Severe Acne of the Skin
Acne can be embarrassing and uncomfortable. If you have severe acne, scarring is a concern. Severe acne requires an aggressive treatment plan that you should discuss with a dermatologist. If a member of your immediate family has had severe acne, you have a greater chance of developing it and should take care to develop a healthy skin-care regimen early in life, the American Academy of Dermatology advises.
Acne conglobata is a severe form of acne characterized by abscesses, inflammation and scarring, according to the Acadamy of Dermatology. Blackheads are "usually conspicuous and widespread, often occurring on the face, neck, trunk, upper arms and/or buttocks," the academy says. Young men are more likely to develop this type of acne than young women, and it typically manifests from ages 18 to 30, according to the academy.
Acne fulminans is a sudden onset of inflammation and is characterized by ulcerated blemishes, fever and aching joings, according to the academy.
Nodulocystic acne is characterized by large cysts that typically appear on the face and neck. Cysts can also develop on the back, shoulders and chest. They are often filled with pus-like fluid, according to the academy.
Gram-negative folliculitis is a type of severe acne characterized by lesions or pustules in areas with infected or inflamed hair follicles. This type of acne is less common, but it is difficult to treat.
Many types of severe acne develop the same way milder forms do. Bacteria, oils and other debris on the skin clog pores, resulting in the formation of a pustules or pimples. Regular acne that does not heal properly can deteriorate and lead to more severe forms of acne. Gram-negative folliculitis often develops from a bacterial infection in people who undergo long-term antibiotic treatment for other forms of acne or infections.
Treatment for severe acne depends on the type and location of the cysts or pustules. Many people who have severe acne undergo several treatments, and the condition can last for years, according to the Academy of Dermatology.
Oral contraceptives for women and oral antibiotics are often the first options dermatologists employ. Your dermatologist may prescribe high doses of antibiotics until your acne begins to clear and then gradually reduce your dose. Women with overactive oil glands often benefit from long-term care with oral contraceptives.
Isoretinoin is a synthetic form of vitamin A that is successful in treating many cases of severe acne that do not clear up with other medications. Isoretinoin has potential side effects, many of them dangerous, so your dermatologist will monitor you closely if you take this drug. Pregnant women and those thinking about conceiving cannot take isoretinoin because of the risk of birth defects. The drug can also cause chest pain, swallowing problems, headache, nausea, diarrhea and depression.
If you have large cysts, your doctor may surgically drain the infection and fluid. Corticosteroid injections can help prevent scarring by decreasing inflammation in severely infected cysts.
Severe acne can be extremely painful, particularly if you develop large cysts. The condition often leaves discolored skin or deep scars once it clears. Many oral antibiotics and other medications prescribed for severe acne can lead to unpleasant side effects. Discuss your condition with your dermatologist thoroughly and disclose any medical conditions you have, along with the drugs or supplements that you take.
Although many cases of severe acne are impossible to prevent, taking good care of your skin can reduce your risk of developing severe problems. Washing your face with a mild cleanser twice a day can help keep your skin clean and reduce the risk of clogged pores that lead to pustules or cysts. Over-the-counter topical medications, such as benzoyl peroxide and salicylic acid, can help clear mild to moderate breakouts and prevent new pustules that could develop into severe acne.
Avoiding cosmetics and other facial products as much as possible when you have problem skin can decrease your risk of acne. Look for products labeled noncomedogenic, meaning they do not clog pores, if you must use makeup or other products on acne-prone skin.
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