Deep Acne Cysts
Acne is the common term for a group of skin lesions caused by the combined effects of excessive skin oil, clogged pores, local inflammation and bacteria called P. acnes. If this combined activity occurs in the deeper layers of your skin, it can trigger the formation of acne lesions called cysts or nodules.
The pore blockage associated with cysts and nodules occurs deeper in your skin than that associated with acne lesions such as pimples, pustules, whiteheads and blackheads, according to the American Academy of Dermatology, or AAD. If you develop a deep blockage, your skin will undergo intense inflammation, leading to pain and noticeable skin disturbance. Doctors commonly refer to this severe form of acne as nodulocystic acne.
Unlike true cysts, which result from unusual enlargement of your normal skin tissue, acne cysts develop from inflamed acne nodules, the AAD reports. You may develop acne-related cysts in numbers that range from a single occurrence to large-scale outbreaks, in locations that commonly include your neck, scalp, face, shoulders, chest and back. You may also develop cyst infections, which produce a yellow, thick fluid similar to pus. Although cysts usually form from deep inflammation, in some instances you may also develop a cyst from inflammation on your outer skin that does not normally occur in acne cases.
If you have a grouping of cysts that are close to each other, they may run together and form a particularly severe form of acne called acne conglobata, according to the New Zealand Dermatological Society. Symptoms of this condition include unusual tissue softening, cellular destruction and the formation of interconnected, pus-filled pockets called abscesses. In some cases, ulcers may form under affected areas of tissue, leading to crust formation and prominent scarring similar to that found in the skin condition called keloids, the AAD notes. You may also develop acne conglobata in association with a disorder called hidradenitis suppurativa, which triggers the formation of lesions and scarring in your groin or armpit, or under your breast.
You may also develop severe nodulocystic acne as a symptom of an uncommon inherited disorder called PAPA syndrome, the New Zealand Dermatological Society reports. PAPA stands for pyogenic arthritis, pyoderma gangrenosum and acne, and the disease features a destructive form of juvenile arthritis in combination with the development of significant skin ulcers. Acne does not always occur in individuals with PAPA syndrome, and when it does it can vary substantially in its intensity.
If you have nodulocystic acne, your doctor may choose to treat it with aggressive doses of antibiotics and a medication called isotretinoin, according to the AAD. In some cases, you may also receive corticosteroid injections designed to dissolve your cysts over a period of several days. If you have acne conglobata, your doctor will likely prescribe isotretinoin, although you may also receive antibiotics. Please note that the treatment of this form of acne can take years, and even then you will need to check regularly for signs of acne recurrence.
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