Cystic Acne in Adults
Cystic acne is one of the more difficult types of acne to treat, regardless of age. Acne is caused by three factors: hormone production or fluctuations that cause increased sebum (oil) production, bacteria, and the continual sloughing of dead skin cells. Because women are more susceptible to hormonal changes during pregnancy and menopause, they are more at risk for persistent or adult-onset acne. But acne of any kind, including cystic acne, can affect an adult of either gender in his or her 30s, 40s and 50s. If you're an adult with cystic acne, the same treatments offered to patients with teen acne are available to you, too.
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What is Cystic Acne?
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Mild to moderately severe acne may consist of comedones (blackheads and whiteheads) that form on the superficial layers of the skin. However, cystic acne results when an infection takes place deep inside the hair follicle, close to the root. Cystic acne are deep lesions that are filled with liquid comprised of white blood cells, dead cells and bacteria. In many cases, they are extremely inflamed and painful and leave scars.
Do Topical Creams Work?
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Mild to moderately severe acne can be reduced by using prescription topicals, such as antimicrobials, which fight bacteria, and retinoids, which aid in turning over dead skin on the surface of the skin. Anyone with acne should be encouraged to use good hygiene. Dermatologists recommend washing the infected area at least twice daily with a mild cleanser, using only the fingertips or hands to avoid irritating the skin into producing more sebum. In some cases of acne can easily be resolved using only topical treatments purchased from the drugstore. But when it comes to getting rid of cystic acne, aggressive medical treatment is required.
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Antibiotics
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Oral antibiotics have been used to treat acne systemically for many years. These drugs work by fighting the bacteria that cause acne. Patients with severe cystic acne may be given a higher dose of an antibiotic. However, there is the danger that the bacteria that causes the acne will become resistant to antibiotic therapy, necessitating use of another type of antibiotic. Drugs typically used to treat acne include doxycline, erythromycin, minocycline, and tetracycline.
Isotretinoin
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According to the American Academy of Dermatology, oral isotretinoin is the most effective cure for cystic acne, as it addresses all of the factors that cause it (excessive oil production, bacteria and accumulation of dead skin cells). This treatment usually takes 16 to 20 weeks, during which time isotretinoin is taken daily. However, this medication does come with some side-effects, including dry eyes and mucosal linings, blurry vision, thinning hair, and headaches. Additionally, because this drug causes damage to a fetus in utero, women of child-bearing age are required to undergo stringent monitoring and pregnancy testing during the course of their treatment. Usually, only one round of isotrentinoin is required to resolve cystic acne.
Other Ways to Treat Cystic Acne
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Sometimes individual cysts can be managed in your doctor's office. Cysts that don't respond to any other type of medical treatment may be surgically drained and extracted. Severely inflamed lesions may be injected with a dilute corticosteroid, which causes the cyst to melt away over a period of a few days, thus reducing the chance of scarring. Women with cystic acne may want to consider using oral contraceptives, which suppress oil production. While these can be used for a long period of time, they are not recommended for women who smoke, are older than 35, or have migraines or a disorder that causes blood-clotting.
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