Cystic acne is a severe form of acne that can be particularly distressing due to its painful and persistent nature. Affecting both appearance and self-esteem, this condition requires a deep understanding and comprehensive treatment approach. This article aims to explain cystic acne by exploring its causes, symptoms, and available acne treatments now.

What is Cystic Acne?

Cystic acne is a type of acne that forms when hair follicles become clogged with sebum, dead skin cells, excess oil, and bacteria. Unlike other forms of acne, cystic acne is characterised by large, inflamed, and pus-filled lesions that develop deep within the skin.

Cystic acne begins much like other types of acne, with the clogging of hair follicles due to an overproduction of sebum and the accumulation of oil and dead skin cells. When bacteria invade these clogged pores, inflammation occurs, leading to the formation of cysts. These cysts are painful and red, and can persist for weeks or even months.

How It Differs from Other Types of Acne

Cystic acne differs significantly from other forms of acne, such as papules, pustules, whiteheads, and blackheads.

• Papules are small, red, tender bumps without pus, typically caused by inflammation. They often result from acne and can be slightly painful to touch.
• Pustules have a central core of pus with a red base, appearing as raised, white bumps surrounded by inflamed skin. They are commonly associated with acne and infections.
• Whiteheads are closed comedones, where the pore is completely blocked by sebum and dead skin cells. They appear as small, white bumps and are a form of non-inflammatory acne.
• Blackheads are open comedones where the pore is partially blocked, allowing the trapped material to oxidise and turn black. They are commonly found on the nose and chin and are a form of mild acne.

Unlike these milder forms, cystic acne is deeper, more inflamed, and carries a higher risk of the most severe form of scarring.

What are the Signs and Symptoms of Cystic Acne?

Several key characteristics can help identify cystic acne:

• Painful, Deep Lesions: The cysts are located deep within the skin and can be extremely painful, often causing discomfort and tenderness in the affected areas.
• Pus-Filled: These lesions contain pus and are often red or swollen, leading to visible inflammation and a feeling of pressure or tightness in the skin.
• Persistent: Cystic acne lasts longer than other forms of acne, sometimes persisting for months. This prolonged duration can lead to significant emotional distress and may require ongoing treatment to manage effectively.

Common Locations

Cystic acne can appear on various body parts, with the most common locations being the face, back, chest, and shoulders.

• Face: The face is one of the most frequently affected areas, particularly the cheeks, jawline, and chin. The visibility of facial cystic acne can lead to significant self-consciousness and emotional distress.
• Back: Often referred to as “bacne,” cystic acne on the back can be particularly uncomfortable due to the pressure from clothing and backpacks. The skin on the back is thicker, which can lead to more severe infections and larger cysts.
• Chest: The chest area is another common site for cystic acne, often linked to hormonal fluctuations and sweating. The appearance of cysts here can be distressing and uncomfortable, particularly when engaging in physical activities.
• Shoulders: The shoulders are susceptible to cystic acne, especially in individuals who engage in sports or wear tight clothing. This area can be prone to friction and pressure, exacerbating the condition.

Potential for Scarring

Due to its severity and depth, cystic acne carries a significant risk of scarring, often leaving behind deep, pitted marks that can be challenging to treat. This can result in both physical and emotional distress, including lowered self-esteem and anxiety, further underscoring the importance of effective treatment. Addressing cystic acne promptly with medical intervention and supportive skincare can help mitigate these long-term effects.

What Causes Cystic Acne?

The exact cause of cystic acne is not fully understood, but several factors are believed to contribute to its development. These include:

Hormones

Hormones, particularly androgens like testosterone, play a pivotal role in the development of cystic acne. During puberty, hormonal fluctuations can increase sebum production by the sebaceous glands and lead to oily skin. This excess sebum and dead skin cells can clog pores and create an environment conducive to bacterial growth, ultimately forming cystic acne. Additionally, hormonal imbalances seen in conditions like polycystic ovary syndrome (PCOS) can further exacerbate acne issues.

Genetics

Individuals with a family history of severe acne are more likely to develop cystic acne themselves. If your parents or siblings have experienced this condition, you may be more genetically predisposed to it. Genetic factors can influence the skin’s response to hormonal changes and the immune system’s reaction to acne-causing bacteria, which are crucial in developing cystic acne.

Medications

Certain medications, such as corticosteroids, antidepressants, and certain types of oral contraceptives, can exacerbate acne. It’s essential to consult a medical practitioner if you notice a correlation between your medication and worsening acne. Adjusting the dosage of prescription medications or switching to an alternative treatment might help mitigate these side effects. Always consult a healthcare provider before making any changes to your medication regimen.

