What is Cystic Acne?

The Structure of the Skin

This article was Medically reviewed by A. Michael, MD

The human skin is made up of two primary layers called the epidermis and dermis. The skin is the first line of defense and it serves as a barrier that protects the body by making molecules such as proteases, lysozymes, and antimicrobial peptides, all of which protect against invasion by bacteria.
The skin epidermis is the outermost layer of the skin and it does not allow microbes or potential toxins to get into one’s body. The dermal skin serves as the host for many other substructures such as hair follicles, sebaceous glands, apocrine and eccrine sweat glands. Due to this, the skin’s surface appears rough or uneven with many lines, ridges, as well as invaginations.

The sebaceous glands found within thicker skin produce sebum, which is filled into the hair follicle. Apocrine sweat glands give off 

a fatty material, while the eccrine sweat glands make a salty liquid which assists in maintaining the temperature of the body. Therefore, the skin is affected by many factors like pH, temperature, moisture content, sweating, as well as sebum content. All these factors make it a complex habitat that is the home for a large variety of microorganisms.
A pilosebaceous unit is a structure which contains a hair, hair follicle, the arrector pili muscle, and a sebaceous gland. The main function of this unit is to carry out transport of compounds across the skin’s natural barrier layer called the stratum corneum. The arrector pili muscle is a very small muscle linked to every hair follicle and the skin. When this muscle contracts, it makes the hair to stand up straight or erect and results in the formation of a “goosebump” on the skin.
Pilosebaceous units are found in every location of the body with the exception of the palms, soles, and the top area of our feet, as well as the lower part of the lip. The density of these units is higher on the face, chest, and upper neck, and this is why acne breakouts usually take place in these locations.

What Is Acne?

Acne vulgaris, also commonly known as acne, is the most prevalent skin disorder in the world. It is one of the most prevalent skin conditions observed amongst outpatient skin clinics in the USA and doesn’t have any particular affinity for any gender, ethnic group, particular race or color.
Acne is a long-term inflammatory disorder that affects the pilosebaceous unit, and can develop due to several reasons, such as:
Acne shows up with open, as well as closed, comedones and inflammatory lesions. Comedones are commonly referred to as blackheads and whiteheads, while inflammatory lesions are red patches on the skin with slight swelling and pain, which can be papules, pustules or nodules.
Acne’s primary lesions are caused due to the pores of the skin getting blocked by collection of oil mixed with dead skin cells and bacterial organisms. These lesions can usually be seen on the face, neck, upper chest, shoulders, and the back.

Different Levels of Acne

Acne’s spectrum ranges from mild to moderate to severe and is further subdivided as non-inflammatory or inflammatory.

Mild Form of Acne

Moderate Form of Acne

Severe Form of Acne

Different Types of Cystic Acne Lesions

Non-inflammatory acne lesions are also called whiteheads or blackheads and are made up of thickened, whitish to yellowish material that consists of debris originating from dead skin cells. Whiteheads, the common name for closed comedones, may develop and form inflammatory acne lesions.

Inflammatory acne lesions are also called papules, pustules, nodules, or cysts, and cause varying degrees of pain. When inflammatory acne progress to 

the cystic form, this kind of acne is termed as “cystic acne.”

Cystic acne lesions are seen in the form of pink cysts and may leave behind regions of discoloration which can persist from a few weeks to months.

Who Can Be Affected

Acne is known to be the most common skin disorder on a global scale. It has happened to 90% of the world’s population at some stage in their lifetime. Although epidemiologic studies show that acne can occur at any age, it usually shows up during puberty and continues to get progressively worse in adolescence.
Puberty and middle age: Acne has been found to mostly occur in people whose age falls between puberty and 30 years. Within this range, 79 to 95% of the people fall in the 16 to 18 years age group, while more than 81% of the patients fall in the puberty to 30 years age group.
Children: Acne has also been documented in young children, wherein 2 to 61% of affected children fall in the 10 years to 12 years age group. However, this skin disorder has also been documented in young children that fall in the four years to seven years age group.

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