The drugs used to treat rheumatoid nodules are known as disease-modifying antirheumatic drugs (DMARD) and work at the molecular level of the disease and drugs known as biologics which work by inhibiting specific immune system proteins. DMARD drugs options include methotrexate, sulfasalazine, hydroxychloroquine, leflunomide, azathioprine, and cyclosporine. Note that treatment of rheumatoid nodules is not required, but there is usually a spontaneous regression or reduction when a specific RA treatment is administered. Use caution with some DMARDs. Some medications may actually cause or worsen the nodules. These include methotrexate and leflunomide for unknown reasons., ,, Tell your doctor if new nodules appear or the previous nodules are getting bigger or painful. You may need a new drug therapy to avoid the appearance of the nodules while treating the rheumatoid arthritis. Your doctor might also recommend a biologic response modifier drug. These include etanercept, adalimumab, infliximab, certolizumab pegol, golimumab, anakinra, abatacept, rituximab, tocilizumab, or tofacitinib. Many studies have been completed that saw reduction in these nodules when treating RA with these medications., , , Arrange an appointment with your doctor to discuss your treatment for rheumatoid arthritis. Your doctor will give you a prescription for the medications you may need, and take these medications as directed. Injecting steroids within the nodules have been proven to reduce size of the nodules. Therapy though may require weeks of injections by your healthcare provider., Steroids help reduce the inflammation process occurring at the nodules. Your doctor will clean the area of the nodules with rubbing alcohol or alcohol pads. A numbing agent/spray or anesthetic may be applied to reduce pain. A needle with steroids will be injected at the site of the nodules. After receiving the shot, you may feel discomfort at the location, and flushing of the face or chest can occur. Do not excessively move the area, and apply ice to the site if pain occurs. Note if you are diabetic, steroids can increase your blood sugar. Excision of the nodules may be warranted if nodules remain, worsen, become infected or ulcerated, meaning that the skin is damaged and blood is exposed. The nodules may also be impinging on nearby nerves and producing sharp diffuse pain, and/or obstructing your everyday functioning, as would be the case with nodules on the foot. Your surgeon will assess what kind of anesthesia to provide, either through injection at or around the site or through IV sedation. Your surgeon may ask you not to eat or drink anything after midnight the night before surgery. The area will be properly cleaned and the surgeon will use a scalpel or other cutting tool to cut the nodule. The surgeon may use a wide margin technique where an oval-shaped excision will be made around the nodule, removing the nodule and small amount of surrounding normal tissue to assure full removal.
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One-sentence summary -- Treat the nodules with disease-modifying antirheumatic drugs. Try biologic drugs if your RA doesn't respond to DMARDs. Ask your doctor about steroid injections. Consider surgery for rheumatoid nodules.

No matter what the subject, know that you will lessen the burden on your shoulders as soon as you share it with your parents. Don't feel worried, anxious, or embarrassed as your parents are meant to be there for you always. They may also know more than you think. With proper planning and communication, you will be able to have the conversation that you're looking for. Your parents get worried because they care about you and want the best for you. With that in mind, they will be happy that you are seeking their advice for a problem. Any problems or awkwardness won't simply go away if you avoid having a conversation with your parents. Relieve the stress by getting it out in the open. Knowing that your parents are trying to understand you and solve any problems can help alleviate your stress and anxiety. Do you want to talk to both your parents or is it something mom is better suited to handle? Your relationship with each parent is going to be different so ask yourself what will be the most appropriate course of action. Some topics might be easier to discuss with one parent over the other, one parent might be calmer while the other is quicker to anger. In this case, it may be best to talk to your calmer parent first and then talk to the other parent together. Know that your parents are most likely going to tell each other about a conversation you have no matter if you only tell one of them. It's best to include both in your conversation but smart to enlist the help of one to talk to the other if you feel that's the best course of action. For example, you don't want to alienate your dad by only telling your mom about a school bully. Ask your mom if you can talk to your dad together because you're scared he will get angry at you for not standing up and fighting. Find out your parents' schedule so you know when a good time to chat will be. You don't want your parents to be distracted thinking about a meeting or having to prepare dinner. The location of your conversation is also important as you may not want any distractions like TV or your parents' coworkers chiming in. While you may know what you want out of the conversation, there could be several different answers your parents give you. Plan for everything. Ideally, you want the conversation to go your way but it's okay if it doesn't. You are never alone as there are numerous resources including teachers and other responsible adults. If the outcome is not what you desired, you can try several things: Talk to your parents again. Perhaps you caught them at a bad time. If they are already having a bad day they might not be in the best frame of mind to discuss your situation with an open mind. For example, don't ask them if you can go to the school dance after you just made them late for your sister's dance recital. Drop it. There's no sense in infuriating your parents and ruining your chance at getting what you want anytime in the near future. If you have had a respectful and open conversation and both sides have pleaded their case, accept that your parent's point of view. Showing them that you are mature enough to respect their perspective will help your case in the future as they will be more receptive to what you have to say knowing that you are able to keep your emotions in check. Seek outside support. Enlist the help of your grandparents, your friends' parents, or teachers to help plead your case. Your parents will always be protective of you so asking outside support can convince them that you can handle a situation. For example, you can ask an older sibling tell your parents that they have been to the area that you want to go to and can escort you to the location to make sure it's safe.
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One-sentence summary --
Be brave. Don't be worried that your parents will get upset or react poorly. Don't avoid the conversation. Know who you want to speak to. Schedule a time and place to have your conversation. Plan for the outcome.