Types of Severe Acne 

Severe Acne can cause a lot of problems in a person’s life. This can be a source of  embarrassment that can lead to the decrease of a person’s confidence and self-esteem. All the more if the acne has become more serious.

Damages that can be caused by severe acne can greatly affect all the facets of a one’s life. Severe acne requires to be consulted to a specialist because it is a serious problem that may lead to permanent damage on your skin.  

Not every person has severe acne, but some can experience one of its four forms. Severe acne has four types in general. They are: acne conglobata, acne fulminans, gram negative folliculitis and nodulocystic acne. Each type will be discussed in detail below. 

Acne Conglobata

Acne conglobata is characterized by deep abscess, inflammation, and scarring. Pain is usually experienced and is sometimes manifested with boils that discharges pus. It is often seen in the torso. This happens initially from blackheads that have inflammatory nodules that are formed around multiple comedones. These increase in size that eventually discharges pus.

Scars can be developed because of the deep ulcers formed beneath the nodules. Men have a  larger probability of acquiring acne conglobata than women; it is usually found in people who are 18 to 20 years old.

Usually, this can be treated by Isotretinoin with antibiotics. Scars caused by acne conglobata can also be treated. Recurrence is possible so a regular checkup to the dermatologist is suggested. 

Acne Fulminans

This is a severe form of acne conglobata. Acne fulminans is characterized by ulcerating nodules accompanied by fever.

Other symptoms include sudden appearance with weakness and joint pains especially on the hips and knees. Since there is a fever, which is a sign of infection, the number of white blood cells tends to increase.

It can be treated with isoretinoin, antibiotics, steroids, and anti-inflammatory agents. Taking of the hormone testosterone is contraindicated when you have acne fulminans for it may cause an outbreak. Like acne conglobata, it can also recur so a dermatologist’s management is advised. 

Gram Negative Folliculitis

Considered a dangerous type of severe acne, gram negative folliculitis has a very deep shape and size. This affects the follicles and is usually caused by bacterial infection, usually Pseudomonas aerugniosa and E.coli. This happens when the hair follicles are clogged that will eventually become inflamed, which causes a lot of pain in the area. This can be infected with bacteria and will create pus.

The treatment includes isotretinoin and antibiotics that can eliminate gram negative bacteria. Deep scars are the end results if not treated correctly, so a dermatologist’s experience is suggested to treat this.  

Nodulocystic Acne

Nodulocystic acne, as the name suggests, is characterized by cysts. This may affect the face, neck, chest and other body parts.

This can be very painful and causes inflammation on the skin. The cysts develop from papule or nodule acne that contains thick and yellow pus. This type is uncommon but is very serious.

A dermatologist’s expertise is needed to drain out the fluid inside it. The usual treatment for this is insotretinoin and antibiotics. Aggressive treatments like surgery (surgical excision or drainage) and intralesional steroids are done in case the isotretinoin and antibiotics did not work.