Cystic acne is a type of abscess that is formed when oil ducts become clogged and infected. Cystic acne affects deeper skin tissue that forms more superficial inflammation from common acne. Cystic acne is most common on the face and typically occurs in the teenage years. Not only are cystic acne breakouts painful, but the extent of damage they are capable of inflicting often goes beyond the reach of topically applied products.

A bacterium, known as Propionibacterium acnes, is a normal denizen of the skin. This bacterium uses sebum as a nutrient for growth, therefore increases in follicles during puberty. It is said by the doctors that people with acne have more Propionibacterium acnes in their follicles than people without acne. Now after reading all this it is pretty clear that the root formation of acne is within the sebaceous follicle, which is basically a hair follicle with attached oil glands. Androgens increase sebum production markedly. Hence this is the reason why rate of cystic acne formation increases in puberty because the hormones increase the sebum production.

Sebum might not be that dangerous to form acne but what accelerates the process of acne is the event of the formation of an oil-duct plug, known as a microcomedone. Cells lining the duct of the sebaceous follicle peel off the side and combine with the oil to form a tight little plug. Behind this plug acne bacteria proliferate, metabolize the sebum, and create an inflammatory reaction. What happens is that the presence of bacteria attracts white blood cells to the follicle. These white blood cells produce an enzyme that damages the wall of the follicle, allowing the contents of the follicle to enter the dermis. Rupture of the plugged gland causes the cystic acne.

It is highly recommended that people with cystic acne should visit a dermatologist. If the patient is suffering from light to moderate cystic acne then he/she can

take antibiotics which have the tendency to kill the bacterium but approximately 30%-45% of today's cystic acne strains are resistant to one or more of the common antibiotics, making them useless. Additionally long-term use of antibiotics is associated with increased cancer risks. Many dermatologists these days give oral drugs such as Accutane and sulfa-based antibiotics for cystic acne. Oral antibiotics such as tetracycline and minocycline are also more effective for cystic acne because they work systemically. However, they can cause such side effects as photosensitivity (higher risk of sunburn), upset stomach, dizziness and skin discoloration, and must be taken for as long as four to six months.

If the patient is interested in using therapies to cure cystic acne then the most important therapy is the use of tretinoin (Retin-A). The reason for using this vitamin A is because it is a comedolytic. It thins the outer layer of skin and slowly over months reverses the formation of the keratin-sebum plugs, which lead to rupture of the sebaceous follicle but one of the side effects is that a persistent red flush is seen in many patients on Retin-A. Certain areas of the face, such as the chin, are easily irritated with tretinoin and the frequency of use might be limited to every two or three days until your skin gets used to it.

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