Cystic Acne – Causes & Treatments

The teenage years are a time commonly characterized by learning how to drive, going on first-dates, and finding one’s own identity. Unfortunately, many teenagers are also required to learn how to deal with the blemishes and breakouts often referred to as acne. While there are a variety of different types of acne, cystic acne is one of the most severe. Fortunately, cystic acne is treatable. However, understanding the causes and dangers of the condition is essential to ensuring appropriate care. Individuals with chronic cases of cystic acne should seek medical assistance to avoid permanent damage.

What is Cystic Acne?

Cystic acne, oftentimes referred to as acne vulgaris, is a skin condition characterized by scaly red skin, blackheads, whiteheads, pinheads, pimples, and nodules. In severe cases, cystic acne can also lead to scarring or changes in skin pigmentation. Unlike traditional forms of acne, which typically only affect superficial tissue on the face, chest, and back, cystic acne is most commonly found on the deeper tissue of the buttocks, groin, and armpits. Other areas in which cystic acne may develop include sweat ducts and hair follicles that are exposed to large amounts of perspiration build-up.

Causes of Cystic Acne

As with milder forms of acne, cystic acne most commonly develops when follicles become plugged with dead skin cells and sebum, a naturally occurring skin oil. When a type of bacteria known as Propionibacterium acnes is exposed to these blocked follicles, redness, irritation, and inflammation soon occur. Changes in hormone levels have also been closely linked to the development of cystic acne. Increases or decreases in the amount of testosterone, dihydrotestosterone, dehydroepiandrosterone sulfate and insulin-like growth factor 1 are also associated with this condition.

As with other medical conditions, cystic acne has also been found to have a significant genetic link. In addition, high amounts of psychological stress and infection by Staphylococcus epidermis can also lead to the development of this condition. In some cases, cystic acne has also been triggered by the development of pregnancy, polycystic ovary syndrome, or Cushing’s syndrome in adult women. Finally, some studies show that the consumption of foods containing a high glycemic load—such as high in fat, sugar, or sodium—can lead to significant increases in the number and severity of cystic acne outbreaks.

Diagnosis of Cystic Acne

Currently, there are three scales used to identify and categorize cystic acne. The Leeds acne grading technique, in which lesions are counted and categorized as being inflammatory or non-inflammatory, and then ranked on a scale of one to 10, is the most widely used diagnostic test. In addition, Cook’s acne grading scale and the Pillsbury scale are also used in the diagnosis of this condition. Other, less-widely recognized tests may also be used on occasion, though they are not as popular.

Treatment of Cystic Acne

The most traditional treatment of cystic acne involves the use of prescription medications. In most cases, patients are provided with a combination of products, including Benzoyl peroxide, antibiotics, topical retinoids, and certain anti-inflammatories. In recent years, the use of prescription hormones has also increased in popularity as a method of treatment for cystic acne. In most cases, hormones work best for female patients whose cystic acne is believed to be triggered by especially high levels of androgen hormones or the development of polycystic ovarian syndrome.

Patients who are interested in a more homeopathic treatment for this condition have a variety of options from which to choose. Exercise, for example, has been found to be highly effective in the treatment and prevention of cystic acne, as it increases blood and oxygen flow to affected areas, while at the same time removing unwanted waste. Exercise has also been proven effective at lowering psychological stress levels, which is indicated in the development of cystic acne. Finally, the more natural approach is the application of tea tree oil and aloe vera, which have been shown beneficial results in the treatment of this condition.

Patients with especially severe cases of cystic acne may require more intensive forms of treatment. For these patients, dermabrasion, phototherapy, laser treatment, or even surgery may be required. Patients considering these forms of treatment are usually required to undergo counseling to ensure comprehension of all risks and benefits. In some cases, ongoing therapy may be required.

Prognosis of Cystic Acne

Cystic acne is believed to affect as many as 40 million people in the United States—about 14% of the current population. Fortunately, most individuals afflicted with this condition will experience relief when they reach their early 20s. In some rare cases, however, cystic acne may persist into adulthood. Individuals diagnosed with this condition should always follow the recommendations of their physicians to ensure optimal treatment and recovery. Attempting to treat cystic acne without a doctor’s supervision can lead to severe illness or infection.