According to many dermatologists and researchers there are four main types of severe acne, regarding the type of lesions that it creates on the skin and side effects on the patient, for example scarring. Beside the body, severe acne can affect the person’s social life causing stress, emotional and psychological disorder.
These are the types of severe acne.
1. Acne Conglobata
This is an extreme form of acne vulgaris which includes the appearance of large and numerous nodules along with widespread blackheads, inflammation and scarring. Acne conglobata is usually located on the face, back, chest, upper arms, buttocks and thighs.It occurs between 18 and 30 years of age and it usually affects males.
The exact cause of acne conglobata is unknown and the bad news is that it can stay active for a long time.
Isotretinoin (Accutane or Roaccutane) is a powerful drug usually prescribed for treatment of all severe acne types. It stops the excess oil production of sebaceous glands and assists your body to normally eliminate dead skin cells, protecting the skin pore from blocking.
Caution: Therapy with isotretinoin should be closely supervised by doctor or dermatologist, because the use of this drug can cause some very serious side effects like birth defects, depression, suicidal thoughts, hallucinations, severe headache, blurred vision, hearing loss, bone pain, etc. Less serious side effects are joint pain, back pain; dry lips and eyes, itching, rash, dizziness, nosebleeds, etc.
2. Acne fulminans
This type of acne is actually a rapid oncoming of acne conglobata. It typically affects young men. The symptoms are nodulocystic, oftenulcerating and painful acne that can eventually develop into the disfiguring scars.
What makes this severe acne different than other acne are symptoms like fever, painful joints, particularly the knees and hips. Varying degrees of weight loss is also common, but that may vary depending on the individual.
Acne fulminans is usually treated with Isotretinoin (Accutane) because antibiotics do not help.
3. Gram-negative folliculitis
Gram-negative folliculitis is a rare and extreme type of acne caused by increase of gram-negative bacteria, like Escherichia coli, Pseudomonas aeruginosa, Serratia marcescens, Proteus mirabilis and Klebsiella. Also, it could appear as a result of long term antibacterial treatments in patients with acne vulgaris or rosacea.
This is a rare condition, just like other forms of severe acne, and still not recognized whether it is more typical for females or males. The term gram-negative relates to a type of blue stain used for laboratory testing. Bacteria that don’t stain blue are known as gram-negative.
Once again, Isotretinoin (Accutane) is often prescribed for gram-negative folliculitis treatment, combined with systemic antibiotics such as cephalosporins.
4. Pyoderma Faciale
Pyoderma Faciale, aslo known as Rosasea Fulminans, is severe facial acne with large painful nodules, pustules and sores which can cause scarring. This type of acne affects only women between 20 and 40 years of age. This type of severe acne usually forms very quickly and may even occur on the face of a woman who never had acne before.
It is not associated with oily skin and it does not arise from comedones. Although pyoderma faciale does not last longer than one year, it can cause serious damage on the skin in a very short period of time.
Combined use of Isotretinoin (Accutane) and systemic or topical steroids is usually prescibed for pyoderma faciale. These steroids are usually used in fight with severe acne for decreasing the inflammation and infection. It should be noticed that long-term use of this steroids use can also cause some serious side effects.