Cystic acne - what are the causes and treatment options?

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Cystic acne is the ugly sister of the acne family. It is the most severe type that forms large, painful, boil-like eruptions under the skin, usually on the face. Not only can it lead to scarring but it can also be extremely painful.

The cause of cystic acne is still a bit hazy, but it is thought to be caused by an influx of hormones, such as those that are produced during a woman’s menstrual cycle. The skin’s oil gland then becomes sensitive to this surge in hormones and reacts by producing an excess of sebum. Due to the excess of sebum the gland then swells and hardens. Struggling under the pressure, the gland then bursts underneath the skin instead of pushing the extra oil into the lining of the hair follicle.

Once the gland has burst, acute inflammation occurs which causes the pain and redness of cystic acne. Scarring is likely to result from cystic acne because the lesions start so deep within the skin.

Cysts and nodules often happen at the same time in a severe type of acne called nodulocystic. However, there is a bit of debate in medical circles about whether true cysts actually occur in actually. Many believe that the lesions called cysts are actually inflamed nodules and that the term nodulocystic should be disregarded.

Cystic acne is one of the most difficult types of acne to treat. The options tend to be limited to oral drugs such as Isotretinoin (Accutane) and antibiotics. Isotretinoin is believed to help reduce the size of the oil gland, resulting in lower oil production. However, it is quite costly and it is linked to several severe side effects. If you are pregnant or considering having a baby in the near future, you should steer clear of isotretinoin as it can cause birth defects and miscarriages.

As tempting as it may be, don’t squeeze or pick at an acne cyst, as this may cause the infection to spread, making it deeper and more inflamed. A squeezed cyst is also likely to be more painful and hang around a lot longer than one that had been left alone.

If you do suffer from cystic acne, make sure you avoid the use of heavy moisturisers in the affected areas. Regularly exfoliate your skin to prevent debris from the hair follicle build-up, but don’t scrub it. And if you plan to be outdoors during the daytime always wear an effective sunscreen.

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