Cystic acne, or nodulocystic acne, is a severe form of acne
characterized by intense redness and inflammation. Skin of cystic acne
sufferers contains a large number of nodules and cysts. Cystic acne is
very painful and often leaves scarring. A dermatologist must treat
cystic acne. It is the most severe form of acne vulgaris. Deep, inflamed
breakouts develop on the face and/or other areas of the body. The
blemishes themselves can become large; some may measure up to several
centimeters across.
Although many people use the term "cystic" to describe any type of
severely inflamed acne, only those who develop cysts truly have cystic
acne. Cysts are the most serious kind of acne blemish. They feel like
soft, fluid-filled lumps under the skin's surface. Cysts can be painful.
Nodulocystic acne sufferers develop nodules as well as cysts. Nodules
are hard, painful lumps under the skin's surface. Much larger than
papules, nodules form deep within the skin and take a long time to heal.
Some skin care experts believe acne cysts are not really cysts at all,
but rather severely inflamed nodular breakouts.
For those who have nodules, but do not have cystic lesions, the term
nodular acne is more accurate. No matter what label you use, a
dermatologist must treat acne of this severity.
Who Gets Cystic Acne?
Cystic acne can affect anyone, but it is more common in teenage boys and
young men. Acne seems to run in families. If your parents had cystic
acne, you are more likely to experience severe acne yourself.
Cystic acne is caused by the same factors as other forms of acne, which
are:
overactive oil glands
excess dead skin cells within the hair follicle (pore), and
a large number of acne-causing bacteria, Propionibacteria acnes
Inflamed acne blemishes develop when the follicle wall ruptures, leaking
infected material into the dermis. If this break occurs near the skin's
surface, the blemish is usually minor and heals quickly. Deeper breaks
in the follicle wall cause more serious lesions. Nodules develop when
the contaminated material infects adjoining follicles.
Like nodules, cysts begin as a deep break in the pore wall. A membrane
then forms around the infection within the dermis. Some people are more
prone to developing these types of serious breakouts than others.
Cystic acne is not caused by a lack of cleansing, drinking soda, or
eating sweets. The sufferer has done nothing to cause his skin problems.
Effects of Cystic Acne
Nodulocystic breakouts damage and destroy healthy skin tissue. Because
of this, the likelihood of developing scars is extremely high. Picking
at the skin and trying to pop cysts or nodules should be avoided at all
costs. Doing so can greatly damage the skin, lead to scarring, and
worsen acne. Aggressively treating this form of acne can help limit the
severity of scarring.
It's also common for those with severe acne to have feelings of
embarrassment, shame, and anger regarding their skin. Some sufferers
avoid mirrors, or shy away from social situations. Acne can hurt the
self-esteem, and may lead to depression. If you feel acne is greatly
affecting the quality of your life, please talk to your doctor. Luckily,
with treatment, most people find their self-confidence improves.
Isotretinoin is an oral medication used to treat severe cystic acne or
nodulocystic acne (inflamed acne with many nodules and cysts).
Isotretinoin is more commonly known by the brand name
Accutane, and is
also sold under the names Amnesteem, Claravis and Sotret.
A derivative of vitamin A, isotretinoin works by shrinking sebaceous
glands. This reduces the number of pore blockages and breakouts.
Isotretinoin has many side effects, including but not limited to:
Drying of the skin and mucous membranes
Peeling of the skin
Nosebleeds
Sensitivity to the sun
Increased risk of depression, psychosis, suicidal behavior, and suicide
Isotretinoin also causes severe birth defects when taken during
pregnancy. The U.S. Food and Drug Administration requires all women of
childbearing potential to use two forms of birth control during
isotretinoin use. Women must also submit to regular pregnancy tests
before obtaining or refilling their prescription.
People with
nodules or cysts should be treated by a dermatologist. For patients with
severe inflammatory acne that does not improve with medicines such as
those described above, a doctor may prescribe isotretinoin (Accutane),
a retinoid. Isotretinoin is an oral drug that is usually taken once or
twice a day with food for 15 to 20 weeks. It markedly reduces the size
of the oil glands so that much less oil is produced. As a result, the
growth of bacteria is decreased.
Advantages of Isotretinoin (Accutane)
Isotretinoin is a very effective medicine that can help prevent
scarring. After 15 to 20 weeks of treatment with isotretinoin, acne
completely or almost completely goes away in up to 90 percent of
patients. In those patients where acne recurs after a course of
isotretinoin, the doctor may institute another course of the same
treatment or prescribe other medicines.
Disadvantages of Isotretinoin (Accutane)
Isotretinoin can cause birth defects in the developing fetus of a
pregnant woman. It is important that women of childbearing age are not
pregnant and do not get pregnant while taking this medicine. Women must
use two separate effective forms of birth control at the same time for 1
month before treatment begins, during the entire course of treatment,
and for 1 full month after stopping the drug. They should ask their
doctor when it is safe to get pregnant after they have stopped taking
Accutane.
Some people with acne become depressed by the changes in the appearance
of their skin. Changes in mental health may be intensified during
treatment or soon after completing a course of medicines like Accutane.
A doctor should be consulted if a person feels unusually sad or has
other symptoms of depression, such as loss of appetite or trouble
concentrating.
Other possible side effects include dry eyes, mouth, lips, nose, or
skin; itching; nosebleeds; muscle aches; sensitivity to the sun; and,
sometimes, poor night vision. More serious side effects include changes
in the blood, such as an increase in triglycerides and cholesterol, or a
change in liver function. To make sure Accutane is stopped if side
effects occur, the doctor monitors blood studies that are done before
treatment is started and periodically during treatment. Side effects
usually go away after the medicine is stopped.
Source: National Institute of Arthritis and Musculoskeletal and Skin
Diseases.
To read more about Isotretinoin (Accutane), click here →
Accutane
Disclaimer: The information, advice, tips, and suggestions on this website are not intended to replace consultation with a qualified dermatology professional.
Cystic acne, or nodulocystic acne, is a severe form of acne
characterized by intense redness and inflammation. Skin of cystic acne
sufferers contains a large number of nodules and cysts. Cystic acne is
very painful and often leaves scarring. A dermatologist must treat
cystic acne. It is the most severe form of acne vulgaris. Deep, inflamed
breakouts develop on the face and/or other areas of the body. The
blemishes themselves can become large; some may measure up to several
centimeters across.
