Hi
From the description given as well as from the photo provided it would seem that the initial inflamed acne has become a nodular cystic acne ,
Such form of acne tends to be more resistant to topical treatment alone . As the acne lesion is isolated to the nose only I usually would not recommend oral medication. However if these lesions are more widespread a course of oral antibiotics would usually be beneficial.
In your case since it is isolated and persistent I would recommend two options
1. Intralesional injection of cortisone / steroid . This is useful in reducing the inflammation and shrinking the cyst wall . The procedure is well tolerated and results can be seen within the week .
2 Agnes Radiofrequency device which uses a very fine RF electrode needle to be inserted directly into the lesion. The tip of the needle will be directed towards the sebaceous gland and the energy/ heat generated will destroy the sebaceous gland . Once the gland is destroyed., the sebum dries out and the clog debris can be removed . You can expect good result about one week after treatment . The good thing about this treatment is that since the sebaceous gland in this area has been destroyed you should not get a recurrence of the acne in this area .
Hope this helps
