Cystic acne is the harshest form of acne and they are very painful. This type of infection is very difficult to treat. There are pus filed red pustules which can be seen on the surface of skin. There are cysts. The reason behind the infection is not certain. The infection may be caused due to different reasons in different individuals. Accumulation dirt on the surface of skin and changes or imbalance in hormones may cause cystic acne. There may be hereditary cause behind cystic acne just like for normal acne. Cystic acne may also be due to trapped toxins in the body. Similar to acne cystic acne can develop at any age but it is more prevalent in teenagers. If pus is removed by squeezing the pustule then the skin looks uglier. There may be bleeding due to repeated squeezing of the pustule. Permanent scar may be formed due to squeezing of the pustule.
There are several treatments for cystic acne. Isotretinoin is a vitamin A derived compound. This can be taken orally once or twice a day for 16 to 20 weeks. This medication is effective on all causes of acne like excess sebum production, inflammation, bacteria and clogged pores and therefore, it is considered as best treatment for cystic acne. The cystic acne may flare up in the first few weeks of treatment, then the condition subsides. The patient is monitored for side effects. Generally one round of the medication is sufficient and in few patients second round is required. The drug can cause birth defects in fetuses and therefore women in child bearing age are not given Isotretinoin and pregnancy should be strictly avoided during the treatment. Other side effects are hearing problem, liver problem, pancreatitis, depression and suicidal thoughts. The decision of taking Isotretinoin treatment should be taken only after thorough consultation with the doctor.
Cysts can be removed surgically. A dilute solution of corticosteroid can be injected in the cyst which dissolves the cyst in three to five days.
As the cysts are deep in the skin oral antibiotic treatment is the preferred one. A broad spectrum antibiotic like doxycycline, erythromycin, tetracycline or minocycline can be used to kill the bacteria. Birth control pills may be taken to prevent excess oil production. A synthetic steroid called spironolactone can be given along with birth control pills for best results.
As the cystic acne may be due to toxins in the body intake of plenty of water is recommended along with well balanced diet including lots of fruits and vegetables. Use of oily cosmetics and make ups is also contraindicated in these patients.