Acne is a relatively common skin condition that affects many people, especially teenagers around the age of puberty and after.  It typically consists of whiteheads, blackheads, pustules and papules, and inflamed red lesions, all more commonly referred to as pimples or zits. 

Acne Vulgaris

Acne vulgaris, as it is formally known, and its symptoms can range from mild to moderate to severe.  The most  severe form of acne vulgaris is cystic acne or nodulocystic acne.  The symptoms of cystic acne include deep, inflamed breakouts on the face and/or other parts of the body, such as the back or buttocks.  The blemishes tend to be deep and painful and they can become quite large, sometimes even as much as a few centimeters across. 

Cystic Acne

While all acne can become severely inflamed, it is only considered cystic acne if the individual actually develops cysts or nodules.  Cysts are typically much more serious and much more painful than a typical pimple.  A cyst feels like a soft fluid-filled lump underneath the skins surface.  A nodule is a hard, painful and inflamed bump underneath the surface.  Nodules are much larger than a typical papule and they form deep within the skin and they take a very long time to heal. 

Dermatologist

If you have acne that is this severe it is important to consult with a dermatologist.  He or she can recommend and prescribe treatments that can actually be helpful.  The majority of over-the-counter medications are not strong enough to treat this type of severe acne.  It is extremely important to avoid picking at your acne as this can make the infection spread further.  It can also cause bleeding and more inflammation.  Cystic acne is extremely prone to scarring and this is something you will want to avoid if at all possible.  The scar removal creams and lotions that are available over the counter are not usually effective with the scarring that comes from cystic acne so it is crucial to do whatever you can to avoid scarring.  If you do develop permanent scarring, often the only effective treatment is plastic surgery procedures such as peels.  Many people who have developed scars from cystic acne have those scars to contend with for the remainder of their lives. 

Cystic acne can affect anyone at any age but it is most common in teenage boys and young men. Acne tends to be hereditary and cystic acne is even more so.  If your parents suffered from cystic acne it is far more likely that you will to.  Cystic acne is not caused by a lack of proper cleansing, a poor diet, or eating too many french fries.  Cystic acne is typically caused by the same things that cause ordinary acne.

Overactive Glands

Acne and cystic acne are caused by overactive oil glands, excessive dead skin cells within the hair follicle or pore, and large numbers of acne-causing bacteria or Propionibacteria acnes.  Inflammation makes acne worse and more painful and it is usually caused with the follicle wall ruptures and leaks infected material into the dermis.  Deep breaks in the follicle cause the deep and painful lesions associated with cystic acne.  Nodules can develop when the contaminated bacterias infects the adjoining pores and follicles. 

Nodulocystic acne is a serious condition.  It can damage and destroy healthy skin tissue and the likelihood of developing scars is very high.  Trying to pop a cyst or a nodule, as you would a normal pimple should be avoided as it will just exacerbate the condition by spreading the infection.  This types of acne needs to be treated aggressively under the care of a qualified dermatologist to limit the severity of potential scarring.

Cystic Acne Treatments

This type of severe acne can be extremely difficult to control and you may need to try a few different treatments or combinations of treatments before you see results.  Treatments can include oral antibiotics, isotretinoin, which is a powerful drug developed just for the treatment of acne.  Oral contraceptives can sometimes be helpful for women but they are not effective or even prescribed for men.  Occasionally the doctor may do some surgical excisions and drainage on the worst lesions.  They may also do intralesional corticosteroid injections directly into the lesions to reduce inflammation and shrink the blemish. 

You can try a home treatment for cystic acne, however, cystic acne is a painful condition and one that needs to be aggressively treated.  If you have this condition you need to contact a good dermatologist and design a treatment plan for your specific acne problems.