Diet

While research is ongoing, some studies suggest a potential link between high glycemic index foods, dairy products, and acne. Foods like sugary snacks, white bread, and dairy may trigger hormonal changes that increase sebum production and inflammation, which may worsen acne. A balanced diet of fruits, vegetables, whole grains, and lean proteins might help manage acne symptoms. Staying hydrated and avoiding excessive sugar and processed foods can also be beneficial.

Stress

Stress is known to exacerbate many skin conditions, including acne. When stressed, your body produces more cortisol and other stress hormones, which can lead to hormonal imbalances that contribute to the development of cystic acne. Practising stress management techniques such as mindfulness, meditation, exercise, and adequate sleep can help keep stress levels in check and may improve your skin’s condition.

What are the Risk Factors for Cystic Acne?

Several factors can increase the likelihood of developing cystic acne:

• Age: Acne is most commonly observed in teenagers and young adults due to the hormonal changes during puberty. However, cystic acne can also persist into adulthood.
• Sex: Acne tends to be more prevalent in males. Men secrete much more oil because they produce higher levels of testosterone. Fluctuations in testosterone levels increase sebum production, and when this excess sebum combines with a clogged follicle, it leads to bacterial overgrowth, which causes inflammation and acne breakouts.
• Polycystic Ovary Syndrome (PCOS): This condition affects hormone levels, leading to symptoms like irregular menstrual cycles, weight gain, and an increased risk of developing cystic acne.
• Occupations: Jobs that expose individuals to oil, grease, or other industrial chemicals can exacerbate acne. This is often observed in occupations such as kitchen staff, mechanics, and oil industry workers.

How to Treat Cystic Acne

Treating cystic acne requires a multifaceted approach, often involving topical and oral medications and other treatments. Here’s a comprehensive look at the available acne treatment options:

Topical Medications

• Benzoyl Peroxide: An effective treatment that targets bacteria and reduces inflammation, making it a popular choice for mild to moderate acne. It is available in various forms, such as cleansers, creams, and gels.
• Retinoids: These vitamin A derivatives help prevent clogged pores by promoting cell turnover and are often used to treat acne and signs of ageing. They can come in prescription and over-the-counter strengths. Common retinoids that are used include Adapalene, Epiduo, and tretinoin creams.
• Salicylic Acid: Works by exfoliating the skin and unclogging pores. It is commonly found in face washes, spot treatments, and pads, making it a versatile option for many skin types.
• Short-term Antibiotics: Used to reduce bacteria and inflammation. These are typically prescribed for a short duration to avoid antibiotic resistance and are often used alongside other treatments.

Oral Medications

• Long-term Antibiotics: Help control bacterial growth and inflammation. These are usually prescribed for severe acne and are often combined with topical treatments for a more comprehensive approach.
• Oral Contraceptives: Effective for women with hormonal imbalances, these medications help regulate hormones that can trigger acne. They are often prescribed after consulting with a healthcare provider to ensure suitability.
• Isotretinoin: This potent medication is specifically reserved for severe cases that do not respond to other treatments. Due to its potential side effects and the necessity for close monitoring, it is typically prescribed by healthcare professionals at specialised clinics, such as Lux Medical Aesthetic Clinic.

Other Treatments

• Corticosteroid Injections: Used for severe cysts to reduce inflammation quickly. A doctor administers this treatment, providing rapid relief from painful, deep acne lesions.
• Light Therapy: Utilises specific wavelengths of light to reduce bacteria and inflammation. Different types of light therapy, such as blue and red, target various aspects of acne and are often used in conjunction with other treatments for optimal results.
• Carbon Laser: Carbon laser treatment can be used to help reduce the amount of bacteria on the skin surface and also to help reduce acne. This laser treatment requires no downtime and is recommended to be done every two weeks.

How to Prevent Cystic Acne

Preventing cystic acne involves maintaining a consistent skincare routine and adopting healthy lifestyle practices. Here are some detailed steps to help you manage and prevent cystic acne:

• Skincare Routine: Use gentle cleansers and oil-free moisturisers tailored to your skin type. Opt for products that are non-comedogenic and free of harsh chemicals. Avoid harsh scrubs and irritants that can aggravate the skin, as they can cause further inflammation and breakouts. Consider incorporating products with ingredients like salicylic acid or benzoyl peroxide, which can help reduce acne. Opt for an oil-free sunscreen to prevent unnecessary clogging of pores.
• Healthy Diet: Focus on a balanced diet rich in fruits, vegetables, and whole grains to give your skin essential nutrients. Foods high in antioxidants and vitamins can promote healthier skin. Monitor any dietary triggers that may exacerbate acne, such as dairy products or high-glycemic foods, and consider reducing their intake if they worsen your condition. Staying hydrated by drinking plenty of water is crucial for maintaining clear skin.
• Stress Management: Incorporate stress-reducing activities such as yoga, meditation, or regular exercise into your routine. Managing stress is important because stress can trigger hormonal changes that lead to acne flare-ups. Additionally, getting adequate sleep each night helps the body repair and regenerate skin cells, contributing to overall skin health.

