Cystic Acne Information | Dermatology Education Cystic Acne Information Video
November 27, 2021

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Cystic Acne Information

Cystic Acne Introduction

Cystic acne is a severe form of acne. Cystic acne occurs on the face chest, back and upper arms. The cyst is a result of total disintegration of a comedo. Adjacent comedones may breakdown and fuse to create a large epithelial lined cyst. An abscess results from disintegration of the comedo and the abscess destroys surrounding follicles. Hemorrhage and purulent material accumulate. Surrounding glands and follicles are destroyed. Acute inflammation ensues and a foreign body reactions occur. Granulation tissue forms and scarring is the end stage.

An acne cyst is not a true cyst. True cysts are round structures lined by epithelium. The cyst fills with keratin and in most case enlarges and remains intact. Occasionally they rupture and exude their contents into the surrounding tissue. This stimulates an intense inflammatory reaction.

Cystic or nodular acne can be a devastating disease. It is not possible to predict which patients will develop this severe form of acne. Family history may be important. The disease lasts longer and is more intense in males. Cystic acne may evolve from papulopustular acne or may be explosive form the onset.

Large deep cysts may smolder and evolve into draining sinuses. These are seen primarily on the cheeks and neck. Epithelial lined tracks are submerged in the dermis. They accumulate blood serum and purulent material. The wall is poorly formed and easily ruptures. Purulent material exudes into the dermis and onto the surface and propagates this festering channel as it wanders through the dermis.