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Cystic Acne: Guides on Severe Acne Vulgaris by Dermatologist

Reviewed by:

 Andrea G. Di Stefano, MD

Dr Andrea G. Di Stefano is an European Board-Certified Dermatologist with a particular interest in Acne, skin cancer, infectious and Sexual Transmitted Diseases and autoimmune skin disorders....more

Acne Vulgaris, or commonly called acne, is a skin problem that can affect people with ages ranging from 10 to 40. Acne is not just a problem for teenagers enter into adolescence, but also a problem faced by adult women and men and even newborn infant. Acne can appear as whiteheads or blackheads (when the oil becomes oxidized) and also inflamed red lesions such as papules (or pimples), pustules (pimples with pus), and cysts (or boils).

Acne happens when tiny skin pores become clogged with both sebum and dead skin cells creating a prime breeding ground for bacteria, due to too much oil produced by oil glands beneath the skin. The blocked pores are called comedones. Comedones may appear as whiteheads or blackheads. When they rupture, the oil and bacteria contained inside will be spread to surrounding areas. The body’s immune system will then be activated to attack the bacteria and thus resulting in inflammation and pus production. The degree of inflammation can range from mild to severe. For mild inflammation, it can be easily treated by applying over-the-counter acne cream and usually heals within a few days. It is less likely to cause scarring. For severe inflammation deep into skin, a painful cyst will appear. It might take weeks to months to heal and also has high risk of scarring.

Cystic acne is the most severe kind of acne disease. This deep, inflamed and painful acne can appear on the face, buttocks, groin, and armpit area and other body parts where sweat is usually collected. The cysts are soft and pus, which contains killed bacteria, is filled inside them. They are usually very painful. Nodules may appear at the same time with cysts. Nodules are also painful lumps form deep under the skin, but it is hard. When both nodules and cysts appear together, it is usually referred to as nodulocystic acne.

Although anyone can have cystic acne, this kind of acne is usually genetically inherited. People, especially teenagers with one or both parents with cystic acne histories, are prone to have cystic outbreaks too. Cystic acne should be treated as soon as possible by dermatologists to avoid severe outbreaks. If left untreated, these kinds of severe acne might result in permanent scarring.


Video: How to Treat Cystic Acne by DermTV.com


  1. About.com Guide, Angela Palmer, Cystic Acne-Understanding Cystic Acne and Nodulocystic Acne, updated July 30, 2009. http://acne.about.com/od/acnesymptoms/a/cystic.htm
  2. Acne.com, Acne Type: Nodules & Cysts. http://www.acne.com/#/types-of-acne/acne-types/nodules-and-cysts/
  3. MedicineNet, Alan Rockoff, MD, Acne (Pimples). http://www.medicinenet.com/acne/article.htm#1whatis
  4. MedlinePlus, U.S. National Library of Medicine, Acne, December 11 2009. http://www.nlm.nih.gov/medlineplus/ency/article/000873.htm
  5. Home Remedies for Acne - Various popular home remedies for acne.
  6. DermTV.com, Dr. Neal Schultz, Video: How to Treat Cystic Acne, Episode #107, Oct 15, 2009. http://www.dermtv.com/how-treat-cystic-acne


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