By following these steps and making mindful choices about your skincare and lifestyle, you can better manage cystic acne and maintain clearer, healthier skin over time.

Conclusion

Cystic acne is challenging but can be managed effectively with the right approach. Understanding the causes, symptoms, and treatment options is crucial for achieving clear skin and maintaining a positive self-image.

Remember, managing cystic acne is a journey. With persistence and the right support, clear skin is attainable. Consider booking a consultation with a medical practitioner for cystic acne treatment or visiting Lux Medical Aesthetic Clinic for personalised advice and treatments.

Stay positive and proactive in your skincare routine, and enjoy the confidence of healthy, clear skin.

Acne is a common skin condition that many experience at some point, especially during adolescence. Its impact extends beyond physical appearance, often affecting self-esteem and overall well-being. This guide will cover acne, its causes, symptoms, types, and various treatment options. It aims to provide valuable information to those affected by acne, helping them better understand the condition and explore ways to manage and treat it.

What is Acne?

Acne is a skin condition when hair follicles become clogged with oil and dead skin cells. It is most prevalent among teenagers, though it can affect people of all ages. Acne appears in various forms, including whiteheads, blackheads, pimples, and cystic acne lesions.

According to a study in Singapore, 88% of teenagers report experiencing some form of hormonal acne themselves. This statistic highlights how common the condition is.

Impact on Self-Esteem

Acne can affect one’s self-esteem and mental health. Many individuals with acne report feeling self-conscious or anxious about their appearance, often avoiding social interactions and public events. This emotional toll can lead to feelings of isolation and depression, making it a critical factor to consider when discussing acne and its treatment.

Addressing acne’s physical and psychological aspects is essential for providing comprehensive care and support to those affected.

What are the Signs and Symptoms of Acne?

Acne symptoms vary, but they typically include several common indicators. These can range from mild to moderate severity and may appear differently depending on the individual. Some common signs of acne include:

• Whiteheads: These are closed plugged pores that appear as small, white bumps on the skin’s surface.
• Blackheads: These are open plugged pores that look dark on the surface due to the oxidation of trapped debris.
• Papules: These are small, red, tender bumps that form when hair follicles become inflamed or infected.
• Pustules: These are pimples with pus at their tips, often resulting from a pore infection.
• Nodules: These are large, solid, painful lumps located deep beneath the skin’s surface, often caused by severe inflammation.
• Cysts: These are painful, pus-filled lumps beneath the skin’s surface, usually resulting from severe infections and can lead to scarring.

What Causes Acne?

Several factors contribute to the development of acne, including:

Excess Oil Production (Sebum)

The sebaceous glands in the skin produce an oily substance called sebum. This natural oil helps to keep the skin moisturised and protected. However, when sebum is produced in excess, it can mix with dead skin cells and other debris, clogging pores and developing acne.

This can result in various forms of acne, such as black and whiteheads or more severe inflammatory lesions. Good skincare and hygiene can help manage sebum production and reduce the risk of clogged pores.

Clogged Pores with Dead Skin Cells

Dead skin cells can accumulate on the skin’s surface and mix with excess oil, leading to clogged pores. This buildup and skin irritation can result in various skin issues, including acne, blackheads, and dull complexion. Regular exfoliation and proper skincare routines are essential to remove these dead cells and maintain healthy, clear skin.

Bacterial Growth

Propionibacterium acnes (P. acnes) can grow in clogged pores and thrive in an oxygen-poor environment. This growth often leads to inflammation, causing the immune system to react and forming pimples and other acne-related symptoms. Understanding the role of P. acnes helps in developing acne treatments.

Inflammation

The inflammatory response in the skin can cause redness (skin discoloration), swelling, and pain, further exacerbating acne. This inflammation often occurs when pores become clogged with excess oil, dead skin cells, and bacteria, forming pimples, cysts, and other blemishes.

Over time, the persistent inflammation can damage the skin and contribute to scarring, making it essential to manage both the inflammation and the underlying causes of acne.

What are the Risk Factors for Acne?

