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Saturday, December 2, 2023
Severe And Worst Acne Types – Symptoms And Treatment – Part 2

Severe And Worst Acne Types – Symptoms And Treatment – Part 2

Posted in: Acne
Sat, Feb 25, 23, 11:59, 10 Months ago
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Acne can be a frustrating and difficult condition to deal with, and there are several types of acne that can be particularly challenging to treat. Some of the worst types of acne

In this part 2, let's learn about the symptoms and treatment options for severe acne.

Symptoms and treatment for Acne conglobata

Acne conglobata is a severe form of acne that causes nodules, cysts, and abscesses to develop on the skin. It commonly affects the face, chest, and back, and can be painful and disfiguring.


  • Large, painful nodules and cysts that can last for weeks or months
  • Blackheads and whiteheads that are difficult to clear
  • Pus-filled lesions that may be accompanied by scarring
  • Tenderness and soreness of the affected areas
  • Interconnected tunnels under the skin may leak fluid


  • Isotretinoin: This medication is a powerful retinoid that can reduce sebum production, prevent acne formation, and reduce inflammation. It is often used in cases of severe acne, but it has potential side effects, such as dry skin, hair loss, and liver problems.
  • Topical retinoids: These creams and gels containing retinoids such as adapalene, tretinoin, and tazarotene help unclog pores and reduce inflammation.
  • Antibiotics: These drugs can help control the bacteria that contribute to acne inflammation, especially if the patient has signs of bacterial infection. Topical antibiotics such as clindamycin, and erythromycin or oral antibiotics such as tetracycline, doxycycline, and minocycline may be prescribed.
  • Corticosteroids: These drugs can be used to reduce inflammation and pain associated with severe acne. They are often injected directly into the affected area, and used for a short period of time.
  • Chemical peels: These treatments involve applying a chemical solution to the skin to remove the top layer and stimulate collagen production. This can help reduce the appearance of acne scars and improve the texture of the skin.
  • Extraction: This procedure involves removing large, painful acne cysts and nodules. It should only be performed by a dermatologist to avoid causing further damage to the skin.

It's important to note that treatment for acne conglobata can take several months or even years, and may require a combination of different therapies.

Symptoms and treatment for Acne Fulminans

Acne fulminans is a severe type of acne that typically occurs in adolescent boys. It is characterized by the sudden onset of highly inflammatory nodules and pustules on the face, chest, and back, along with fever and joint pain.


  • Sudden onset of highly inflammatory nodules and pustules on the face, chest, and back
  • Fever
  • Joint pain
  • Muscle aches
  • Weight loss
  • Enlarged lymph nodes
  • Erosive lesions with scab formation


  • Systemic corticosteroids: This is the first-line treatment for acne fulminans. High-dose oral corticosteroids are given to reduce inflammation and improve symptoms.
  • Isotretinoin: This is a powerful medication used to treat severe acne. It is typically given after the initial inflammation has been controlled with corticosteroids.
  • Antibiotics: Antibiotics may be prescribed to treat secondary bacterial infections.
  • Non-steroidal anti-inflammatory drugs (NSAIDs): These medications can help reduce joint pain and muscle aches associated with acne fulminans.
  • Supportive care: Patients with acne fulminans may require hospitalization for supportive care, such as hydration, nutritional support, and pain management.

Patients with severe acne should see a dermatologist for an individualized treatment plan.

Symptoms and treatment for Gram-Negative Folliculitis

Gram-negative folliculitis is a bacterial infection that can occur in people who have been treated with long-term antibiotics for acne. It is caused by bacteria such as Escherichia coli, Klebsiella, Pseudomonas, and Proteus.


  • Pimples that are inflamed, puffy, and aching
  • Lesions that may appear anywhere on the face or body
  • Itching or burning sensations
  • Scarring or hyperpigmentation after healing


  • Antibiotics: Gram-negative folliculitis is treated with antibiotics that target the specific bacteria causing the infection. Commonly prescribed antibiotics include tetracyclines, macrolides, and fluoroquinolones.
  • Topical therapies: Topical creams or ointments containing antibiotics or antiseptics can be used to treat mild cases of Gram-negative folliculitis.
  • Isotretinoin: This medication is a potent acne medication that can be used to treat Gram-negative folliculitis in severe cases.
  • Moisturizers: To prevent further irritation of the skin, the use of a gentle, fragrance-free moisturizer may be helpful.
  • Good skin hygiene: It is important to maintain good skin hygiene by washing the affected area with a mild cleanser and avoiding touching or picking at the lesions.

It is important to consult with a dermatologist to determine the best treatment plan for Gram-negative folliculitis.

Severe acne can be frustrating but manageable. Take time and work with a dermatologist, and follow the treatment plan committedly…..Never give up! 


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