Cystic Acne

Professional makeup artist Jazmin has struggled with cystic acne since she was in the fourth grade. She says she has tried various treatments without success and ultimately learned how to hide her condition under layers of makeup. The disfiguring bumps have negatively affected her self-esteem, she says, and consequently, have impacted her professional life as well. She reached out to The Doctors in the hopes of finding a treatment that would allow her to finally have the confidence to leave her house without wearing makeup. The Doctors send Jazmin to board-certified dermatologist Dr. Glynis Ablon for a consultation.

Cystic acne, also known as acne vulgarus, is the most severe form of acne. It occurs when oil and dead skin cells build up deep within hair follicles resulting in boil-like infections. Characterized by red scaly skin, blackheads, whiteheads, pimples and nodules, the condition most commonly affects the deeper tissue of the buttocks, groin and armpits, although sweat ducts, the face, chest, back and upper arms and shoulders can also be affected.

Common causes

Dr. Ablon explains there are four common causes of acne:

  • Bacteria on the skin
  • Secretions of the face (e.g. an oily T-zone)
  • Sticky cells – skin cells that do not slough off normally and can and build up and become infected
  • Hormones

Factors that can trigger or aggravate a case of acne:

  • Medications, including drugs containing corticosteroids, androgens or lithium
  • Hormonal changes
  • Diet, including dairy products, carbohydrates, and foods that raise blood sugar

Sources: Mayo Clinic, WebMD

Treatment options

Dr. Ablon examines Jazmin and determines, based on the pattern and placement of the acne and Jazmin’s history of oral contraception use, that the underlying cause of her acne is not a hormonal imbalance. Therefore, Dr. Ablon recommends Jazmin begin a short course of antibiotics as well as topical treatments to counteract the other three common causes. 

Dr. Ablon's first course of action is to inject a low dose of cortisone into Jazmin's larger cysts to shrink them. She then gives Jazmin a beta-hydroxy acid peel, which will help increase skin cell turnover and reduce build up. Jazmin also receives LED light therapy, a cutting-edge treatment for acne that kills bacteria and reduces inflammation. Dr. Ablon says she will continue to treat Jazmin for the next four months, free of charge.

   

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