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The Agony Of Cystic Acne

Few people who have experienced cystic acne are likely to forget the agony. In very basic terms, cystic acne, also known as nodulocystic acne, is one of the most virulent forms of acne vulgaris, and occurs when common acne lesions develop into cysts. Thankfully, cystic acne is not as widespread as ordinary acne vulgaris, though it remains a potential threat for any acne sufferer.

Can I get cystic acne?

If that is the question uppermost on your mind, then the answer is yes, you can. William Jackson, a 22-year-old professional dancer from Atlanta, describes his experiences of cystic acne as "harrowing". William, who first had acne as a 13-year-old, saw his condition deteriorate over a period of mere months as he approached his 19th birthday. "I don't really know why my pimples turned into cysts, but for almost two years, I suffered physical and mental agony because not only were the cysts messing up my face, but also interfering with my profession," he says.

The trouble with cystic acne is that if not treated in time, it may lead to the formation of permanent and disfiguring scars, as happened in William's case. Yes, you can go in for anti-scarring treatment, but in a majority of cases, it is unlikely that the scars will disappear for good. Moreover, says dermatologist Dr Jennifer Sanders, cystic acne scars on parts of the body other than the face may not respond very well to treatment.

What is cystic acne?

Cysts or nodules form when normal acne lesions burst open to spread the inflammation and pus to surrounding tissue. Because the infection usually occurs deep beneath the skin, cystic acne is relatively difficult to treat and the cysts heal extremely slowly. And why do the blockages burst open? Dr Sanders says this is most often because the acne lesions have been interfered with in some way. "You'd be surprised at the number of patients who come to me because they have picked at their acne lesions and they have turned into cysts," she says.

Cystic acne most often affects the face, but it can also develop on the chest, back, shoulders and, more rarely, on the upper arms. Like normal pimples, cysts are usually filled with a pus-like substance, but they are significantly larger than pimples, and infinitely more painful.

Cystic acne treatment

William Jackson underwent a course of Accutane, which is the brand name for isotretinoin, an oral drug. Isotretinoin works on the sebaceous glands to reduce their size and thus stopping them from secreting excess sebum. It is one of the best treatments for cystic acne and can usually clear it up for good, though it should NEVER be taken unless under strict medical supervision, because it has several potential side effects.

An alternative to Accutane is intralesional corticosteroid therapy, a procedure in which each cyst is injected with cortisone solution. This brings immediate relief to the patient, though the cysts may re-form at a later stage.

Yet another option is acne surgery, whereby a surgeon manually removes blackheads and white heads. Once again, however, it would be disastrous should the process be performed by anyone other than a trained dermatological surgeon, because inappropriate ruptures to skin tissue can actually help spread the infection.


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