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What is Cystic Acne?

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Cystic acne does not begin as "cysts." This designation is given (Grade IV acne) after cysts have formed. The acne lesions in this form begin like all acne lesions and have the same factors involved. Specifically, there is an over production of sebaceous secretion, wax-like plugging of the hair follicle/sebaceous duct that traps a mix of bacteria (including P. Acne, S. Aureus, S. Epidermitis, and other surface flora).

This anaerobic environment is favorable for bacteria to multiply and cause the inflammatory process to commence. Bacterial enzymes proceed to break down the triglyceride lipids in sebum into free fatty acids. The body's normal response to this inflammation is to congregate white blood cells to combat the bacteria overgrowth leading to pustular/liquid debris.

At this point in time, cysts have not formed yet, but those individuals predisposed to cystic formation have a spreading to lateral and sub dermal areas outside the follicle. In patients with existing cystic acne, Reversion works quite well to prevent new lesions prior to cyst formation. After cystic acne has formed and developed walled-off spaces, surgical drainage is usually necessary along with systemic antibiotics to heal the bacterial infection and cyst/sinus tracts.