How to manage cystic acne that has spread on popping?

Hi,

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I understand your concern. Treatment of acne depends on the grade of acne. Cystic acne requires oral Isotretinoin capsules (strength of Isotretinoin depends on your body weight and the number of cysts) or injection of Triamcinolone into the cyst. For an accurate diagnosis of both problems, you need to visit a dermatologist. I am very sorry I cannot prescribe you any medication without having seen your clinical picture. Please attach your clinical picture along with your query so that it is convenient for me to comment on your condition and suggest proper medications. However, let me give you some information regarding acne. Acne is a disorder of the pilosebaceous unit, pilo-hair, sebaceous- oil-producing gland. These pilosebaceous glands are densely distributed over the face, neck, chest, back, shoulder, and arms. It also has a genetic component, meaning the appearance/ severity of acne depends on the genes of the parents. Sebaceous gland produces oil that is expelled out through the duct, which opens on the skin surface. As long as this duct is intact, oil flows freely out onto the skin. If there is any blockage in the duct, the oil cannot come out, then it starts irritating the surrounding skin and causes comedone (black and white heads). Our skin has a harmless commensal bacteria called Propionibacterium acne (P acne). This bacteria acts on the oil collected inside and causes inflammation leading to red bumps, pustules, and cysts or nodules as it progresses. If acne is not treated on time, it will leave scars. Hormones have a strong effect on acne. Increased androgen hormone can cause thickening of the wall of the duct, leading to its blockage causing comedones (black and white heads). PCOD or PCOS - Polycystic ovarian disease or syndrome is the most frequent hormonal disease causing acne in teenagers as well as adult women. External or Emotional factors: Hot and humid climate, causing increased sweat, can clog the pores. Application of oil/oil-based cosmetics/ steroid cream are other causes of acne. Psychological stress is one of the important factors in acne. Yet I would like to mention a few general acne skin care tips here, face wash. Wash your face with mild cleansers like Cetaphil cleanser if your face is dry, or use Benzoyl peroxide face wash if your face is oily. Wash your face three times a day to remove excess oil and dust which accumulates over time on the face. Sunscreen. Use a good sunscreen with SPF 50, and apply it to the whole face 30 minutes before you step out, irrespective of the presence of sunlight. Ultraviolet (UV) rays will always be there during day hours (even if cloudy). Apply every four hours for maximum benefits. This is because sunscreen can protect your skin from UV rays for four hours. Hence you need to repeat every four hours. Always use non-comedogenic sunscreen. Do not pick or squeeze your acne. It will leave dark pigmentation and scars, which are even more difficult to treat. Regular physical exercise. Very much essential to keep hormones under check. Exercise for at least 40 minutes a day, six days a week. No oil massage. Avoid oil massage to the scalp, and it will aggravate dandruff. If there is oil flow on the facial skin, it can clog the pores leading to comedones. Vitamin and water. Eat vitamin A-rich fruits and vegetables like papaya, mango, musk melon, pumpkin, carrot, and beetroot - these have beta carotene in them, a good antioxidant- very much helpful for healthy skin. Drink two to three liters of water per day. This keeps the skin hydrated. Cosmetics. Always use water-based cosmetics which have the "non-comedogenic" label on them. Stress mangement. Stress (mental as well as physical) causes acne breakouts. Meditation is very helpful for controlling mental stress. No waxing of hairs on the face. Waxing irritates hair follicles and can aggravate pimples. However, threading to remove unwanted hairs over the face is fine. Threading has no effect on acne. Never use steroid creams. Steroid causes very bad acne, and it makes the skin very thin and sensitive. Avoid over-the-counter (OTC) steroid creams like Betnovate (Betamathasone and Neomycin) and Panderm (Clobetasol, Miconazole, and Neomycin). Hope this piece of information is helpful for you. Kind regards.