Cystic Acne

What Is Cystic Acne?

Cystic acne, one of the severest forms of acne, is a type of abscess that is formed when oil ducts become clogged and infected. Cystic acne tends to affect the deeper skin tissue, as opposed to the more common acne that is more superficial.  Cystic acne is generally experienced on the face of a patient and typically occurs during the teen years.

Because cystic acne is a type of skin abscess, also know as a boil, it represents a localized infection deep in the skin. The typical beginning of an abscess is a reddened, tender area of skin.  Over time, the area becomes firm and hard.  Eventually, the center of the abscess will soften and become filled with white blood cells.  This is the body's defense against infection.  The collection of white blood cells, bacteria, and proteins form a substance known as pus. In the final stage, the pus will force a "head" to form, which can be surgically opened or spontaneously drained through the surface of the skin.

Because this form of acne is serious and may lead to permanent skin damage, individuals with severe nodular or cystic acne should be treated by a dermatologist.  For individuals with severe inflammatory acne that doesn't improve with other acne medications, Accutane (isotretinoin) may be needed. Isotretinoin, or Accutane, is an oral acne medicine that is usually taken for a period of 16 to 20 weeks.

This medication works by dramatically reducing the size of the oil glands, so that much less oil is produced.  Due to this oil reduction, the growth of P. acnes is decreased.  Also, Isotretinoin will reduce cell shedding and the stickiness of cells in the follicles.  This action helps prevent the development of comedones.

How Effective Is Isotretinoin?

Isotretinoin, sold under the brand name Accutane, is a very effective cystic acne medicine that helps prevent extensive scarring in acne sufferers.  During treatment, usually a 16 to 20 week period, acne completely or almost completely goes away in most patients.  The statistics show that Isotretinoin has an effective rate of up to 90 percent.  However, for some individuals, the acne does return, and will require additional treatment of isotretinoin.

Disadvantages Of Isotretinoin

There are a number of disadvantages and side effects associated with Isotretinoin, and therefore, individuals should carefully weigh the advantages and disadvantages of using this form of acne treatment.  To start with, the drug is not only costly but is also linked to some adverse reactions that can be severe.  Possible side effects include:

• inflammation of the lip and mucous membrane of the eye;
• dry mouth, nose, or skin; itching;
• nosebleeds;
• muscle aches;
• photosensitivity; and,
• decreased night vision (rare).

There are also some other more serious side effects that should be considered -- increased blood cholesterol, triglyceride, lipid levels and abnormal liver enzymes. Because of the serious nature of these side effects, your physician will generally monitor a patient's complete blood count, blood chemistries, cholesterol, triglycerides, and liver enzymes before and during treatment.  The good news is that these side effects will usually cease upon stopping the medication.  

Women should take special note of the potential adverse side effects due to the fact that Isotretinoin is classified as a teratogenic.  This means that it can cause birth defects in the developing fetus of pregnant women.  So, it is very crucial that women of childbearing age are not pregnant, or do not get pregnant, while taking this cystic acne medication.  

Also, females are required to use an appropriate birth control method for one month prior to therapy beginning, during the course of the therapy, and for one full month after therapy is completed.  Once the cystic acne treatment is completed, women should consult with their physician regarding when it is safe to get pregnant.