Acne can be a devastating blow to the self-esteem, not to mention difficult to treat. But did you know that like many skin conditions, there are several grades of acne? Although one of the least common, the most severe form of acne, cystic acne, can result in large, painful lesions which can be difficult to treat and leave the skin riddled with scars.

What is it?

Cystic acne presents with white and black heads, as well as papules, pustules, nodules and cysts which can be red and swollen, and can appear on the face, back, neck or shoulders. With cystic acne, large cysts also form deep underneath the skin, and are often covered by wollen, pus-filled pustules, formed of dead skin cells, bacteria, and white blood cells.

While the temptation to squeeze or ‘pop’ these cysts may be strong, it is wise to avoid extraction of these types of blemishes. Blemishes associated with cystic acne are large and deeply embedded in the skin; improper extraction (except by a trained professional such as a doctor or esthetician) could result in more deeply impacted blemishes or scars. Also, avoid picking or pulling at these types of lesions, which could spread the bacteria to unaffected areas of the face and create more cysts.

How do you get it?

One of the most frustrating aspects of cystic acne is that not only is it inconvenient and embarrassing, no one knows the exact cause. Cystic acne can occur at any age and in any skin type, and genetics are thought to be largely responsible. In addition, hormonal changes and allergic reactions have also been implicated.

Treatment

For sufferers of cystic acne, it is important to note that traditional acne treatments may not be strong enough to treat this highly aggressive form of acne. As soon as the signs of any grade of acne manifest on the skin (excessive white or black heads or deeply imbedded blemishes), schedule a visit to the dermatologist to discuss treatment options. Even mild cases of acne vulgaris can devolve into cystic acne if left untreated and, as they heal, cysts can leave behind scars making early treatment vital. Do not wait for cystic acne to merely “clear up,” as this rarely happens. Finally, although you may be tempted to use harsh acne treatments in an attempt to dry out the pustules, don’t; doing so can actually over-dry the skin out and increase susceptibility to further breakouts.

Product Picks

Treatment of cystic acne usually begins with topical medications prescribed by a dermatologist and may include oral medications such as antibiotics or Accutane, or topical treatments such as retinol (vitamin A) creams or gels. In addition, some doctors may use clinical strength benzoyl peroxide cleansers and treatments, steroid injections, cryogenic therapy and simple extractions. Once cystic acne is under control, many over the counter treatments can be used to maintain skin clarity, and these include salicylic acid, glycolic acid and vitamin C.

Special considerations

As with all types of acne, scars can result from picking at or forcibly extracting deeply imbedded acne lesions and these scars can be severe and life-long. Additionally, complications can include dark, rough patches of skin and permanent pits that can only be removed with cosmetic skin treatments such as laser resurfacing or dermabrasion.

Although cystic acne may seem like a huge skincare inconvenience, with a little education and by partnering with a skilled doctor, the skin can ultimately become clear and blemish-free.