Cystic acne is a particular type of acne vulgaris that develops deeper in the epidermis than other types of acne. It is the most severe type of acne vulgaris. Cystic acne is characterized by deep, inflamed breakouts which develop on the face (and possibly other areas of the body). The breakouts can become quite large, some measuring up to several centimeters each.
Although the word “cystic” is popularly used to describe any form of inflamed acne, only acne where cysts develop is truly cystic acne. Cysts feel soft and fluid-filled, and these lumps develop under the skin’s surface. They can be quite painful to the touch.
Nodulocystic acne is the condition in which nodules develop on the skin as well as cysts. Nodules differ from cysts in that they are hard, painful lumps deep under the skin’s surface. They are much larger than papules and take quite a long time to heal.
If you have nodules, but don’t have cysts, the term “nodular acne” is a more accurate name for your particular type of acne. Regardless of the name for it, a dermatologist should be consulted for treatment of acne of this severity.
Who Can Get Cystic Acne?
Although anyone can get cystic acne, it is more commonly seen in teenage boys and young men. Scientists think that testosterone levels may come into play in the occurrence of cystic acne. Adult cystic acne is far less common, although when it does occur, it is typically more severe cystic acne than what teenagers face.
What are the Causes of Cystic Acne?
Cystic acne seems to have the same possible causes as any other type of acne. These include:
- Hormone fluctuations
- Overactive oil glands
- A large population of acne causing bacteria, Propionibacteria acne.
When the follicle wall ruptures in a pore, inflamed acne blemishes develop because infected material leaks into the dermis. If the rupture occurs close to the skin’s surface, the blemish is typically minor and will heal quickly. If the rupture happens deeper in the follicle wall, however, the blemish is a more serious lesion, which takes a longer time to heal. When the contaminated material infects nearby follicles, nodules develop.
Cysts begin as deep ruptures in the pore wall, just like nodules; however, with a cyst, a membrane forms around the infection within the dermis. Some people are more likely to develop these serious types of skin breakouts, although the reason is unclear. To be clear, cystic acne does not appear due to a lack of facial cleansing or by eating too many greasy foods, sweets, or drinking soda. Although the causation of the occurrence of cystic acne outbreaks is unknown, scientists do know that neither diet nor hygiene has anything to do with cystic acne outbreaks.
The Effects of Cystic Acne
Nodulocystic breakouts can damage and destroy healthy skin tissue. If you suffer from this type of breakout, the likelihood of having permanent scars is high. If you pick at the skin around the breakouts or try to pop cysts or nodules, you are more likely to have permanent scarring. It can even worsen the occurrence of acne. With the help of your dermatologist, you can aggressively treat the severe cystic acne, which can help to limit the severity of your scarring.
It is common for deep cystic acne sufferers to develop feelings of shame, embarrassment, and anger in regards to their condition. Some people limit their social interactions, and may even avoid mirrors. Most people who suffer from severe forms of acne report lowered self-esteem and even depression. The most important thing to do is to be honest with your doctor. He or she can help you to attain the best level of care for your skin, and can help you through the emotional ramifications of having acne.
Treatment of Cystic Acne
There are several treatments for cystic acne, but it is important to note that these treatments should fall under the care of your dermatologist. Only your dermatologist can analyze your acne to determine the best course of action. Typically, powerful medications are required to get cystic acne under control. When acne is severe, it can be hard to control, so don’t be discouraged if the first line of treatment fails to remedy your acne. It may take trying several different medications to find what will work for you. Some of the treatments your dermatologist may try include:
- Antibiotics – These are orally taken, and work to contain acne from the inside out.
- Isotretinoin – (Accutane) This treatment seems to work well for most acne sufferers.
- Birth control pills – (for women, of course). It seems that the hormonal balancing that is typical of oral contraception also helps with cystic acne outbreaks.
- Drainage – A doctor makes a tiny incision in the skin and extracts the infected material that caused the outbreak.
- Intralesional corticosteroid injections – Your dermatologist will inject medication straight into the lesion to reduce inflammation.
Treatment of Scarring Due to Cystic Acne
The biggest concern of those who suffer from acne is the permanent result of acne – the scarring. There are several types of treatments for scarring. Speak with your dermatologist to find out what might be the best option for you. Here are a few examples of treatments for scarring:
- Microdermabrasion – this is for very light scarring and is the most noninvasive treatment.
- Dermabrasion – This is done in a medical office and is a bit more invasive. This is for lighter scarring that was not corrected by microdermabrasion.
- Dermal Fillers – These are injected into the scar “pockets” to raise the skin.
- Punch excision – This is used on moderate to severe scarring. Under anesthesia, a punch tool is used to punch out the scar and the sides are sutured together.
- Punch Excision with Skin Graft – Like above, but instead of suturing the sides of the skin together, a skin graft is placed at the site of the scar.