Acne conglobata is the most severe form of acne vulgaris – it is a highly inflammatory form of cystic acne. It usually affects males and the onset age for acne conglobata is usually between 18 to 30 years – the condition can stay active for years until a person is in their 40s. The condition usually occurrence conglobatas when an individual is already suffering from acne. It can also affect someone when their acne has already diminished or disappeared.
This form of acne is characterized by numerous large lesions, which are sometimes interconnected under the skin to other nodules. Widespread blackheads are also common in conjuction with this type of acne. Acne conglobata is often painful and will appear on the face, back, chest, upper arms, buttock and thighs. The condition is difficult to treat and can cause severe and disfiguring scarring. Scabbing of the skin is caused by continual rupturing and reforming of the nodules.
What causes this acne is unknown but there appears to be a link to testosterone, which indicates why men are more likely to be afflicted by this condition. Studies have linked acne conglobata to using anabolic steroids. Evidence also indicates that the condition will appear once a man stops undergoing testosterone therapy. The condition may also present itself in those who have a tumor(s) producing a high number of androgens.
Medication: The most common form of treatment for acne conglobata is isotretinoin (Accutane) which is often used along with prednisone. Acne conglobata can be resistant to treatment, over time it can be controlled through aggressive treatment. More severe cases can be treated with dapsone, a form of medication which is used in the treatment of leprosy.
Laser therapy: Laser therapy with a carbon dioxide laser has been used successfully to treat acne conglobata. CO(2) ablation is combined with topical tretinoin. The CO(2) laser is used to open the cysts and remove the top of the sinuses and their tracts. Topical tretinoin therapy is then initiated simultaneously in order to prevent the appearance of new acne lesions. This two pronged approach is a powerful treatment option for acne conglobata.