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Acne is a common skin condition that affects most people at some point in their lives. It’s characterized by the appearance of spots on the skin, particularly the face, back, and chest. While many people experience acne during their teenage years, it can persist into adulthood and develop into severe acne.

Severe acne is often more than just a cosmetic concern. It can lead to psychological distress, including feelings of embarrassment, depression, and low self-esteem, which can impact quality of life.

What is Severe Acne?

Severe acne, also known as nodulocystic or cystic acne, is a more intense form of regular acne. This condition is characterized by inflamed cysts and nodules that appear on the skin’s surface. These blemishes are larger and deeper in your skin compared to regular acne, and they may be painful. Cystic acne is the most severe form of acne and carries the risk of permanent scarring if not treated promptly and effectively.

The main cause of severe acne is the overproduction of oil, combined with a buildup of dead skin cells. These substances can block the pores, providing a suitable environment for propionibacterium acnes (P. acnes), the bacteria that contribute to the development of acne.

How is severe acne treated?

Treatment of severe acne often requires a more intensive approach compared to mild or moderate acne. Over-the-counter creams and lotions containing salicylic acid, benzoyl peroxide, and retinoids may not be effective for severe acne. In such cases, it may be necessary to consult a dermatologist who can prescribe stronger medications.

Oral antibiotics, topical creams, or even isotretinoin, a powerful acne medication, may be prescribed. In some cases, dermatologists may recommend procedures like laser therapy, chemical peels, or steroid injections.

Keeping your face clean and not picking, popping or squeezing the acne can also prevent it from getting worse and reduce the risk of scarring.

Severe Acne and Hidradenitis Suppurativa

In some cases, severe acne may be confused with

hidradenitis suppurativa

, a chronic and debilitating inflammatory skin condition that affects hair follicles in sweat glands. Unlike severe acne, hidradenitis suppurativa causes painful lumps that can burst and drain foul-smelling pus. Furthermore, hidradenitis suppurativa can cause tunnels under the skin and lead to significant scarring.

Since hidradenitis suppurativa and severe acne may appear similar, accurate diagnosis is critical. Dermatologists will be able to differentiate between the two conditions and propose a suitable treatment regime.

Hidradenitis Suppurativa Treatments

While there is currently no cure for hidradenitis suppurativa, several treatments are available to help manage the symptoms and prevent complications. These include antibiotics, pain relievers, and medicines that reduce the immune system’s action. Nowadays, several emerging therapies, such as hormonal therapies and biological medicines, have shown promise.

Similarly, lifestyle changes, such as maintaining a healthy weight, avoiding tight clothing, quitting smoking, and adopting good hygiene practices, can help reduce symptoms.

It’s essential to remember that choosing the right treatment for either severe acne or hidradenitis suppurativa should be tailored to the individual needs and circumstances of the patient and carried out under the supervision of a skilled dermatologist.

Though managing severe acne or hidradenitis suppurativa can be challenging, many effective treatment options can help control symptoms, minimize psychological distress, and enhance quality of life.

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