Severe Acne Symptoms and Causes

Acne conglobata is a chronic condition which usually appears in males between the ages of 18 and 30. The most common signs and symptoms include deep abscesses, inflammation, severe damage to the skin, and significant scarring. In acne conglobata, inflamed nodules (bumps under the skin) form around multiple comedones (blackheads and whiteheads). These nodules slowly become larger until they break down and discharge pus. Deep pockets may form under the nodules and leave indented and irregular (keloid) scars where tissue is missing; crusts may form over the deepest nodules.

The second type of severe acne, acne fulminans, comes on suddenly and creates an inflammation of the skin that can be highly destructive. Ulcerating blemishes appear along with fever and joint ache, especially in the hips and knees. At times, sufferers of acne conglobata who have had unsuccessful treatment can develop acne fulminans.

The third variety of severe acne, nodulocystic, is characterized by cysts which are otherwise uncommon in acne. These cysts may measure several centimeters in diameter and may occur one-by-one, or could be widespread over the face, neck, scalp, back, chest and shoulders. These lesions may be quite painful.

The cystic nodules may arise from an open or closed acne lesion. Inflamed and infected cysts may appear to be filled with thick, yellow pus-like fluid. Under no circumstances should the patient try to drain the cyst in front of the bathroom mirror. A physician’s office under sterile conditions is the best place to relieve the lesions, or else serious scarring and more widespread infection may result. Gram negative folliculitis, the fourth kind of severe acne, is an inflammation of follicles that can be brought on by long-term antibiotic treatment that results in bacterial infection. Patients who are being treated with antibiotics for severe acne may develop gram negative folliculitis. “Gram” is a blue stain used in laboratories to detect microscopic organisms. Certain varieties of bacteria that do not stain blue and are called “gram negative,” and are resistant to all but the most powerful retinoids or antibiotics.

Anyone with severe acne should be under the care of a dermatologist who possesses the experience needed to control virtually every case of acne. Severe, disfiguring forms of acne may require years of treatment and patients can experience one or more treatment failures.