Severe acne can involve many facets of anyone’s life. This causes a great deal of embarrassment and stress. Severe acne might significantly limit person’s social life and can also interfere with chances for employment. Since the condition can be disfiguring and needs years of treatment, it is very essential to see a specialist. Dermatologist has the most experience to treat the different types of severe acne.

Severe Acne is nothing but stubborn acne that has not responded to many treatment methods. They are the ones that require special attention. However, there is mix opinion about what exactly is severe acne but generally, they are of four types.

1) Acne conglobata, 2) Acne fulminans, 3) Gram negative folliculitis and 4) Nodulocystic acne

Acne Conglobata : It is a chronic and severe form of acne vulgaris that is featured by deep abscesses, swelling, severe damage to the skin and scarring. The blackheads (open comedones) here are generally conspicuous and widespread that frequently occur on the face, neck, chest, upper arms and/or bums. There are some inflammatory nodules that build around multiple comedones, eventually increase in size until they breakdown and discharge some pus. Deep ulcers might form underneath the nodules and this might lead to keloid-type scars.

Treatment : Isotretinoin is the general though very effective treatment of choice for acne conglobata. Antibiotics might also be prescribed and several courses of therapies may be needed over a period of years. Even after effectual treatment, the person should have regular medical examination by a dermatologist for any hints of recurrence.

Acne Fulminans : This kind of severe acne is very sudden in onset that generally features highly destructive inflammations. Such condition appears suddenly in a patient with inflammatory acne and is featured by often ulcerating acne with moderate to high grade of fever. It also has inflammation and aching of joints, especially at buttocks and knees. A person who has developed acne fulminans might have had unsuccessful remedy for another kind of severe acne, acne conglobata.

Treatment : It is nothing but corticosteroids or non-steroidal anti-inflammatory drugs – NSAIDs. They are given to reduce inflammation. Attacks of acne fulminans might recur, and a person may develop acne that would require long-term treatment with isotretinoin.

Nodulocystic Acne : Here, the cysts are relatively uncommon in such acne type. Nevertheless, this form of severe acne is featured cysts that might measure several centimeters in diameter. The cysts might occur singly, or might appear widespread onto the face, neck, scalps, back, torso and shoulder. And, they might be painful. The nodular cyst of acne is not exactly or typically a cyst, which is an abnormal dilatation of a normal skin structure. Acne cysts are nodules that are swollen. The cyst arises from a papular or nodular acne lesion, or from time to time, from a type of cysts that develop in the outer dermal layer—a type of cyst not generally linked with acne.

Cysts occurring close together may combine and produce soft areas undermined with small channels, cells’ wiping out and swelling, that results in another form of severe acne, acne conglobata.

Treatment: Nodulocystic acne generally involves some aggressive treatment regimens that might include isotretinoin with some broad spectrum antibiotics, or intralesional corticosteroids that can melt-down the cysts over a period of one week approximately. Some of the large follicular cysts that don’t respond to medicines may require drainage and/or surgical incisions.

Gram-negative folliculitis : This is an inflammation of follicles that are made up of bacterial infection that might have resulted from long-term antibiotic treatments. Patients who are being cured with antibiotics for severe acne might develop Gram negative folliculitis. The word Gram cites to a blue stain that is used in labs for detecting microscopic organisms. Some of the bacteria that don’t stain blue and are labeled as Gram negative.

Treatment : In this, the bacteria are immune to many antibiotics. Isotretinoin and antibiotics that are effectual against Gram -ve bacteria are used to treat such conditions.

Any person with severe acne must be under the care of a dermatologist as dermatologists are experts in this field. In any case of severe acne, homemade remedies or natural remedies cannot be considered as first line treatment. However, they are proven to be favorable in case of mild to moderate acne and in prevention of the acne.