CAREER-DRIVEN Kawela M’ule (26) spent close to N$1 000 every three months on facial and cosmetics products to hide large and painful bumps growing on her face.
“It was disgusting having these bumps on my face. It started as normal puberty pimples when I was 14 years old. They would come and go. As I was growing older, they were coming back, but more aggressively, especially when I was on my periods. Because it was painful at times, I decided to go see a dermatologist, who diagnosed me with cystic acne,” M’ule explained.
According to resident specialist dermatologist at the Ongwediva Medipark, Dr Elisah Agaba, it was not unusual for a teenager to have pimples. But if they became large and painful, then it was a problem.
“Cystic acne affects a large area of the skin, and it is a form of inflammatory acne.
“In other words, it’s when you get a pimple when a pore in your skin gets clogged, usually with dead skin cells. Sometimes, bacteria get trapped inside the pore too, causing the area to become red and swollen,” Agaba said.
He added that this could also be referred to as nodulocystic acne because most of the time, cysts occur together with nodules.
M’ule said her skin was very itchy, and when she scratched it, the acne would spread. Agaba said this happens when the cysts burst, and the infection can spread, causing more breakouts.
Cystic acne can appear on your face, shoulders, back and chest. Those are the areas with well developed sebaceous glands, and Agaba said women often develop cysts on the lower half of the face, while severe cystic acne was more common in men.
“Several factors are involved, which include genetic predisposition, sebum production, hormonal factors, inflammation and infection of the skin,” he stated.
He said those most likely to develop the condition were teenagers and adolescents. “Other groups include people on medication for system diseases, as side-effects of some of these medicines, it may be part of the manifestations of certain syndromes which involve other parts of the body other than the skin,” explained Agaba.
M’ule added that since starting on medication, she has been feeling beautiful. “I am on medication for 10 months now, and I feel beautiful, confident. I am on Oratane and birth control pills to help me control my hormones.”
Practical measures to avoid making acne worse are useful for anyone with acne, including people with cystic acne:
Do not wash too often – twice a day is enough; use 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 make-up, choose water-based, non-comedogenic formulations, avoid oily formulations, and make sure to remove make-up before bed.
Acne produces symptoms familiar to all of us. Cystic acne is even more visible because it is the most severe form, and produces cysts and nodules, alongside inflammatory papules and pustules. Acne can also cause visible scarring.
All forms of acne can affect self-esteem and mood, but the risk of psychological distress is higher for cystic acne as it typically has a greater impact on the appearance of the face, and disproportionately affects young adults who may be more socially sensitive.
Most people with acne do not usually experience physical symptoms, but the skin’s appearance can cause emotional distress. In cystic acne, however, the distress may be greater, and the cysts may be painful.
The importance of treatment is underlined by the risk of scarring from long-term cystic acne. This can produce long term and permanent damage in the form of ‘ice pick’ scars (small, deep pits), larger pits, shallow depressions or hypertrophic scarring (red, raised scars).
