Tests and diagnosis of cystic acne
Acne is diagnosed simply by examination – it is clear for a doctor to see, although there may be a need for closer examination to differentiate acne from other conditions such as rosacea.1
The doctor may ask questions (take a history) to confirm, for example, that the problem is not due to the use of drugs such as corticosteroids. The doctor is also likely to assess the psychosocial impact of severe acne – how it affects a person’s activity and mood.
Cystic acne is typically diagnosed when five or more cysts are visible in addition to over 100 comedones.1
Treatment and prevention of cystic acne
Treatment of severe, cystic acne requires the help of a specialist doctor and some self-care measures.3 Drug treatment is effective at preventing cysts and scarring
Whereas mild or moderate acne can be managed with the help of a primary care physician, severe acne that is characterized by nodules and cysts, and that risks scarring (or already shows signs of scarring) may need referral to a specialist, partly because the main drug treatment is tightly controlled.3,7
Benzoyl peroxide is a treatment available to anyone with acne of any severity, and is a treatment option for people with severe acne who are awaiting specialist treatment.8
Benzoyl peroxide is available directly from pharmacies over the counter (without prescription) in a number of formulations that may be applied to the skin. It has been a mainstay in the treatment of acne for over 50 years, and works by killing bacteria, particularly P. acnes, and breaking up comedones (it has mild “comedolytic” properties).8
Water-based and alcohol-based formulations of benzoyl peroxide are available, and the most appropriate form depends on skin type. Alcohol-based preparations have a drying effect, making these more suitable for people with oily skin.8
Benzoyl peroxide products, which include cleansing liquids and bars, lotions, creams and gels, are used once or twice a day.9 The most common side-effect is skin irritation, and allergies occur rarely.8
Practical measures to avoid making acne worse are useful for anyone with acne, including people with the most severe form of the condition:
- Do not wash too often – twice a day is enough, using a mild soap or cleanser and lukewarm water
- Do not scrub harshly when washing – avoid abrasive soaps, cleansing granules, astringents, or exfoliating agents
- Leave pimples alone since picking and squeezing is likely to worsen the acne
- Avoid using heavy makeup, choose water-based, non-comedogenic formulations, avoid oily formulations and make sure to remove make-up before bed.