Cystic acne – photo, treatment, causes

Cystic acne is one of the most severe forms of acne and is an inflammation of the sebaceous glands. Nodular acne, filled with pus, localized on the face and torso. After they usually leave scars and dark spots on the skin. The dermatological disease is characteristic for the adolescent category, but can also occur in adults. Cystic acne requires complex treatment with the use of general and local antibiotic therapy.

Causes of cystic acne

The cause of cystic acne is hyperactive sebaceous glands. The sebum produced by them clogs the ducts and leads to the development of an inflammatory process against the background of active reproduction of pathogenic bacteria. The following factors contribute to an increase in the production of sebaceous secretion by the glands:

  • seborrheic dermatitis
  • hormonal changes
  • unhealthy diet
  • alcohol abuse
  • hormonal drugs.

Seborrheic dermatitis is one of the main causes of severe acne. Dermatological pathology is accompanied by an increase in secretion and a change in the quality of sebum. The yeast-like lipophilic fungi Pityrosporum ovale provoke the pathological process. In this case, cystic acne is a complication of seborrheic dermatitis, which requires separate therapy.

Hormone reorganization is characteristic during puberty, pregnancy, and also in pathologies associated with the adrenal glands and ovaries. Changes in the hormonal background lead to the active work of the sebaceous glands. That is why during this period, the cystic form of acne is most often observed.

Frequent consumption of alcohol, sugary carbonated drinks, confectionery, chips, smoked meats, fried and fatty foods inevitably leads not only to the intensive production of sebum but also to a decrease in immunity. As a result, the skin becomes unable to independently combat the reproduction of pathogenic microorganisms, which provoke acne in severe form.

Hormonal drugs, which include contraceptive oral medications, insulin-based medications, and inhibitors, also provoke a malfunction of the sebaceous glands and can lead to the development of a dermatological disease.

The clinical picture of cystic acne

The hyperactive work of the sebaceous glands, in which a thick secret is formed, becomes the reason for the difficulty of outflow along the excretory ducts. Sebum accumulated in the ducts of the glands is a favorable environment for the development and reproduction of pathogenic microorganisms. An infection of the skin occurs, resulting in an inflammatory process. In severe acne, inflammation affects both the superficial and deep layers of the epidermis. As a result, such a pathological process leads to the appearance of fibrous cicatricial formations.

Localization of cystic acne is most often the skin of the face, chest, and back. On the affected areas there is a widening of the pores, a strong redness that extends beyond the sebaceous glands, as well as fibrous nodular growths. As skin formations mature, cysts form, which are subsequently filled with pus. The affected areas become dark red with a bluish tinge. Fibrous purulent growths bring not only aesthetic discomfort but also cause pain.

The formation of fibrous cicatricial elements in the period of post-acne occurs due to the replacement of the affected cells of the epidermis with dense connective tissue

Cystic acne - photo, treatment, causes

Cystic acne - photo, treatment, causes

Cystic acne - photo, treatment, causes

In the presented photos you can see a typical clinical picture characteristic of cystic acne.

Differential diagnosis of skin disease

In addition to examining a dermatologist, the diagnosis of cystic acne includes the following activities:

  • dermatoscopy
  • pH-metric
  • bacteriological seeding.

Dermatoscopy is a hardware method of differential diagnosis, with which you can conduct a visual assessment of the pathological processes occurring in the dermis.

Determination of acid-base balance is performed using pH-meters in the form of glass electrodes. This diagnostic method allows you to differentiate the cystic form of acne from various forms of pyoderma, representing purulent-inflammatory skin diseases.

The material for bacteriological seeding is the purulent contents of cysts and epidermis scales. The results of this analysis help to identify the type of bacteria and their resistance to various antibiotics.

Methods of treating nodular cystic acne

Cystic acne includes the following therapeutic measures:

  • taking antibiotics and retinoids
  • topical preparations
  • hardware treatment
  • power correction.

Treatment of a dermatological disease begins with the identification and elimination of the cause of cystic acne. The duration of therapy can range from several months to a year or more, depending on the severity of acne

Systemic antibiotics and retinoids

For severe acne, the following systemic antibiotics are prescribed:


Drugs in this category are able to penetrate the fat barrier and accumulate in the area of inflammation. Potent antibiotics inhibit the growth of pathogenic bacteria and reduce inflammation. The duration of antibiotic therapy ranges from 1.5 to 2 months.

