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One of the more severe forms of acne, cystic acne is the final progression of normal acne and one of the forms most likely to give you acne scarring; getting rid of it is essential if you want to avoid permanent scarring. Nearly 80% of adolescents develop acne but most of them do not develop cystic acne. It can be a physically and emotionally damaging condition and has been found to have lasting effects on social and emotional development.
Cystic acne usually starts as a regular acne. This is caused usually by hormonal changes that occur during adolescence. The skin is full of hair follicles, even if there are no visible hairs. In these follicles there are tiny sebaceous glands.These glands produce sebum or skin oil. Usually, they produce just enough to keep the follicles clean and the skin in proper condition. However, during the tempestuous years of adolescence (and often afterwards), the changes in hormones can cause the sebocytes (the cells that produce sebum) to become overactive, producing more sebum than the skin can tolerate or cope with.
When this sebum builds up, it blocks pores and hair follicles it forms what’s called a white head. There is a type of bacteria that usually resides harmlessly in the skin. When there is an excess of sebum, this bacteria finds itself in an ideal situation, feeding on the sebum and the dead skin cells that are trapped in the blocked pores.
This is the beginning of an infection and the body fights back using our immune system. The immune response makes the skin red and swollen and the area is flooded with immune cells, which attack the bacteria. This causes pustules and pimples (comedones) which are filled with dead bacteria and skin cells. For most people, this is the extent of acne: an inconvenient and disfiguring, but ultimately temporary condition.
Nobody is exactly sure why some people develop more severe acne, but a significant proportion does. It seems to have genetic factors, as well as being affected by diet, hormones exercise, levels of sunlight, and antibiotic use.
Cystic acne causes nodules and draining cysts to appear on the face, chin, neck, back, and sometimes the scalp. These are painful, swollen, and sensitive. Individual cysts can cause “ice pick” scars, collections of them can cause more diffuse and harder to treat scarring. Popping cystic acne is a bad idea: they are much more likely to leave scars if they are disturbed. This is difficult to cope with as they are so visible and popping them makes them less visually objectionable.
Cystic acne is a serious condition and the scars that cystic acne on the chin might leave on your skin could be visible for the rest of your life if untreated. It is difficult to tell when someone might develop cystic acne instead of regular acne but if a close relative has had it, you are much more likely to develop it yourself.
Monitoring the skin during early adolescence is important. If caught early, cystic acne on the chin can be prevented from causing scars and disfigurement with:
There is no outright cure cystic acne but treatments do work well for most people.
Ensuring that you eat a healthy balanced diet is very important for all-over health and will improve your skin and mental health at the same time. Foods high on the glycaemic index are thought to contribute to acne, as does milk for some people. Not being stressed is important but almost impossible to avoid as you negotiate the difficult world of adolescence (or the rest of your life). Stress causes hormonal changes and suppresses the immune system, making for ideal acne conditions.
Exercise is believed by many to be important as it boosts the immune system, reduces stress, and helps to maintain efficient homeostasis (keeping the body in order). Plus, it just feels good. Preventing acne is difficult and in many cases, you can do all the above and still develop the condition. In that case, you have to look at effective treatment. Talk to your doctor as soon as possible about getting a diagnosis and finding the right treatment options.
For women and girls, there is hormone replacement therapy, HRT. This is a widely used form of contraception that is safe and available on prescription. Because cystic acne is usually caused by hormonal imbalances, restoring the hormonal balance to a non-ovulating cycle can reduce or eliminate acne outbreaks. Especially if they occur around menstruation. Home remedies like:
There all have varying levels of success and while they might be effective for less severe acne, they should not be relied upon for cystic acne.
For males and females, the next option is antibiotics. If you have tried other therapies with your doctor, they might prescribe you a course of antibiotics. This is generally regarded as a last-resort because of the risks of developing antibiotic resistance and the effects that antibiotics can have on the natural and beneficial flora of your body. They are usually very effective. It is essential that you complete your course of antibiotics if you are prescribed them because if you do not, the bacteria that have survived are now resistant to the antibiotics you have taken and can come back, causing cystic acne to return but now being untreatable.
You should not be afraid of getting treatment for this condition. The treatments are usually effective and are non-invasive. The consequences of not getting treatment can be lifelong scarring and expensive, painful surgeries to remove these scars. Acne treatment is usually covered on children’s medical insurance, so it should not be prohibitively expensive to treat.