What is Cystic Acne?
Cystic acne is a common variant of acne vulgaris. It remains disparate enough from acne vulgaris to be an independent form of acne, however, and requires its own special brand of care. Cystic acne is considerably more severe than acne vulgaris, and while it is a relatively common acne variant, it is still far less common than acne vulgaris itself (most acne variants are, as the vast majority of the population suffers from acne vulgaris on some small scale, even if they do not suffer regular breakouts or are not adolescents).
Cystic acne differs from acne vulgaris in that rather than forming simple pimples and pustules on the surface of the skin, deeper cysts form. These liquid-filled cysts generally penetrate much deeper into the skin. This can make them infinitely more uncomfortable for those suffering from them and increases the risk of their scarring over. Cystic acne can be very difficult to get rid of, moreso than more basic forms of acne.
Who gets Cystic Acne?
Cystic acne can afflict many different individuals. There is little that differentiates those that suffer from cystic acne rather than run-of-the-mill acne vulgaris, but the common indicators for acne still apply in roughly equal proportions. Whether one of the individuals prone to acne vulgaris will go on to develop a case of cystic acne is left to question, of course, but it stands to reason that those more likely to suffer from acne vulgaris are transitively more likely to suffer from cystic acne, simply because both forms of acne have the same underlying root causes (although not all of the same treatments).
Men are significantly more prone to cystic acne than women. This is a product of hormonal differences. Those with more testosterone (which includes males, to a huge proportional difference) than estrogen have a tendency to produce more sebum, a natural oil that is unfortunately largely responsible for humanity’s acne problem. Women with elevated testosterone carry a similar likelihood, but men maintain the risk because their sebum production levels are always relatively high. This means that their pores are more likely to be clogged with excess sebum, and they are more likely to suffer from acne vulgaris breakouts at any give time.
Adolescents are more prone than anyone to cystic acne. During adolescence and puberty, the hormones of both boys and girls are thrown very far out of whack, relative to their usual stasis. These rapid changes in hormones result in a number of deleterious effects, like sebum hyperproduction and stress that can compound to make acne more likely, and make existing cases of acne worse than they were to begin with. Adolescent males are more likely than adolescent females to suffer from acne and cystic acne, but adolescent females are more likely than adult females to suffer from acne and cystic acne.
There is some genetic component to cystic acne as well. This is more a matter of cystic acne arising from a confluence of factors than anything else, however; there is no single ‘acne gene’ that can get passed on that will guarantee horrible cases of cystic acne to one’s progeny. There do exist circumstantial traits which can be passed on genetically that can contribute to the likelihood of acne and cystic acne in any given individual. It should be noted that these do not necessarily lead to cystic acne specifically, but they also do not exclude it; the number of factors at hand make it rather difficult to consider every variable at once.
What causes Cystic Acne?
Cystic acne is caused by a broad and deep confluence of factors. The commonality of acne and cystic acne is due in large part to the sheer number of possible triggers for it that exist in the environment and in the bodies of all human beings. Everyone has in them the potential for a case of acne because everyone, barring a few medical exceptions, produces sebum and sheds dead skin. Those that do not do even one of these, let alone both, are likely already suffering from something infinitely more serious than acne.
The primary cause of cystic acne is sebum hyperproduction. This is the root cause of all acneiform conditions, and is in fact the definition of an acneiform outbreak. However, there are many conditions and circumstances that, themselves, can cause sebum hyperproduction.
Perhaps the first among these is endocrine health. A person’s hormonal makeup has far-reaching effects that can make a difference in all areas of health. This includes the health of the skin. Testosterone results in various glands working harder and producing more; individuals with elevated testosterone will find that their skin and hair grow oilier. This is a result of increased sebum production. However, the body can only make use of so much of it at once before any additional quantity just becomes excssive and troublesome. When this occurs, sebum is likely to clog pores. This results in the blackheads and whiteheads of acne vulgaris. With cystic acne, these clogs provoke a proper response from the body as the body tries to expel what it perceives as a foreign invader, resulting in cysts. These cysts tend to occur only when acne vulgaris itself is very severe; cystic acne is frequently thought of as a more severe form of acne.
Overproduction of sebum is not the only contributing factor. Other items clogging the pores can also contribute to acne and cystic acne, and some of these are actually exacerbated by having more estrogen than testosterone. The primary factor in play here is generally dead skin. Dead skin collects naturally as the body goes through its normal operations and sheds used skin cells away. Individuals with more estrogen than testosterone tend to have drier skin, and drier skin means more dead skin; having more dead skin means more dead skin runs the risk of collecting in the pores. This clogging of the pores by dead skin is one of the most common contributors to acne vulgaris and cystic acne.
What does Cystic Acne cause?
Cystic acne carries with it a number of symptoms. The first of these are, as one can imagine, cysts. While most pimples are simply raised, sebum-filled blisters, cystic acne involves distended, pus-filled pustules atop these. This further expansion of the already-difficult blemish brings a number of unpleasant and unfortunate secondary effects.
