Last reviewed by Editorial Team on August 13th, 2018.
What is Acne Conglobata?
This medical condition primarily affects Caucasian men between the ages of eighteen and thirty and can often last until they are forty years of age. It is the most severe form of acne a person can have. When a person has this form of acne it is often found on their neck, buttocks, thighs, tummy, back, and chest walls. It can even be seen on the face sometimes. Many times it will occur when the person also has an active acne condition and even to people who had acne that has subsided. It is also referred to as cystic acne, nodular acne, or nodulocystic acne.
Acne Conglobata Symptoms
- Acne conglobata will often start out as normal acne with blackheads that appear in groups of two or more with pimples forming around these blackheads.
- These are not your normal pimples but are large and filled with fluid.
- Many times they are sensitive to touch and painful.
- The lesions are usually highly inflammatory
- They will continue to grow and fill with fluid until they finally rupture into oozing painful lesions.
- Once they have drained they will fill up with fluid again
- After they have ruptured several of these nodules could fuse together to form bigger shapes.
- These lesions will remain for a long period of time and will form a scab in the center and continue to spread outwards
- When they finally heal they can leave one of two different scars. They can leave behind a keloidal which is a bump that is raised and is usually left behind after being cut or burned. The other type of scar can be a atrophic which is the type of scar that acne usually leaves behind. Most of the time the scars left behind is deep and irreversible and can cause disfigurement.
Some people may also experience psychological symptoms that can be significant because of the disfiguring scars that can occur. Some of these symptoms include anxiety, self-consciousness, and depression.
Exactly what causes acne conglobata is not known but there are different theories as to why it develops and primarily affects men. Some of the causes, or theories, include:
- A genetic disorder called PAPA Syndrome in which the person will later develop joint pain and severe skin infections possibly caused by inheriting an abnormal Chromosome 15. PAPA stands for Pyogenic Arthritis Pyoderma gangrenosum and conglobata acne)
- It can be inherited from either parent even if the parents have not shown any physical symptoms of acne conglobata.
- Using anabolic steroids
- Withdrawal of testosterone treatment or testosterone therapy
- Foods or medications that contain bromine or iodine. Some foods can included kombu or brown kelp that is popular in Japanese food dishes
- Having a tumor in your adrenal gland that is releasing a big amount of androgens
- Being in remission from some autoimmune disease like leukemia
- Overproduction of oils from your sebaceous glands.
If you think that you have acne conglobata it is best that you see your dermatologist as soon as possible to get a correct diagnosis of what you have and have a long-term treatment plan created to reduce your symptoms and try to help prevent deep scarring. The initial treatment for this medical condition would include prescription topical creams and antibiotic medications. Later in the treatment plan you will require stronger medications along with therapy techniques that are specialized for your condition.
Many times you will receive a prescription for an oral medication that is high strength called isotretinoin, also known as Accutane. These medications will help to prevent your sebaceous glands from producing an excessive amount of oils. Accutane is derived from vitamin A and is in a pill form. This treatment can last for as long as twenty weeks and if you take it for the full prescribed time you can have it go into remission for a long period of time. In some people this treatment will cure it completely while in others it will return. If you are a woman who has acne conglobata you should be aware that taking this oral treatment could trigger a miscarriage or cause severe birth defects. Your dermatologist may also combine it with the steroid medication Prednisone. You may also be prescribed antibiotics like Erythromycin or tetracycline.
You may also be given topical treatments to use in the morning and before you go to bed to help reduce breakouts. If you have a severe case you may use both the oral and topical treatment at the same time. Your dermatologist may suggest that you undergo laser and light therapy to lessen the appearance of any scars and to help reduce the size of the nodules. If there are large cysts you could have surgery to remove them and then graft healthy skin on the areas that are damaged.
Although it is not always possible to prevent this medical condition there are ways that you can reduce your chances for it developing. It is a good idea if you are prone to acne or have had acne conglobata before that you schedule regular appointments with your dermatologist in order to stop any acne conditions before they even start or to keep them from becoming worse. You should also make sure that you are bathing regularly. If you have oily skin you should avoid using any creams, lotions, or makeup that could make your skin oilier. You can also use over-the-counter topical creams.