Do I have Cystic Acne? Symptoms, Warnings and Treatment

Cystic acne is the most severe form of acne vulgaris.  Acne in general develops due to overactive sebaceous glands.  At the base of each hair follicle is a gland called the sebaceous gland, which makes sebum. Sebum is an oily substance, which under normal circumstances travels along the hair follicle to the surface of the skin. Sebaceous glands are most numerous on the face, chest, back, neck and scalp; consequently, these are the most common sites of acne.  A number of factors can cause an increase in sebaceous gland secretions.  A primary culprit are the androgen hormones (analogs of testosterone) DHT(dehydrotestotsterone) DHEAS (dihydroepiandrosterone).  Elevated levels of these androgens cause an increase secretion of sebum, which can lead to clogged pores and the start of the acne cascade.

Under normal conditions, sebum flows to the surface of the skin along the hair follicle (figure 1).

For an individual with acne, the normal transport of sebum out of the follicle is impeded, which leads to an accumulation of sebum providing an enriched breeding ground for bacteria. Cleansing with soap is not capable of removing the bacteria entrapped at the base of the hair follicle. The rapid growth of the bacteria in combination with the accumulated sebum cause the follicle to enlarge and can result in a mild form of acne called comedones (blackhead, open comedone or whitehead, closed comedone) both of which are non-inflammatory (Figure 2).

This is the start of the acne cascade. Under most circumstances acne does not proceed any further, the skin forms a “wall” around the follicle which contains the bacteria so a healing process can start.  For those individuals that have cystic acne the process does not stop here; instead the acne can progress to inflammatory type of lesions that are red in color called pustules and nodules.  The next stage is the development of a clearly inflammatory lesion called the pustule, which contains limited number of bacteria and pus below the surface of the skin. Nodules or cysts are the most advanced and severe form of acne. Nodules result when the contents of a comedone expand from the follicular region to the surrounding tissue causing a local inflammatory reaction that may damage the skin.

The final stage of the acne cascade is cystic acne and it is the most severe form of acne vulgaris, Cystic acne appears similar to a nodule, but is pus-filled and routinely has a diameter of 5mm or more. The cysts result from a more chronic inflammatory response that can lead to local tissue destruction.  Unlike common pimples where a “wall” is established around the hair follicle to prevent expansion of the local infection and to reduce the degree of inflammation, with cysts, the inflammation expands to the surrounding tissue. Cysts originate deeper in the skin than typical pimples. These inflammatory lesions can be painful and commonly produce scarring.

Individuals should never squeeze an acne cyst, since squeezing the cyst can cause an even deeper infection and more painful inflammation spreading under the surface of the skin.  This further damage can result in the cyst lasting much longer and lead to the development of additional cysts, more permanent tissue damage and scarring. 

AcnEase, our all-botanical acne treatment, has been VERY successful in treating cystic acne for both women and men.  AcnEase is designed to not only eliminate symptoms of acne, but to also prevent it – which is the key to getting rid of acne.  This one-month treatment is clinically proven to be safe and effective for all ages and skin types, and has absolutely no-chemicals and is also gluten-free.  With a 96% user success rate, the body is rebalanced so that the sebaceous glands are able to produce a normal amount of sebum – another key to winning the fight against acne.