The cysts take up much more space than the ordinary blackheads and whiteheads caused by acne vulgaris. They displace more skin and cause more strain to it, resulting in more severe symptoms. While acne vulgaris generally cannot be felt, cystic acne can frequently be felt on the skin even when an individual isn’t touching their face.
Cystic acne is far more likely than other forms of acne vulgaris to leave behind scars. This is because cysts affect deeper tissues of the skin than do other pustules and pimples, resulting in deeper skin trauma. This holds especially true for cysts that are artificially ruptured or tampered with. Over time, cysts will come to a head, after which they may rupture on their own; this is the safest end for any acne cyst to avoid scarring.
One of the greatest risks associated with acne has little to do with the aesthetics or appearance of acne at all, but rather the psychological impact. Because acne has a tendency to affect the face and other visible skin, and because it is a disease, it tends to have a very strong psychological impact. Acne is frequently mistaken as a sign of poor self-care, when in reality hygiene can have little to do with whether or not acne forms and how long it stays. Acne has a tendency to afflict adolescents, who are most vulnerable to social disapproval and ostracization. This can result in severe psychological problems in severe enough cases with bad enough surrounding circumstances.
The most serious risk to physical health stemming from cystic acne is that of infection. While cysts are relatively harmless on their own, and at worst will leave scars, ruptured cysts can become open sores which are vulnerable to secondary infections. While secondary infections can be very minor and easy for the body to fight off, they can also include far more serious ailments, many of which can result in extreme damage to the skin and other tissues, deep scarring and the formation of scar tissue, and worse. For this reason, it is important never to tamper with acne cysts that have formed on the skin. Secondary infections are a very real risk, and perhaps the most important reason to seek treatment for severe acne that can leave open sores and vulnerabilities to secondary infection.
How serious is Cystic Acne?
Cystic acne is more serious than acne vulgaris. That said, it is still not an exceptionally serious skin ailment; it is fairly common in and of itself, and many treatments are readily available, most over-the-counter. Cystic acne does not pose a threat to one’s life, and cannot cause exceptional harm, aside from aesthetic damage brought on by the presence of cystic acne itself and subsequent possible scarring.
The most serious element of cystic acne is, in fact, the potential for secondary infections. The rupturing of cysts can cause open sores to form in the skin. Open sores are extremely vulnerable to secondary infections, which can cause far worse damage to the skin and other tissues than acne will ever be capable of. Secondary infections, unlike acne, can pose a very real risk to one’s overall health, and can require serious treatment to match.
The psychological effects of acne are not to be overlooked under any circumstances, nor should they be downplayed. While the response in relation to many psychological issues is simply the admonishment that one ought to be strong or ‘get over it’, the fact is that cystic acne can cause very serious psychological harm. Acne disrupts one’s self-image, and their image in society. This does cause very real and tangible problems even before issues of mocking, ostracization or self-esteem can begin to truly take root. While acne in and of itself is rarely enough to cause heavy psychological harm, it does have the potential and can certainly contribute, and for this it cannot be ignored.
Scarring is a common side effect of acne. While acne can be grown out of, acne scars have an unfortunate tendency to remain, sometimes for years after the fact. Acne scarring occurs most commonly when acne is not treated appropriately and is mechanically excoriated and scratched by the affected individual. However, acne scarring can also occur on its own just by running its course. Even acne treated with the utmost care can still result in scarring. It is unfortunate and unfair, but it is the truth.
What does Cystic Acne treatment look like?
Treatment for cystic acne can vary greatly depending upon its severity. The most common form of treatment for cystic acne is generally maintaining a proper skincare regimen, including facial cleansing. However, it should be noted that dirt actually plays a very small role in causing acne, especially cystic acne. What cleansing the face does do is help balance out oils. If one has exceptionally oily skin, and washes their face regularly, their skin will dry out and maintain a healthier equilibrium. However, the reverse is true for those with dry skin: washing the face to dry it out when one’s skin is already dry can cause damage, and excessive dead skin, which can also lead to acne.
Maintaining a certain diet can be a contributing factor to keeping cystic acne at bay. Greasy foods can have a very similar effect to sebaceous hyperplasia—that is, oily skin. Many dairy products and red meat products in this modern era contain traces of hormones used to increase milk production and growth in cows, and this fluctuation can cause acne breakouts.
There are a number of treatments available to treat acne directly. They all function along different routes. Some are intended to dry up oily skin. Others are intended to moisturize healthy skin. Some are designed to arrest sebum production without drying the skin, which can be a great asset to those looking to take good care of their skin.
Antibiotics and steroids may be used as a treatment for severe acne. Said antibiotics will likely be taken orally, while the steroids are generally administered in the form of a topical cream. Steroids act as an immunosuppressant and prevent much of the body’s reaction to the clogged pores, which can nullify cysts and acne entirely. However, this is only appropriate for particularly stubborn cases of acne, and the use of antibiotics and steroids requires a prescription.
How do I know if I have Cystic Acne?
Cystic acne differs from acne vulgaris in that the resulting acneiform eruptions are far more visible.