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Date of last update: 10/18/2017.

Forum Name: Dermatology Topics

Question: Very large recurring acne cyst on face

 ikkyu - Thu Jul 08, 2010 9:52 pm


I am 26 years old, and used to suffer from severe acne as a teenager, for which I received treatment for several years of antibiotics and topical medications. I have for the most part outgrown the breakouts, but I still get recurring large cystic pimples on my face, almost always in the same location on either side of my nose, that are frequently the diameter of a dime, and take several weeks to reduce in size.

I can typically, but not always, feel the bumps under my skin before they become that large, and have been hesitant about attacking them for fear of making the inflamation worse. These occur maybe several times a year, and up until now I have attributed it to a kind of final flourish of my teenage acne, but now I see that it may be a lifetime issue that I will have to treat.

Is there any kind of regimen for physically eliminating these cysts? I believe they are something that has to be sugically removed by a dermatologist, but I was wondering if there is any way I can form a lifelong habit that will treat these cysts once they form, as prevention has been up to now impossible. Is there any kind of way to safely drain the cysts myself, without causing further infection, or is this something that I will always have to see a doctor for? I have recently begun taking Tetracycline, but if past behavior continues, these acne cysts continue to form, like I have a continual infection in the same location.

Thanks very much,
 Dr.M.Aroon kamath - Tue Jul 13, 2010 1:37 am

User avatar Hi,
What you are describing seem to be one of the following severe types of acne vulgaris.

- Nodulocystic Acne:

Cysts are an uncommon occurrence in acne. Nodulocystic form is characterized by "cysts" of varying sizes, some of which may be several centimeters in diameter.

Neighbouring cysts may coalesce, resulting in boggy, soft areas of skin undermined with tunnels. On-going cell destruction and inflammation, results in yet another form of severe acne - "acne conglobata".

Nodulocystic acne usually requires an aggressive approach in management usually consisting of isotretinoin and antibiotics, or intralesional corticosteroids. Some of the very large cysts that fail to respond, may require drainage and/or surgical excision.

- Acne conglobata:

is a chronic and severe form of acne vulgaris, characterized by:
- persistent low grade inflammation,
- Deep abscesses,
- Severe damage to the skin and
- considerable scarring.

In this form, inflammatory nodules form around multiple, conspicuous comedones, gradually growing in size until they break down and discharge pus or burrow deep to form deep abscesses. Severe scarring (keloidal scars) may ensue and crusting over deeply ulcerated nodules may be seen. Management is similar to that of nodulocystic acne (isotretinoin and antibiotics). Several courses of treatment may be needed over a period of years.Continued follow-up with one's dermatologist is recommended.

I do not think i am aware of or can suggest to you some 'Do-it-yourself' management.
Best wishes!

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