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How to Treat Cystic Acne
Poziom:
Temat: Życie codzienne
[music]
Hello, I’m Dr. Neal Schultz
[pause]
and welcome to DermTV.
In cystic acne, usually you need internal
treatment. In cystic acne, you
get red, swollen, large cysts—usually on
the face, sometimes on the upper
back and the upper chest. But it’s not just
the fact that you have these
unattractive cysts that’s the problem. They
hurt, and the reason that they
hurt is because they’re so large and they’re
so deep. As the cyst gets
larger and larger, it stretches the skin over
it, and stretching the skin,
stretches the nerves. That’s what makes
the nerves fire. If you stretch
pain nerves, you'll make them fire and that’s
what causes pain. Also, the
fact that they’re so deep also pushes on
pain fibers and causes them to
fire and create pain. It’s the same depth
that’s causing this problem
that’s also responsible for the fact that
topical medications for
blackheads and whiteheads and even superficial
pus pimples don’t work, and
that’s why you need to have internal treatment.
We discussed how Accutane
is really a great miracle cure for really
bad cystic acne, but most people
with cystic acne don’t need Accutane. Most
people will improve with oral
antibiotics—sometimes for two weeks, sometimes
for three weeks. And
sometimes the first antibiotic doesn’t work,
and your dermatologist will
give you a second antibiotic. But usually
antibiotics will be helpful. But
when they’re used for acne, it’s very
different than having antibiotics for
a cold or a sore throat because, in those
cases, when you’re finished with
your infection, you stop the antibiotic abruptly,
not with acne. With acne,
we gradually reduce the dose of the antibiotic
from three times a day, to
twice a day, to once a day and, by gradually
reducing it, we fool the body
into thinking it’s still having the medication,
and that’s how, when you
finally do stop the antibiotic, you have a
sustained improvement, and you
don’t have to keep taking antibiotics
If antibiotic treatment doesn’t help men,
they then have the option of
going to Accutane. But women have another
choice. If antibiotics don’t help
women, they can take birth control pills.
Because birth control pills that
are estrogen-dominant tend to help acne, and
there are a least a half-a-
dozen on the market which are very, very helpful.
So if women have a need
for contraception and acne, estrogen-dominant
birth control pills are a
perfect choice. But the important thing to
remember here is that, if you do
have cystic acne, see your dermatologist.
There are oral medications that
will control this problem and you no longer
need to have these unattractive
painful cysts.
