Cystic acne is a chronic variant of acne. It has comedones, cystic nodules, fistulas and abscesses that cause deforming scars. It mainly affects men.
It usually occurs between 15 and 25 years of age and can result from acne vulgaris. It mainly affects the face, neck, chest and shoulders. In this article we explain what it is and what are the main features.
What is cystic acne?
Acne is a very common inflammatory skin disease among teenagers and young people. It is in fact the cause for which we most often undergo a dermatological examination.
Specifically, it is a disorder of the pilosebaceous follicles with a multifactorial etiology. Specifically, it is the combination of factors such as increased sebum production, secondary inflammation and increased sensitivity to androgens.
Acne lesions are called comedones that can evolve and cause papules and pustules. Even nodules and cysts can form. Based on this, there is a broad classification of acne.
- Age: neonatal, infant, preteen, adolescent and adult acne.
- Predominant lesion : comedonic, papular-pustular or nodular-cystic.
- Severity : mild, moderate or severe.
- Special manifestations, which include cystic (or conglobate) acne.
The latter is considered a particular form because it is more serious. Cystic acne tends to leave extensive scars. In addition, the lesions go beyond the points where acne normally occurs, in fact it can also affect the buttocks, abdomen, armpits, etc. Basically, we could define it as the most severe and chronic type of acne.
Symptoms of cystic acne
The clinical picture is characterized above all by:
- Comedones, papules and pustules.
- Inflamed nodules and abscesses.
- Ache. Most skin lesions are heavily inflamed, which is why they hurt a lot.
- Purulent (foul-smelling) discharge.
- Skin damage and deformations.
- Irregular scars that can turn into hypertrophic and keloid.
Sometimes cystic acne is accompanied by abnormal blood values. For example, anemia and leukocytosis can arise. The lesions may be sterile or infected with some microorganisms. The most common bacteria are Propionibacterium acnes .
Physical symptoms are obvious, but psychological repercussions must also be considered. Cystic acne is responsible for several self-esteem problems. Furthermore, the individual may feel weak and insecure.
The causes of cystic acne are different. Contrary to what one might think, diet has not been shown to directly affect its occurrence. The triggers are mainly:
- Greater production of sebum, whose composition is altered. In addition, the sebaceous glands are larger.
- Abnormalities of keratinization, which is why comedones are formed. This means that an imbalance in sebum production irritates the walls of the follicles. The keratinizing cells desquamate and cannot be eliminated. This forms an accumulation of cells and sebum that forms the blackhead.
- The presence of Propionibacterium acnes, a bacterium that feeds on sebum which, therefore, proliferates more easily.
- Inflammatory process. It is believed to be due to the erosion of the follicle and the bacterium.
- Androgens, hormones responsible for the increased production of sebum. It is believed that in the presence of high levels of androgens the walls of the follicles are more delicate.
Cystic acne: conclusions
Cystic acne causes very painful skin lesions that have a major impact on the patient. Its consequences are not only physical in nature, they also affect self-esteem and mental balance.
For this reason it is important to identify the problem and intervene in time. In cystic (or conglobate) acne this aspect takes on even more importance, as it will help limit the incidence of scars and treat inflammation.