What is Cystic Acne?
Cystic acne is a dermatological condition and is commonly treated as a more severe form of normal acne. It usually occurs in teenagers or young adults but can also occur in smaller children or even adults who are in their 50s. Normal acne is a condition when pimples are formed due to a bacterial infection inside a clogged pore on the skin. Cystic acne takes this infection a step further by taking it deep into the skin such that the pimple becomes larger and full of pus. Cystic acne starts with the formation of one such pimple but the infection spreads when this pimple bursts and causes more breakouts.
The cause behind cystic acne is a bacterial infection which is the same as that of normal acne. The bacteria is called Propionibacterium acnes, or more commonly as P. acnes. Many a times, the cause of acne may also be hormonal such as increase in production of androgens such as testosterone during puberty or during menstrual cycle. Psychological factors also play a big role in causing cystic acne since extreme mental stress or depression can cause a severe acne outbreak which can turn into cystic acne.
It may get difficult to differentiate between normal acne and cystic acne at the time of formation since they both show the same symptoms. However, as the pimple grows over a period of 1-2 days, a normal acne pimple would generally not grow very big. However, cystic acne is much larger than a normal pimple, is generally redder and tenderer to the touch. It is also unusually painful. The most distinguishing symptom is that it is filled with pus. A normal acne pimple would never be pus filled, but cystic acne would.
An emerging pimple is the first sign of cystic acne. If you are prone to acne due to oily skin or have experienced acne outbreaks in the past due to genetics or hormonal factors, you would know that a pimple can appear overnight. However, it takes a couple of days to grow to its full size. Cystic acne develops as a small painful bump initially but it soon turns into quite a large pimple which is filled with pus and is extremely painful. Sometimes, cystic acne can also appear in the stomach, lower back or midriff, but it is not very common in these regions.
Generally, only a visual examination of the acne is sufficient to identify a case of cystic acne and no separate test is needed. Cystic acne is easily identifiable by its unique characteristic of producing pus inside the pimple. However, if you have very frequent outbreaks of cystic acne, the doctor may do a skin biopsy in which a sample of the skin is taken to study the bacteria infecting it and to identify how severe the infection is.
Although any type of acne, including cystic acne can be diagnosed only through a detailed visual examination of the skin condition, the doctors, along with a positive diagnosis of acne will also grade the severity of the acne. There are three grading scales for acne which are followed by doctors all over the world :
- Leeds Acne Grading Technique – The acne is graded on the basis of the inflammation caused by them on a scale of 0-10.
- Cooks’ Acne Grading Scale – Grades the pimples on the basis of photographs.
- Pillsbury Scale – This is the most common scale used and grades the acne on 1-4 with 1 being the least severe infection and 4 being the most severe.
Cystic acne, along with other types of acne generally tends to occur in pre-teens and teens since they are affected mostly by hormonal factors. Usually, after the age of 20, even those who were susceptible to frequent outbreaks of pimples during teenage, stop experiencing this skin condition.
Since cystic acne usually develops as an advanced and more severe form of simple acne, taking preventive steps to avoid development of acne itself will also automatically prevent cystic acne. Some preventive measures you can take are :
- Wash the acne-prone areas such as cheeks and foreheads with a good antibacterial soap at least twice a day.
- If oily skin is a trigger for pimples for you, then buy a non-prescription gel to keep your skin from getting too oily.
- Use non-oily makeup and make sure to remove all makeup and washing your face before going to bed.
- If you develop a single pimple, avoid touching it and apply a suitable ointment on it so that it does not trigger an outbreak.
Cystic acne is itself a type of acne and does not have any further sub-types. Other kinds of acne in order of their severity are:
- Blackheads or Whiteheads – Oil and dead skin can block some skin pores. If the pore remains open, the oil inside turns brown or black causes a blackhead. If it closes up, it appears as a tiny white bump called a whitehead.
- Papules and Pustules – These are what we commonly call pimples or acne. These are small red inflamed bumps which may or may not have a tiny amount of pus at their tip.
- Cystic Acne – These are the most severe kind of bacterial infection which causes acne. The bumps are at least 2-3 times bigger than a normal pimple, are very painful and are filled with pus which will later burst.
Apart from making your face look ugly for 3-4 days, cystic acne does not have any real complications. However, if you suffer from a very frequent outbreak of cystic acne and if proper treatment is not given to such acne, they can leave permanent scars on your face.
Home Remedies :
- Facial Steam – Taking steam would help open the pores on your face. Steam will also kill the bacteria inside the skin or at least subdue it.
- Prepare a face wash by missing baking soda, water and cucumber juice. You can even apply baking soda directly to the face to relieve the infection.
- Tea tree oil is an excellent remedy with its anti-bacterial and anti-fungal properties. A solution of tea tree oil and water can be applied gently on the acne with a cotton ball.
- A mixture of egg whites and honey can apply as a mask for 5-10 minutes before washing off. This will remove the excess oil from the skin and make the skin look naturally clean.
The most effective treatment for cystic acne is applying benzoyl peroxide cream which can effectively kill the P. acnes bacteria. In fact, this cream is recommended for all kinds of acne. Commonly used antibiotics for countering cystic acne include erythromycin, clindamycin and metronidazole. However, these antibiotics should not be taken without referring to a doctor first. For people in whom breakouts of cystic acne occurs due to hormonal changes, antiandrogens such as cyproterone acetate are also prescribed.
When To See A Doctor ?
Acne, including cystic acne does not usually require a trip to the doctor. With the help of some home remedies which are quite effective in treating the acne, a trip to the doctor can easily be avoided. However, if the acne does not show signs of heaving even after 3-4 days or if new acne keeps on appearing for 1-2 weeks, then it is a sure sign that you need to consult a dermatologist. This is necessary because although eventually the acne will heal itself, but they might leave scars on your face which may be permanent.