Several risk factors can increase the likelihood of developing acne:

• Age: Teenagers and young adults are more prone to acne due to hormonal changes that occur during puberty. These hormonal shifts can lead to increased oil production and clogged pores, the primary causes of acne.
• Hormonal Changes: Puberty, menstruation, and pregnancy can trigger hormonal fluctuations that lead to acne. For example, elevated levels of androgens during puberty stimulate the sebaceous glands in the skin, resulting in more oil production and potential breakouts.
• Genetics: A family history of acne increases the likelihood of developing the condition. If your parents or close relatives had acne, you may be genetically predisposed to experiencing similar skin issues.
• Certain Medications: Drugs containing corticosteroids, androgens, or lithium can cause severe acne. These medications may alter hormone levels or affect the skin’s oil production, leading to breakouts.
• Diet: High glycemic foods might contribute to acne, though research is ongoing. Foods that cause a rapid spike in blood sugar levels can increase insulin levels, which may, in turn, boost oil production and inflammation in the skin.

Stress: Stress can worsen acne by increasing hormone levels that stimulate oil production. When you’re stressed, your body produces more cortisol and other stress-related hormones, which can lead to more oil production and clogged pores.

Types of Acne

Comedonal Acne

Comedonal acne primarily consists of blackheads and whiteheads. Blackheads, or open comedones, appear when pores are clogged with oil and dead skin cells. The pore’s surface remains open, and the accumulated substances oxidise, turning black.

Whiteheads, or closed comedones, form when the clogged pore closes up, creating a small bump under the skin. Both types of comedonal acne are non-inflammatory and generally less severe than other forms of acne.

Inflammatory Acne

Inflammatory acne includes papules, pustules, nodules, and cysts, typically characterised by redness, swelling, and pain:

• Papules: Small, red, tender bumps that occur when the walls surrounding the pores break down due to severe inflammation.
• Pustules: Pimples containing pus at their tips. They appear red at the base with a white or yellow head.
• Nodules: Large, solid, and often painful lumps beneath the skin’s surface. Nodules can be more challenging to treat because they form deeper within the skin.
• Cysts: Painful, pus-filled lumps akin to nodules, but cysts are filled with pus. They can cause significant scarring due to their severity and depth within the skin.

Each type of inflammatory acne varies in severity and requires different treatment approaches to manage effectively.

When to See a Professional

Consulting a medical or aesthetic practitioner is recommended in the following situations:

• Severe or cystic acne
• Persistent acne that doesn’t respond to over-the-counter treatments
• Acne that leads to scarring or dark spots
• Emotional distress due to acne

How Can You Manage Acne?

In addition to prescribed treatments, some self-care methods can help manage and prevent acne breakouts.

• Gentle Cleansing Routine: Wash your face twice daily with a gentle, non-comedogenic cleanser. Avoid over-washing, as this can strip the skin of its natural oils and increase oil production. Using lukewarm water instead of hot water can also help prevent further irritation and dryness.
• Non-comedogenic Skincare Products: Use products labelled as non-comedogenic, meaning they are less likely to clog pores. This includes moisturisers, sunscreens, and makeup. Look for products containing beneficial ingredients, such as hyaluronic acid for hydration or niacinamide for soothing inflammation.
• Avoiding Harsh Scrubs and Irritants: Avoid abrasive scrubs and ingredients that irritate the skin, such as alcohol-based products and fragrances. These can exacerbate acne and lead to further inflammation. Instead, opt for gentle exfoliants like salicylic acid or lactic acid, which can help to clear pores without irritating them.
• Reducing Stress: Incorporate stress-management techniques into your daily routine, such as yoga, meditation, or adequate sleep. Lowering stress levels can help balance hormone levels and reduce breakouts. Practising mindfulness or engaging in hobbies you enjoy can contribute to overall mental well-being, which may also reflect in your skin.

Maintaining a Healthy Diet: Opt for a balanced diet rich in fruits, vegetables, and lean proteins. Avoid high glycemic index foods and processed items, as they can spike insulin levels and potentially worsen acne. Additionally, consider incorporating probiotics, as emerging research suggests they positively impact skin health. Foods rich in omega-3 fatty acids, like salmon and walnuts, can also support skin health by reducing inflammation.

Conclusion

Acne is a common yet complex condition that affects many individuals, especially young adults. Understanding the causes, symptoms, risk factors, and treatment options is crucial in managing acne effectively. While over-the-counter treatments and lifestyle changes can help, seeking advice from a professional is beneficial.

If you’re struggling with acne, remember that you are not alone, and there are various ways to manage and treat the condition. Take the first step in managing your skin health by exploring available treatment options and consulting a professional for advice.