A M E R I C A N J O U R N A L O F M E S O T H E R A P Y
Acne is a chronic inflammatory disease of the skin. A number
of factors influence acne, including overproduction of sebum
and keratin, the buildup of bacteria in the skin, and the inflamma-
tory response. The male hormone androgen is also believed to
play a role in acne because it affects the production of sebum.
Most topical acne treatments focus on reducing sebum, reduc-
ing the buildup of dead skin cells, and reducing inflammation.
Cysts or nodules are blockages of the oil glands that have
burst open and produced inflammation and pus in the sur-
rounding tissue. These lesions have the potential to produce
long-term scarring. These infections are usually deep under
the skin and do not rise to the surface. Cystic acne heals ex-
tremely slowly because the infection waste is not discharged.
There is a number of different traditional treatments avail-
able and widely used.
Benzoyl Peroxide and metronidazole are the most common
preparations used in topical treatment. Infection is treated
with antibiotics and sometimes corticosteroids.
Many cases of severe nodular acne or cystic acne are treated
with isotretinoin, which could be purchased under the product
name of Accutane.
Isotretinoin is an oral drug that is usually taken once or
twice a day with food for four to five months. The drug works
by reducing the size of oil glands so that much less oil is pro-
duced and the growth of bacteria is decreased.
Another treatment for severe nodular and cystic acne in-
clude intralesional corticosteroid therapy. This involves a rela-
tively painless procedure where each cyst is given an injection
of dilute cortisone solution. The injections provide fast relief
for the painful inflammations.
All the above described treatment modalities are widely
known and more or less effective.
None of them will remove nodules or cysts completely.
One exemption maybe related to isotretinoin, but this drug
has been known to cause depression, psychosis and, rarely,