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Subcutaneous acne

Subcutaneous acne

Subcutaneous acne: how do this type of acne develops?

Subcutaneous acne is a subtype of cystic acne, which is one of the most severe forms of acne. Luckily, this type is much rarer than acne vulgaris. Big, painful, red pimples (cysts) which form deep beneath the skin characterize subcutaneous acne. Typical rash appears when inflamed hair follicle bursts and all the content spreads into surrounding tissues. Consequently, deep, hard and painful cysts develop. Cystic acne is more advanced form of acne vulgaris. The main risk factors for development of subcutaneous acne are harsh skin peeling and exfoliations, picking your pimples at home, etc. This type of acne usually affects face, back, chest and shoulders. Males suffer from this disease more than females. However, facial lesions are commoner amongst women, especially on chin and along jawline.

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One of the contributing factors to the development of subcutaneous acne is hormonal imbalance, especially increased concentration of androgens (male hormones) in your blood. Other important triggers and risk factors include:

  • For women: menstruation abnormalities (for example, in polycystic ovary syndrome), pregnancy, hormonal contraceptives (especially those including only progesterone, for example, hormonal intrauterine systems). Some women suffer from hormonal cystic acne, which is a part of premenstrual syndrome. 
  • Stress
  • Comedogenic skincare products, synthetic clothing
  • Humidity, excessive sweating
  • Some medication, for example, glucocorticoids
  • Genetic predisposition

Subcutaneous acne treatment

Cysts severely damage your skin and heal in scars. For this reason, appropriate treatment has to be started as soon as possible. Do not try treating subcutaneous acne at home, as this may only worsen the situation. Dermatologist will evaluate the condition and prescribe proper treatment. If you want to get rid of cystic acne, you should follow these recommendations:

1. Appropriate daily skincare:

  • It is sufficient to wash your face twice a day. Use gentle facial cleansers and avoid hot water. Do not rub your face roughly. Do not use harsh facial scrubs, especially those with mechanic particles.
  • Do not touch or squeeze pimples as this may induce scaring and spreading of the rashes. Cystic acne scars are very noticeable and difficult to treat.
  • Avoid heavy, oil-based make up products. Instead, use water-based non-comedogenic products. Thoroughly wash your face and remove all make-up products before going to bed.

2. Topical treatment. Benzoyl peroxide is a substance used to treat every type of acne. It kills Propionibacterium acnes, which is known to take a vital part in acne formation. It is important to take some precautions while treatment with benzoyl peroxide is in progress. This agent makes skin more sensitive to sunrays, so you must use proper sunblock whenever you go outside.
3. Oral treatment. In subcutaneous acne cases, dermatologists usually prescribe oral treatment with retinoids. It is a first choice option for managing this type of acne. Retinoids affect almost every pathological process in pimple development- they suppress sebum production and decrease sebaceous glands in size. It is the only medication that minimizes risk of developing post-acne scars. Despite all these advantages, retinoids also have some drawbacks, for example, it is strictly forbidden to use retinoids when treating pregnant women as they are proved teratogens. Other side effects include chapped lips, dry skin and dry mucous membranes, liver damage etc. Female subcutaneous acne can be managed with hormonal contraceptives (which include both estrogen and progesterone). Advantages of birth control pills are their safety to use long-termly and effective suppression of sebum production. Last, but not least, antibiotics also aid in treating subcutaneous acne by killing responsible microbes and reducing inflammation.
4. Invasive procedures. Only dermatologists perform such procedures. Big cysts can be drained. In some cases, certain medications are injected into lesion to reduce inflammation and induce healing process.