Cystic Acne
Definition
Cystic acne is the most severe form of acne, characterized by large, deep, painful, inflamed breakouts that form beneath the skin's surface. These cysts are filled with pus and can be several centimeters in diameter. Unlike surface-level pimples, cystic acne affects deeper layers of the skin and is more likely to cause permanent scarring. It is primarily driven by hormonal factors — particularly androgens — that increase sebum production and inflammation. Cystic acne is most common during puberty, menstrual cycles, and in conditions like polycystic ovary syndrome (PCOS). Over-the-counter treatments are rarely effective; dermatologists typically prescribe oral medications like isotretinoin (Accutane), hormonal therapies (spironolactone, oral contraceptives), or oral antibiotics. Professional treatments and early intervention are important to minimize scarring.
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