Acne, in its severe form, can disfigure the external appearance as well as shatter one’s mental stability. Therefore, although very rare, severe acne is really the greatest challenge and hardship for the victims. This type of persistent skin eruptions are generally characterized by inflammations, deep cysts, scarring, or extensive skin damage. And therefore their treatment is rather specific and equally tough to handle.
Types of Severe Acne
The severe form of acne has five different variations which are differentiated from one another in terms of their characteristics:
1. Acne conglobata
This is a severe variation of acne vulgaris, the most common form of acne. The main features of acne conglobata are multiple big lesions or deep abscesses. These lesions might sometimes be interconnected and also contain a few blackheads or open comedones.
In fact the nodules take shape comprising a few open comedones and start gaining size and finally rupture. Inflammation or accumulation of pus is a very common phenomenon of severe acne. Risk of extreme, irrecoverable damage and disfigurement of the skin remains prevalent which might ultimately lead to horrible permanent scarring.
Stringent cases of acne conglobata might carry an initial history of untreated and worsened instances of papules, pustules, and cysts. Males, between the age group of 18 and 30, are more likely to suffer from acne conglobata than females. The actual reason behind this type of acne is still unknown.
The commonest treatment procedure of acne conglobata involves the application of isotetrinoin or Acutane. However, other antibiotics are also prescribed depending on the case history. Since it is not an easy procedure, there might be a requirement of quite a few prolonged remedial sessions and the patient must try to remain calm till it is over.
2. Acne fulminans
Acne fulmians is another type of severe acne which emerges abruptly and suddenly.
The nature of this type of acne is much like acne conglobata with an exception that their onset is highly unpredictable and inflammatory since the beginning. The severity might even lead to ulcerous eruptions.
Young men usually get afflicted by acne fulminans. Extreme disfigurement and scarring are very common as with acne conglobata. It is also characterized by fever and joint pain. Surprisingly it is found that more than often people with an unsuccessful treatment history of acne conglobata are highly prone toward acne fulminans.
Unlike acne conglobata, the remedial procedure of acne fulminans, however, does not work well with antibiotics. Corticosteroids or nonsteroidal anti-inflammatory drugs are used quite often as good remedial substances. Risk of recurrence is highly prevalent in this form of severe acne which might again require a prolonged medication procedure involving isotetrinoin.
3. Gram-negative folliculitis
Cysts, papules, or pustules are sometimes formed as a side effect caused by prolonged consumption of antibiotic drugs. The follicles are swollen by bacterial infection and formation of lumps and cysts are quite likely to happen under such circumstances. And this can even occur as an outcome of long-drawn antibiotic treatment course of acne conglobata.
The bacterial growths in gram-negative folliculitis are typically non-responsive to many antibiotics. And for this reason they are often treated by isotetrinoin or some particular antibiotics to which they respond well.
4. Nodulocystic acne as Severe acne
This is another type of severe acne which is typically characterized by formation of one or more large cysts which might be of larger size. Usually these lesions are painful and inflamed. However, the nodulocystic acne are not true cysts, rather they are formed as an effect of anomalous dilatation of regular skin structure.
A rigorous treatment involving isotetrinoin and antibiotics is generally followed in such cases. Intralesional corticosteroids which are able to melt the cyst within 5 or 6 days are also used extensively to do away with the nodules. Sometimes surgical remedies might also be essential depending on the complexity of the nodule formation.
Regardless of any issues, severe acne should always be treated by some experienced dermatologist. Tasting any kind of oral or topical drugs and even other remedial measures to heal them should be strictly avoided. Patience is a major question in treating such acne since the treatment procedures might involve several prolonged sessions and no one can guarantee any means to stop further reappearance.