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Acne therapy can continue for months and even years. Patients who conscientiously follow the prescribed regimen greatly increase their chances for improvement and the prevention of permanent scarring and pitting of the skin.
When acne has left permanent, disfiguring scars, there are medical techniques that can remove or improve the blemishes. One method is planing with a rotary, high-speed brush. This removes the outer layer of pitted skin, leaving the growing layer and the layers containing the glands and hair follicles. New epithelium grows from the layers underneath; it is rosy at first and gradually becomes normal in color. The technique has also been used successfully in removing some types of disfigurations resulting from accidents. This so-called “sand-paper surgery” or dermabrasion is recommended only for selected cases of acne and results are not always satisfying.
Laypersons often are misinformed about the cause and effects of acne. It is not a contagious disease, nor is it due to uncleanliness or poor personal hygiene. It is not caused or made worse by lack of sleep, constipation, masturbation, venereal disease, or by anger or hostility. Dietary indiscretion can sometimes contribute to the appearance of lesions, but there are very few people who can find a cause-effect relationship between certain foods they have eaten and the appearance of acne lesions. In general, cola drinks, chocolate, and fried foods need not be restricted or eliminated from the diet in hopes that acne can be avoided or cured. A well-balanced diet is all that is recommended for the management of acne.
Scrubbing the skin and using harsh soaps is not recommended because this only serves to damage the skin and predispose it to breakdown. A mild soap is as effective as special medicated soaps. If the hair is excessively oily, it may help to shampoo regularly and keep the hair off the face.
Pimples and pustules should not be squeezed. This can press the sebum and accumulated debris more firmly into the clogged duct and increase the chance of inflammation and the spread of infection. Blackheads and whiteheads are best removed by applying a prescription medication that causes peeling of the skin.
Since the management of acne can go on for years, requiring periodic evaluation by a dermatologist, patients and their families will need continued support and encouragement. Patients taking prescription medications will need to know the expected results, any adverse reactions that might occur, their symptoms, and to whom they should be reported.
pyoderma gangrenosum and
Lab Hypogammaglobulinaemia, elevated tumour necrosis factor-alpha
Management Intra-articular corticosteroid therapy, methotrexate, colchicine
cystic acneMutilating acne Dermatology A form of acne vulgaris which may affect teenagers, 2º to bacterial infection of clogged sebaceous ducts deep in the skin Management Antibiotics, isotretinoin Prognosis Untreated CA may result in scarring. See Acne vulgaris.
cys·tic ac·ne(sis'tik ak'nē)
Isotretinoin, a vitamin A derivative, has been effective in treating this condition. For Caution concerning its use, See: isotretinoin
Patient discussion about cystic acne
Q. would bipolar and severe cystic acne have anything to do with the other? I am 22 years old and was diagnosed with bipolar about 3 1/2 years ago and have been on and off meds since then. Since 5th grade I have dealt with acne. I have had stages where it has cleared up and then come back. For about one year now it has been cystic and now it's worse than it has ever been. It is extrememly painful. What the heck is going on?