1982, the U.S. Food and Drug Administration (FDA) approved Accutane for the treatment of severe, recalcitrant nodular acne ...

It offers Epuris (isotretinoin), an oral retinoid indicated for the treatment of severe nodular and/or inflammatory acne, acne conglobate and recalcitrant acne; Actikerall, a topical solution ...