Acne Conglobata

Acne conglobata is a severe, long-lasting inflammatory skin condition. “Inflammatory” means your skin swells and is painful and irritated.

This rare condition causes deep bumps called nodules, along with abscesses and cysts that can connect under your skin. They form tunnel-like tracks. Acne usually appears on your chest, back, face and neck. It can lead to scarring.

Don’t wait for this type of acne to go away. Talk to a dermatologist if you notice symptoms. They can help you manage it.

Symptoms of acne conglobata

Acne conglobata can be painful and uncomfortable. Symptoms may flare up and last for years. You might experience:

• Pain, soreness
• Pimples or cysts that hurt when touched
• Pressure under your skin
• Bumps that break open and sting
• Oozing that can smell bad

What does conglobata acne look like?

This condition causes severe acne on your skin. You may see:

• Bumps that start like pimples but grow into big knots
• Big pus-filled bumps or cysts that connect under your skin
• Groups of blackheads in pairs or clusters
• Large, deep lumps under your skin
• Tunnels under your skin between bumps
• Pus leaking from open pimples or cysts
• Scabs or crusts after bumps drain

Acne conglobata causes

Acne conglobata develops when several skin changes build on each other over time. This happens when:

1. Pores clog because dead skin cells stick together.
2. Oil builds up behind the clogged pore.
3. The clogged pore swells and can break under your skin.
4. A skin break causes inflammation.
5. Certain strains of Cutibacterium acnes (a type of skin bacteria) create more inflammation.
6. An imbalance in your skin’s microbiome (too many inflammatory bacteria and not enough protective ones) makes inflammation worse.

Risk factors of acne conglobata

This type of acne is most common in males, adolescents and adults between the ages of 20 and 30.

Certain factors can raise your chance of developing acne or making it worse. These include:

• High androgen levels during puberty
• Androgen-producing tumors
• Anabolic steroid use
• Industrial chemical exposure
• Pustular acne
• Skin conditions where hair follicles get blocked (like hidradenitis suppurativa, pilonidal disease and dissecting cellulitis)

Rarely, this condition may happen with certain genetic conditions, but it’s uncommon.

Complications of acne conglobata

This condition can cause large, uneven scars on your skin. It can change the way your skin looks and feels. These changes may affect how you feel about your body. You may also pull back from social situations. If you want support with your emotional well-being, reach out to a mental health provider.

How doctors diagnose acne conglobata

A healthcare provider diagnoses this condition by looking closely at your skin and asking you questions.

They’ll check where the acne appears. They’ll ask about your medical history. They may want to know if the acne suddenly got worse or if you’ve used anabolic steroids (as that can trigger this condition).

If you have sores draining pus, they may swab it to check for infection. They may start antibiotics right away if they think there’s an infection.

Acne conglobata treatment

Providers use several treatments to calm inflammation, prevent new bumps and protect your skin from scarring. You may need more than one treatment at the same time.

Common medications include:

• Isotretinoin: This is the main treatment. It’s a type of retinoid medication. You may take it for five to seven months or longer.
• Antibiotics: These may reduce inflammation and help control bacteria in your skin.
• Prednisone: This steroid may reduce inflammation. You may take it for a short time with isotretinoin.
• Topical retinoids: These help keep pores clear. They work best when used with other medicines.
• Dapsone: This may reduce inflammation.
• Biologic medicines: These may help if your acne occurs with other inflammatory conditions.

Common procedures include:

• Draining bumps with a needle
• Freezing bumps (cryotherapy)
• Injecting a steroid medicine
• Removing bumps surgically

When should I see my healthcare provider?

You should see a healthcare provider, like a dermatologist, if you have acne that’s getting worse or isn’t improving with over-the-counter treatments. Early care may prevent serious scarring.

Seek medical help if you notice:

• Very large, deep or painful acne
• Bumps that connect under your skin
• Areas that drain pus
• Clusters of blackheads in the same spot
• “Burrowing” nodules that spread under your skin

If you’re worried about any changes in your skin, it’s a good idea to make an appointment.

What can I expect if I have acne conglobata?

Acne conglobata is a severe, long-lasting type of acne. You may have flare-ups that come and go for years. In some cases, it may last into your 30s and 40s. These flare-ups can cause painful bumps that may leave scars as they heal.

Living with this condition can be difficult. It’s common to feel stressed or self-conscious about your skin. Try not to cover the area with tight or heavy clothing, as heat and sweat can make symptoms worse. A healthcare provider can help you manage the physical symptoms and support your emotional well-being.

With treatment, many people see their skin improve. Medicines can calm the acne and reduce new breakouts. Following a regular skin care routine may also help. Procedures are also available to improve scarring and smooth your skin.