Most cases of adult acne are straightforward to treat as they have, more or less, a fixed cause. Once in a while though; a dermatologist will get to see a rare form of acne in his/her office. These rarer acne types do not fit the ‘normal’ adult acne category. In this 2-part article, we will be discussing some of the rarer varieties of acne and what one can do about them:
Acne Conglobata- A rare acne condition
This type of adult acne is seen in both men and women in the age groups of 18 to 30 years. It is usually present on the chin, cheeks though other sites having pustules or pimples in one’s adolescence may also be affected. This relatively rare and serious skin condition needs medical intervention; the treatment is usually very aggressive compared to other normal types of acne. Even with treatment, there may be residual scars left behind. Acne conglobata consists of characteristically large cysts that may be interconnected below the skin’s surface-you can actually see lines or traces connecting these lumps of acne. The cysts are pus filled and often they take weeks to clear. Even after they do, they tend to get inflamed all over after a few days resulting in permanent scar formation. This type of rare acne may sometimes be seen on buttocks, back neck etc. The treatment usually consists of strong antibiotics along with steroids.
Acne Fulminans- Very rare acne seen in boys
Usually women tend to suffer more from normal types of adult acne, but in case of Acne fulminans, a very rare and serious skin condition, the opposite is true. More teenage boys are known to suffer from this skin disease than girls.It starts gradually with one or two pimples, but flares up and increases within a matter of weeks. Some patients also experience joint pain and arthritis-like symptoms while suffering from acne fulminans. In a few cases, fever may be present. This rare form of acne is linked to adrenal gland disorders that may interfere with one’s hormonal balance. Antibiotics rarely work on this type of acne and the only solution, in most cases, is steroidal treatment.
This is another very rare acne condition that affects the sweat glands or apocrine glands in some people. The glands tend to get overheated and certain bodily changes such as menopause or puberty as well as sexual stimulation etc further exacerbate the condition. This type of rare acne is often mistaken to be acne vulgaris since many patients suffering from the latter also simultaneously develop Suppurativa nodules. The apocrine glands that are stimulated owing to adrenalin production usually form such acne flare-ups in the armpits, or in areas around the breasts. This rare type of acne may be present in single nodular form but group and clusters are not uncommon. These lesions are often similar to Acne Conglobata (described above) but the only difference is that they affect women more than men. Naturally, it is very distressing and painful condition that may require surgical intervention.
This rare form of acne is also called dissecting cellulitis of the scalp and is very similar to Acne Conglobata. However the acne nodules are only limited to the head and scalp region and are often accompanied by intense scarring and hair loss. It is not uncommon to see secondary skin infections arising from such rare forms of scalp acne. The only treatment for this condition is direct scalp injections into the lesions-something which is best left to an expert.
This relatively rare form of acne is caused by friction- anything that puts unnecessary pressure or generates heat from rubbing a body part can trigger this kind of acne. This includes items like clothing, headbands, caps, helmets etc. Sweaty clothes after a workout can also lead to acne mechanica. Similarly, sweaty sports equipment held against a body part can also lead to this kind of acne. The US Army has a strict rule of not taking recruits having mild to moderate acne; since harsh work conditions could increase acne mechanica flare-ups. This condition may be further aggravated in tropical conditions; the humidity and other environmental factors can all increase frictional acne leading to severe blood septicemia which is a life threatening condition. Many precautions can thankfully help reduce such rare acne: sleeping on clean and silky pillow covers at night, washing all head gear where possible, carrying wipes to remove sweat from time to time are some tips to reduce this form of rare acne.
Stay tuned for part 2 of rare acne types and what you can do about it.