Cystic Acne Cases and Acne Scars

Cystic acne is the severest form of acne. This is an early case with a

moderate number of lesions confined to the face. Comedones are also

present. A few shallow scars are in the same field.

Here the lesions are more extensive. Some cysts have broken down,

drained to the surface and crusted. Many shallow and pitted scars have

formed.

Cysts have expanded into surrounding tissue and destroyed other

follicles to form even larger cysts. These cysts may drain to the

surface or remain fixed in the dermis. They are slow to resolve and

will eventually scar. Cysts may expand or join with adjacent cysts to

form sinuses tracts.

A large sinus track has persisted for months. This channel contains

blood, purulent material and serum. It heals slowly, tends to recur and

will leave a large, long, shallow scar.

Cystic acne occurs frequently on the back and chest. Lesions are most

often found on the upper back. The extent and intensity varies.

Comedones, papules, pustules and cystic lesions appear in the same

field. This patient had involvement of the entire back and chest.

The potential for scaring varies. Some patients seem to have little

scarring even after the resolution of large cysts while others may

develop large thick hypertrophic or keloidal scars.

Scarring on the face tends to be pitted or wide, shallow and red. It is

unusual to see hypertrophic or keloidal scars on the face. These scars

become less shallow and the redness fades after several months.