Taking antibiotics without a doctor’s prescription is prohibited, as it can lead to a worsening of the condition of the skin if the drug is not properly selected and the treatment regimen is prepared

Cystic acne - photo, treatment, causes

When nodular cystic acne does not respond to systemic antibiotics, the patient is prescribed retinoids. Drugs in this category are available under the following pharmaceutical names:

  • Roaccutane
  • Aknekutan

Treatment with retinoids is carried out from 4 months to six months. As a rule, cystic acne disappears completely after the first course. In rare cases, you may need a second course of admission.

Cystic acne - photo, treatment, causes

The dosage of retinoids is chosen by the doctor strictly individually, depending on the characteristics of the course of acne.

It is impossible to take drugs of this group without a prescription by a dermatologist since retinoids can cause serious side effects, including hypervitaminosis, depression, headaches, visual acuity, dyspepsia, anemia, etc. Also, medicines for cystic acne have a large list of contraindications.

Local Drugs

Preparations based on azelaic acid have an antiproliferative and antibacterial effect. They normalize impaired keratinization processes in the ducts of the sebaceous glands and reduce sebum production.

Cystic acne - photo, treatment, causes

Local products, which include benzoyl peroxide, have a similar principle of action. These drugs restore the damaged cells of the epidermis, saturate them with oxygen and reduce the production of sebum. The use of creams, ointments, and gels of this group reduces the risk of fibrous cicatricial elements in the period of post-acne.

Local drugs from the retinoid group have an anti-inflammatory effect and reduce the risk of acne cysts by reducing the density of the sebaceous secretions. The first improvements in the condition of the skin are observed after 1-2 months with regular use of retinoids.


The following types of physiotherapy are the most effective apparatus treatment methods:

  • laser therapy
  • phototherapy
  • darsonvalization.

Cystic acne - photo, treatment, causes

The above procedures help reduce inflammation, improve local blood circulation, increase the body’s protective functions, and enhance the effect of drugs. Physiotherapy with an integrated approach to treatment leads to the resorption of infiltrates, which in turn avoids scarring.

The resulting scars after acne are treated with cryotherapy, laser peeling, and mesotherapy. Such methods of therapy are used exclusively after the elimination of the inflammatory process to eliminate scar formation.

Diet therapy

One of the ways to treat cystic acne is diet therapy. It is aimed at eliminating from the diet foods that lead to increased sebum production. During the period of treatment, it is recommended to completely eliminate or significantly reduce the consumption of the following products from the patient’s diet:

  • semi-finished products
  • smoked meat
  • roast
  • fatty
  • spicy
  • sweet
  • alcohol.

You should eat as much vegetable and protein foods as possible. Vegetables, fruits, berries, poultry, fish, beef, eggs, dairy products help to improve the condition of the skin and reduce inflammation.

The duration of diet therapy ranges from 1 month to six months or more.

Hygiene measures during treatment

Cystic acne during therapy requires careful skin care. The use of cleansers in the form of foams, gels for washing and lotions is welcome. During treatment, it is recommended to completely abandon the use of comedogenic cosmetics.

Folk remedies therapy of Cystic acne

Methods of traditional medicine can be used in the treatment of cystic acne as an additional, but not the main treatment. The following components of natural origin are used to reduce inflammation:

  • aloe juice
  • chamomile decoction
  • the decoction of calendula.

The above tools have a weak antiseptic effect and therefore can not cure a severe form of acne. They are used both for topical use and for oral administration.

Relapse prevention

Acid cysts require not only a serious approach to treatment but also need to prevent relapse. The following measures will help prevent the development of cystic acne:

  • thorough care of the skin
  • rejection of comedogenic cosmetics
  • weekly use of scrubs
  • the use of antiseptic lotions
  • proper nutrition and rejection of bad habits
  • timely treatment of internal pathologies
  • strengthening immunity.

Before using this or that drug, do not forget to get expert advice. Properly designed treatment regimen and selected dosage of drugs will reduce the risk of complications in the presence of cystic acne, and increase the effectiveness of therapy several times.

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