Cystic Acne: focus

Acne is a chronic inflammatory disorder of the hair follicle and sebaceous glands, characterized by the presence of comedones (closed and open blackheads), papules (inflamed bumps), and pustules (pimples with a white or yellow tip). Comedones appear when cells proliferate (cornification) and sebum production increases, resulting in a plug at the follicle outlet. Papules and pustules, meanwhile, form due to the excessive growth of skin bacteria within follicles. There are many different types of acne and cystic acne is the most severe form of all. It most commonly appears during puberty, or between the ages of 20 and 30, and is characterized by the presence of nodules and cysts.

Description

Cystic acne, also known as nodulocystic acne or conglobate acne is marked by the presence of nodules and cysts that form on the face and trunk. The acne can vary in size, ranging from a few millimeters to several centimeters in diameter, and affects both women and men alike.

Causes

Although the exact causes of cystic acne are still unknown, it is thought to be linked to the excessive activation of sebaceous glands due to neuroendocrine stimulation. Nodules form from the accumulation of secretions deep within the skin. Cysts, on the other hand, are pus-filled lumps beneath the skin’s surface, that are often painful, and can cause scarring, especially if not properly treated.

Symptoms

The symptoms of this type of acne are the presence of nodules and cysts, significant inflammation and pain.

Diagnosis

Diagnosis is made through a physical examination that highlights the presence of nodules and cysts.

Treatment

The most effective drug is isotretinoin, a derivative of vitamin A, which can regress cystic acne in four to six months of treatment in almost all cases. However, long-term use of this drug can lead to various types of toxicity, and therefore it should be used under dermatological control and only in selected cases.
When isotretinoin cannot be used, micropeeling and photodynamic therapy are effective alternatives. Although these methods cure cystic acne over a longer period of time, they are non-toxic, non-pharmaceutical alternatives.

Prevention

For people with cystic acne, some preventative measures can include:

• Cleansing the skin no more than twice per day with gentle, non-foaming products. Doing so will cleanse the skin of dead cells and excess sebum without irritating it.
• Avoiding using creamy cosmetics as they can trigger acne. As an alternative, use mineral makeup.
• Removing makeup with a non-foaming cleanser before going to sleep to allow the skin to breathe.
• Wearing cotton t-shirts, open collars and avoiding scarves to reduce friction and trapping heat from clothing which can aggravate symptoms.
• Protecting the skin from sun with mineral light reflectant products instead of traditional sun creams.