Deep cysts, inflammation, extensive damage to the skin and scarring characterize severe acne. It often requires an aggressive treatment regimen and should be treated by a dermatologist. Severe forms of acne can require years of treatment and may experience one or more treatment failures. However, almost every case of acne can be successfully treated. There are five popular treatments for acne cysts. There are many effective treatments that are available currently. Drainage and surgical excision, inner lesion corticosteroid injection, isotretinoin (a potent drug for treating severe cystic acne), oral antibiotics, and oral contraceptives are the most popular treatments. Some people may choose a more natural treatment for severe acne, which will also be covered briefly in this article.

Drainage and extraction, or acne surgery as it is also called, should not be performed by patients and is used on some large cysts that do not respond to medication and require drainage and extraction. Dermatologists are trained in the proper technique and perform acne surgery under sterile conditions. Patient attempts to drain and extract acne cysts, by squeezing or picking, can lead to infection, worsening of the acne and scarring. When an acne cyst becomes severely inflamed, there is a good chance it will rupture and scarring will occur. To treat these severely inflamed cysts and prevent scarring, dermatologists may inject such cysts with a diluted corticosteroid. This lessens the inflammation and promotes healing of the acne cyst. An inner lesion corticosteroid injection works by melting the cyst over the course of a few days.

Isotretinoin is the most effective treatment known today for severe acne and acne that is resistant to other medications and treatments. Isotretinoin is a form of vitamin A, a synthetic creation, which comes in a pill form. It is administered once or twice a day for anywhere from sixteen to twenty weeks total. There are many possible side effects that may occur while undergoing this therapy. Possible side effects include severe pain in the chest or abdomen, trouble swallowing or painful swallowing, severe headache, blurred vision or dizziness, bone and joint pain, nausea or vomiting, diarrhea or rectal bleeding, depression, dryness of the skin, eyes and nose, and thinning hair. While taking isotretinoin patients are monitored closely by their healthcare provider through follow up appointments.

Oral antibiotics have been a basis of therapy for severe acne for many years. Like topical antibiotics, oral antibiotics work to reduce the acnes. Acnes are normal residents on the skin, which decreases inflammation. Treatment with oral antibiotics usually begins with a high dosage, which is eventually reduced as the acne resolves. Over time, the acnes bacteria can become resistant to the treatment. When resistance occurs, another antibiotic can be prescribed or other treatment options may need to be explored.

Oral contraceptives have been shown to effectively clear acne in women by suppressing the overactive sebaceous glands. Oral contraceptives can be used as long-term acne therapy; however, this medication should not be prescribed to women who smoke, have a blood clotting disorder, are older than thirty-five or have a history of migraine headaches, without the advice of a gynecologist. Spironolactone, a synthetic steroid, may be used in combination with oral contraceptives to treat acne in adult females. Spironolactone inhibits androgen, hormones that stimulate oil glands in addition to other effects on the body, production. There are possible side effects that may accompany Spironolactone treatment. A few side affects include irregular menstruation, breast tenderness, headache and fatigue.

Some people choose more natural ways to combat cystic acne. Some natural treatments are eating a whole foods diet that consists of only natural foods that have not been chemically or mechanically processed. Yoga or deep relaxation techniques may be used to reduce the amount of stress that is put on the body and the mind. Essential oils are another natural treatment that may be added to the diet of sufferers of severe acne. These are just a few of the natural methods of treatment for cystic acne. No matter what method of treatment you decide to try you should always consult a professional, whether it is your dermatologist or an herbalist. Your doctor should be able to refer you to a board certified dermatologist if needed.

Severe acne can cause physical as well as emotional scars. Although most people stress out over the occasional zit, acne can deliver serious blows to an individual’s sense of confidence and self-perception.

Acne can cause a person to experience consistently blemished skin that may include pimples, papules, abscesses, cysts, blackheads, whiteheads, and other painful inflammations of the skin. Moreover, acne can be a whole body problem. While most people are seriously afflicted primarily in the facial area, many people also experience considerable blemishing across their back, chest, neck, and other areas of the body.

While most people experience the brunt of acne during the difficult adolescent years, imagine the agony of living with acne well into your middle years. With the stress of modern day living and increased exposure to environmental pollutants, adult acne is becoming a fact of life for many adults. Although most people will only have to deal with transient acne, some will experience far worse. Here is a quick run-down of the most serious forms of acne.

Acne Conglobata (AC): This is a very uncommon form of acne that can produce significant disfiguration. Acne conglobata is characterized by the development of burrows in the skin, along with papules, abscesses, keloidal and atrophic facial scars. Individuals with AC often develop blemishes that appear in clusters of two or three. Cysts are often present that are filled with pus. Nodules may also be present, especially in the area of the back and chest.

Who is more susceptible to acne conglobata? In general, males are more likely to experience AC. Onset of AC usually occurs at a young age, between the ages of 18 and 30. Although no one knows the exact cause of AC, some believe it is caused by a mutation in the XXY karyotype chromosomes. A person with AC may experience extensive scarring and subsequent disfigurement. Because the effects of AC can often be dramatic, individuals afflicted with the skin disorder may be at greater risk of suffering from self-esteem issues, depression, anxiety, and they may feel stigmatized.

Acne Fulminans (AF): Acne fulminans, sometimes referred to as acne maligna, was originally thought to be acne conglobata (AC).

The major characteristics of acne fulminans include sudden onset of ulcerating acne, which may be accompanied by fever and symptoms of polyarthritis. Usually, AF does not respond well to conventional acne treatment, such as antibacterial therapy. The most successful treatments appear to be debridement used in conjunction with steroid therapy.

What causes AF? It appears that acne fulminans is caused by a weakened immune system and increased levels of testosterone and certain anabolic steroids. These high levels of hormones cause an increase in the production and excretion of sebum and the acne-inducing bacteria known as propionibacterium acnes (P acnes). Some skin professionals believe that isotretinoin may also precipitate an eruption of AF.

How can you tell the difference between acne conglobata and acne fulminans? Although the physical symptoms may at first appear identical, AF is usually characterized by the presence of more physical pain. Patients with AF may describe feelings of bone or facial pain, migraines, and fever. Acne conglobata and acne fulminans also differ in the way they are treated. While AC may be treated with conventional anti-acne oral and topical agents, AF typically does not respond well to such treatments. AF responds better to steroid treatments.

Gram-Negative Folliculitis: Gram-negative folliculitis refers to an infection of gram-negative rods that usually occurs after an extended period of antibiotic therapy. Scientists use the word “gram” to describe the blue stain that is used in laboratories. This is often used to locate microscopic organisms. The bacteria that cause gram-negative folliculitis does not stain blue, thus the term ‘gram-negative.’ The most common forms of bacteria that are believed to cause gram-negative folliculitis include E. coli, serratia marcesoens, pseudomonas aeruginosa, and bacteria’s from the proteus and klebsiella species.

How does gram-negative folliculitis differ from regular acne vulgaris? Most cases of gram-negative folliculitis produce less papules and comedones than acne vulgaris. Treatment of gram-negative folliculitis is fortunately much easier to treat than other severe types of acne. In most cases, conventional antibiotic therapy will help clear up gram-negative folliculitis. Isotretinoin may also help clear up this condition.

Copyright 2006 Nora P. Dyson