Teenage and Adult Acne Severe Acne

Severe Acne

Acne is a condition involving the sebaceous glands of the skin. These sebaceous glands surround each hair follicle and produce sebum, an oily substance, to lubricate the hair. The oil glands found in your hair follicles are stimulated to produce extra oil called sebum. This sebum, the hair and the dead cells on your skin cause bacteria to develop in your follicles, which in turn causes, the skin to become inflamed. Acne occurs in three degrees of severity- mild, moderate and severe.

There are four distinct types of severe acne:

Acne conglobata which is characterized by deep and sometimes large abscesses, inflammation, numerous blackheads which are large and widespread often occurring on the face, neck, trunk, upper arms and/or buttocks, scarring of the skin. In acne conglobata, inflammatory nodules form around multiple comedones, gradually increasing in size until they become infected. Deep ulcers may form under the nodules, leading to scars, and crusts may form over deeply ulcerated nodules. Burrowing abscesses commonly result in deep, irregular scarring. Acne conglobata can involve acne cysts, papules or pustules that do not heal, but instead rapidly deteriorate. Males are more likely to have acne conglobata; the age of onset is usually between 18 and 30 years

Acne fulminans is a sudden onset of severe inflammation. It appears suddenly in a person with inflammatory acne and is characterized by severe and often ulcerating acne lesions, fever, as well as inflammation and aching of joints, especially in the hips and knees.

Nodulocystic acne is a severe form of acne that is characterized by numerous deep, inflamed nodules and large, pus-filled lesions that cysts. Nodulocystic acne is an abnormal membranous sac containing a liquid or semi-liquid substance consisting of white blood cells, dead cells, and bacteria. Often very painful and they extend to deeper layers of skin. Acne cysts are nodules of inflammation. The cysts may arise from a papule or nodular acne lesion, or occasionally from a type of cyst that develops in the outer layer of the skin—a type of cyst not usually associated with acne. A cyst may appear to be filled with thick, yellow pus-like fluid. This is usually an inflamed and infected cyst. Nodulocystic acne is when nodules and cysts appear together.The severe inflammation can cause the acne to become very red or even purple. Scarring often results when the acne heals. Like a papule nodules are white and dome-shaped. Nodular acne is very severe and doesn’t respond well to many forms of therapy. Nodules are large, hard bumps under the skin's surface and can sometimes last for months. Scarring is common.

Gram negative folliculitis is an inflammation of follicles caused by a bacterial infection that can result from long-term antibiotic treatment. Patients who are being treated with antibiotics for severe acne may develop Gram negative folliculitis. The word "Gram" refers to a blue stain used in laboratories to detect microscopic organisms. Certain bacteria do not stain blue and are called “Gram negative.” In Gram negative folliculitis, the bacteria are resistant to many antibiotics. Isotretinoin, antibiotics and Acne-Ltd III are effective against Gram negative bacteria are used to treat this condition.