What is Cystic Acne?
Cystic acne is the most serious form of acne in which the risk of developing pitted scars and keloids is significantly great. In this condition, the skin’s surface has swollen pustules or cysts that can be very painful and pervasive that the infection cannot be treated by most over-the-counter medications.
Contrary to popular belief, all forms of acne are not caused by bacteria, although they can aggravate the infection. Meanwhile, this skin problem commonly appears on face, back, and chest and affects almost all people, at a varying degree, during their puberty stage; however, it is not uncommon for some women to develop this condition in their mid- to late-20s.
Why Acne Develops on the Skin
Aside from cysts, acne can also appear on the skin as pimples and zits (tender red bumps), congested pores (“comodones”) manifested by whiteheads and blackheads, and pustules.
No single factor causes acne, although doctors say that this can happen when the oil or sebaceous glands attached to the hair follicles become clogged because of the increase of oil production during puberty. If this occurs, the pores gradually enlarge and turn into a bump, allowing normal skin bacteria and irritants to travel into the deeper layers of skin, infecting the area and resulting to inflammation.
The inflammation on the surface of the skin can lead to pustules, whiteheads, blackheads and pimples; but if this happens deeper, the result is the formation of cysts.
Causes of Acne
People with severe acne may have inherited this condition to their parents, although this is not always the case in mild to moderate acne. Meanwhile, no studies have linked chocolate, pizza, peanut, and greasy foods to this skin problem.
These are the contributing factors that can result to acne:
- Certain drugs – oral and injected steroids and medications that contain bromides and iodides may cause or worsen this skin problem.
- Cosmetics and skin-care products – some products, especially oil-based, can clog the pores and predispose the patients from acne. To avoid this problem, dermatologists recommend water-based cosmetics and creams.
- Occupation – exposure to certain industrial products may cause and aggravate acne.
- Pressure on the skin – pressure from suspenders, chin straps, collars, and helmets may cause acne to some individuals.
The acne treatments should depend on the severity of the problem and its main causes. These usually include topical medicines (e.g., gel, lotions, and creams) and oral medications, or sometimes combination of both especially for patients with cystic acne.
The treatments for mild acne include topical medications (externally applied) with salicylic acid and benzoyl peroxide. However, these are not effective for treating moderate to severe acne which often need stronger products such as antibiotic lotions or gels which can address the clogged hair follicles.
For patients with cystic acne, they need stronger medicines to prevent deep scarring and keloids; in most cases, their treatments include oral antibiotics that are often combined with several therapies.
Brands such as Tazorac and Differin contain retinoids which can unclog pores. While considered milder and gentler than most acne treatments, these products can be used under the sun as long as the patients will apply sunscreen to protect their skin.
Topical Creams, Lotions, and Gels
These products, which are usually antibiotics, include Klaron, Azelex Finacea, BenzaClin, Duac, E-Mycin, Ery-Tab, Eryc, Ilosone, PCE, and Pediazole.
Examples of these products include Duricef, Sumycin, Adoxa, Atridox, Vibramycin, Oracea, Minocin, Dynacin, Trimox, Amoxil, and DisperMox. However, these treatments are only given in the shortest time possible due to risk of gastrointestinal upset, allergic reactions, and increased sun sensitivity that may result to sunburns.
Spironolactone (Aldactone) – this can inhibit androgen (male hormone) receptors to prevent the formation of acne; young women in general are ideal to have this treatment, especially those with resistant acne.
Some oral contraceptive pills are effective in treating acne that is primarily caused by hormonal imbalance. When recommending this type of treatment, most dermatologists work closely with their patients’ primary physicians.
Examples of products with this compound include Accutane, Amnesteem, Clavaris, and Sotret. This treatment is ideal for patients suffering from cystic acne which is not responding to other conventional therapies; while relatively safe for a significant number of people, this may result to side effects such as dry lips and muscle aches. This is also known to cause birth defects, so sexually active women who are using such products should take contraceptives to avoid becoming pregnant.
Cortisone Injections cystic acne and large pimples can be injected with cortisone which can immediately flatten them out.
While some doctors claim that laser is an effective way to treat acne, the consensus is to use this as a complementary treatment to conventional therapy rather than as a stand-alone procedure.
Just like laser treatments, chemical peels (e.g., glycolic acid) are also seen as a good adjunct to conventional therapies in order to achieve a long-lasting result.
In this treatment, a wand-like device releases tiny crystals that slough off the top layer of the skin to make its surface smoother. However, most doctors use this procedure to address acne scars and abnormal pigmentation rather than a stand-alone treatment for moderate to severe acne.
The Right Time to Seek Acne Treatments
Since majority of people will have some acne or pimple at some point in their lives, the right time to seek professional help is when pustules and cysts develop and may potentially cause scarring. Also, individuals who are bothered with this skin problem can also ask their doctor on the best treatments for their condition.
Consideration Before Getting Treatments
It is important to remember that most acne treatments take six to eight weeks before a person can see a noticeable improvement. Some even result to acne flares before the skin clears up and the blemishes subside.
As much as possible, doctors recommend topical treatments for their patients, however, these may not be effective in addressing cystic acne that are often treated with stronger drugs such as oral retinoid, which is expensive and has side effects on some individuals.
For women whose acne flares are caused by overproduction of a hormone called androgen, certain low-dose contraceptive pills can be an effective treatment. Patients should follow their doctors’ advice on the use of topical and oral medications and avoid sun exposure and strong products because it is not uncommon to have increased sensitivity to sun (which may result to sunburns) and irritants.