How can a cystic acne be treated without devastating the face? And advice about men's health on cystic acne and what is the best treatment for cystic acne?
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Cystic acne comes under acne vulgaris grade 4. The generation they present as large inflamed pus-filled nodules which later develop into cysts along with draining sinuses. Treatment of severe acne includes,
1. We need to counsel the patient that severe acne can be treated entirely within six to eight months of treatment with little scarring.
2. We can use a combination of oral antibiotics like Azithromycin 500 mg thrice a week initially for a minimum duration of six to eight weeks but can be continued maximum up to 12 to 14 weeks and oral Isotretinoin dose 0.5 mg per kg body weight to a maximum of 1 mg per kg body weight.
3. Isotretinoin is a retinoid which acts on all significant factors involved in the pathogenesis of acne vulgaris and helps in complete remission in most cases. Dermatologists can prescribe it, and a pregnancy prevention program like iPLEDGE should be followed. Signed consent should be obtained, confirming that the patient knows not to get pregnant during therapy and for four weeks afterward. A pre‐treatment pregnancy test and routine blood investigation like liver function tests, lipid profile is required, and monthly pregnancy testing along with LFT and lipid profile throughout treatment is advised.
The patient should be explained of minor effects of Isotretinoin, such as dryness and soreness of eyes, skin, oral mucosa, nasal mucosa, muscle aches and pains, hypertriglyceridemia. Mucocutaneous drying can be managed by emollients and tear substitutes. A rare complication of Isotretinoin therapy are pseudotumor cerebri, and benign intracranial hypertension with papilloedema has been reported when combined with oral Tetracyclines.
4. Initially, you can use oral steroids to reduce the flare of acne.
5. Atrophic scarring can be treated with laser resurfacing, dermal collagen injection like fillers. Hypertrophic scarring can be treated by chemical peels, microdermabrasion, intralesional Triamcinolone injection, and surgical excision.
Query: Hello doctor, I recently started getting cystic acne all over my cheeks and chin. I am 21 and I had never had any problem with acne until about nine months ago when this red, inflamed underground acne started occurring and mostly only on my cheeks. It has been five months since my last big flare up... Read Full »
Query: Hello doctor, I am 38 years old and I weigh 55 kg. l am having chest congestion and cold. The doctor prescribed me Azithromycin 500 mg for three days and Levocetirizine. I am asthmatic. I am also taking Foracort 400 twice a day whenever I have a breathing problem. My symptoms are not impr... Read Full »
Article Overview: Acne vulgaris or what is commonly known as pimples starts in teens. It leads to the lowering of self-esteem, decreased work capacity and some form of permanent scarring. There is a huge misinformation among parents and patients about the disease, thus leaving them perplexed as to how to deal with it. In this article, I have gathered the top 10 questions on acne to help both parents as well as patients to guide them to make informed choices on the issue. These, however, are general guidelines and patients are advised to consult a qualified dermatologist for treatment. Read Article
What Is Acne? Acne is a disorder of pilosebaceous unit found in the skin. Sebaceous gland is often associated with a hair follicle and is known as a pilosebaceous unit. The most important lesion in acne is a comedone. Besides, papules, pustules, and nodules are also found. In common terms, these ar... Read Article
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