ACNE VULGARIS & CYSTIC ACNE

OVERVIEW

Acne vulgaris is a common skin condition affecting the face, chest, and back. It develops when hair follicles become clogged with oil (sebum) and dead skin cells, leading to the formation of comedones (blackheads and whiteheads), papules, pustules, nodules, and cysts.

Acne often begins in adolescence but may persist into adulthood. While acne cannot be completely prevented or “cured” in the traditional sense, it can be managed effectively with appropriate medical care to reduce active lesions and minimize the risk of scarring.

ACNE AND SCARRING

The primary goals of acne management are to:

Reduce active inflammatory lesions
Prevent progression to deeper nodules and cysts
Minimize the risk of permanent scarring

Acne scarring represents a natural progression of untreated or inadequately controlled inflammatory acne.
When inflammation extends into deeper layers of the skin, it can disrupt normal healing and collagen formation, leading to permanent textural changes. For this reason, one of the primary goals of acne treatment is the prevention of scarring, not just the reduction of visible breakouts.

Early medical evaluation and appropriate management of active acne may help reduce the severity and extent of scarring by controlling inflammation before deeper skin damage occurs. Once scars have formed, treatment becomes more complex and typically focuses on improving appearance rather than reversal.

MEDICAL EVALUATION

A medical evaluation begins with a clinical skin examination to assess:

Acne type and severity
Distribution of lesions
Presence of nodules, cysts, or scarring
Contributing factors, such as hormonal influences or skin-care practices

In some cases, additional evaluation may be needed. Certain conditions that resemble acne — including folliculitis, bacterial skin infections, or dermatitis — may require different management.

ACNE PATTERNS ACROSS AGE AND GENDER

Acne does not present the same way in all patients. Patterns may vary based on age, hormonal activity, and timing of medical evaluation.

Male patients often present for evaluation later in the course of acne, which may be associated with more severe inflammatory lesions, including nodular or cystic acne at the time of diagnosis.
Adult female patients, particularly those over age 25, frequently experience acne that is persistent or recurrent rather than severe in appearance. This pattern is often influenced by hormonal factors and may require a long-term management approach rather than short-term treatment alone.

Recognizing these patterns helps guide individualized evaluation and treatment planning.

GENERAL TREATMENT PRINCIPLES

Acne management typically involves a combination approach, tailored to the severity and type of acne.

MILD PAPULAR / COMEDONAL ACNE

Topical therapies, such as retinoids, benzoyl peroxide, or combination products
Gentle, consistent skin-care routines

PUSTULAR OR MIXED ACNE

Combination of topical and, when appropriate, systemic therapies
Antibiotics or hormonal therapies may be considered under medical guidance

MODERATE TO SEVERE INFLAMMATORY OR NODULOCYSTIC ACNE

Systemic therapies (such as oral antibiotics or hormonal treatments) may be recommended
Referral to specialized programs (including iPledge for isotretinoin) may be appropriate based on clinical judgment

Note: All systemic treatment options are discussed in detail during evaluation and tailored to each patient’s medical history and individual needs.

ALTERNATIVE AND ADJUNCTIVE TREATMENT OPTIONS

Some patients may benefit from procedural therapies in addition to medical management. These options are offered when appropriate and incorporated into a personalized care plan.

CO₂ LASER–ASSISTED INCISION & DRAINAGE (I&D)

In select cases of cystic acne, a CO₂ laser may be used to assist with incision and drainage of deep inflammatory lesions. This approach may:

Facilitate lesion drainage
Reduce inflammation
Support improved outcomes when combined with medical therapy

Laser-assisted I&D may help reduce recurrence and limit scar formation in appropriate cases.

PHOTODYNAMIC THERAPY (PDT)

Photodynamic therapy involves:

Application of aminolevulinic acid (ALA) to the skin
A controlled incubation period
Activation with light, such as blue light and pulsed dye laser

PDT may be considered for moderate to severe acne that has not responded adequately to topical therapy or for patients seeking alternatives to systemic medications.

Common temporary effects include redness, peeling, and skin sensitivity. Recovery time varies depending on treatment intensity and acne severity.

PULSED DYE LASER (PDL)

PDL may be used as an adjunctive therapy to:

Reduce inflammation associated with acne
Decrease redness from post-acne changes
Support reduction in comedones

PDL does not prevent new acne lesions and is not a standalone treatment. Multiple sessions may be recommended based on clinical response.

BLU-U BLUE LIGHT THERAPY

Narrow-band blue light therapy may be offered as a non-pharmacologic or complementary option. Treatment typically requires multiple sessions over several weeks.

INDIVIDUALIZED TREATMENT PLANNING

Each patient’s acne presentation is unique. Effective management may involve one or more treatment modalities used together with medical therapy.

During your visit, Dr. Tryzno will:

Review your acne history
Perform a detailed skin examination
Discuss treatment options appropriate for your acne type
Consider patient preferences and treatment goals

WHEN TO SEEK EVALUATION

Professional evaluation is recommended if:

Acne is persistent or worsening
Lesions are painful, nodular, or cystic
Scarring is present or a concern
Previous treatments have been ineffective

Early consultation may help improve outcomes and reduce long-term skin changes.

SCHEDULE A CONSULTATION

📞 Call (847) 518-9999 to schedule an acne evaluation and personalized treatment plan.

MEDICAL DISCLAIMER

This information is provided for educational purposes only and does not replace professional medical evaluation, diagnosis, or treatment. Individual treatment decisions depend on clinical findings, patient history, and diagnostic testing.