Severe acne: Types, causes and treatment

Sometimes it can feel like severe acne hits you harder than Tyson Fury on a good day. It’s visible for everyone to see, it can damage your confidence and it can stay with you for years. It’s stubborn to treat and can leave you with scars.

It can also feel like you’ll never beat it. But tackle it you can. If you treat your acne in the right way you can reduce how severe it is. And you can even banish it for good. Here’s what you need to know about severe acne.

What is acne?

Acne is a skin condition that causes you to have various kinds of spots and inflammation in your skin. But it’s really all about the spots. And you get these spots when the follicles in your skin become blocked – usually by sebum oil or dead skin cells.

The mildest spots are whiteheads and blackheads which are essentially just blocked follicles. But bacteria from your face can infect blocked follicles and make your spots worse. As the bacteria feed on whatever is blocking your follicle they multiply. When the bacteria reach a certain level your immune system identifies the bacterial infection and fights back. This causes inflammation and pus to form (pus is a delightful mix of dead bacteria and white blood cells), giving you red spots filled with pus. These are called papules.

What is severe acne?

Think of blackheads and whiteheads as level 1 of acne. Papules are level 2. Then anything above this is severe acne. Severe acne happens when the bacterial infection in papules spreads outside of the follicle. This gives you bigger and more stubborn spots and causes more serious inflammation in your skin.

Roughly speaking level 3 of acne is when you get spots called pustules. These are bigger versions of papules with more pus inside them caused by a more serious infection. Level 4 of acne is when you get spots called cysts and nodules. These form when the infection moves into deeper layers of your skin and larger pockets of pus form. Because these spots go deep into the skin they can be tough to treat and can cause scars as they damage lower skin layers. Read more about severe acne scars. As it can cause spots like cysts, severe acne is also called cystic acne.

How do you know if you have severe acne?

You have severe acne if your spots have become pustules, cysts or nodules. Pustules are like regular pus-filled spots but generally larger – around about the width of the end of a pencil. Cysts can be even larger and usually have visible pus in them whilst nodules look like large red bumps without visible pus. Both cysts and nodules can feel tender or painful to touch as they’re surrounded by inflamed skin. Read more about the different types of spots and how they look.

If this sounds familiar then you most likely have severe acne. Still not sure? You can always see your GP or a pharmacist to get a professional diagnosis.

How to treat severe acne

Acne can be tough to shift and severe acne can feel unbearable. But don’t give up, there are effective treatments for severe acne that can make a real difference. These include:

Retinoic acids: These are a group of acids based on vitamin A. They are found in a range of products you apply to your face like gels and creams. Because retinoic acids are powerful you can only get these products with a prescription in the UK. Retinoic acids can clear your pores and remove oil and dead skin cells. They also encourage your skin to heal more effectively than over-the-counter acne products. They can even reduce inflammation in your skin.

Antibiotics: Taken either orally or applied to your affected skin, antibiotics can kill the bacterial infections that make your spots more serious. They can also reduce inflammation, redness and pain.

Treclin gel: Treclin gel is a prescription product that contains both retinoic acid and an antibiotic to help tackle even the toughest of acne. You can order Treclin directly FROM MARS.

See a dermatologist: A dermatologist is a doctor who specialises in skin conditions. They’ll be able to recommend and perform treatments such as laser light therapy that can help with severe acne. See your GP and ask for a referral if this is something you’re interested in.

How to take care of your face

As well as trying the above treatments you can also take care of your face and tackle your acne by sticking to a daily acne skin care routine.

Once a day – either in the morning or evening – you should take time to wash your face to remove excess dead skin and oil that can cause spots. Also, apply acne treatments to help your face heal. Your daily skin care routine should involve:

  • A gentle cleanser
  • A toner or astringent
  • A topical acne treatment
  • A water-based moisturiser
  • Sunscreen

You can read more about skin care for acne and each of these steps.

Severe acne FAQs

What is considered severe acne?

Acne is considered severe when you have larger, more stubborn spots like pustules, cysts and nodules. These spots can contain lots of pus. And because they protrude deeper into your skin they can leave you with scars. More severe acne is usually accompanied by more swelling in your skin which can feel uncomfortable and cause pain.

What causes sudden severe acne?

A range of causes can trigger a sudden and severe outbreak of acne including hormonal changes, high levels of stress, eating the wrong foods (high glycaemic and high‐fat dairy), illnesses and reactions to new medications you’re taking.

How long does severe acne last?

This varies by person. Some people experience severe acne for a short time in response to a specific cause like a medication disrupting hormone levels. However, some people live with severe acne for years. If you treat your acne and take care of your face every day you can reduce even the most severe cystic acne.

How to treat severe acne

The best way to treat severe acne is to use a topical treatment that contains retinoic acid, an antibiotic or a combination of both of these in a product like Treclin gel. You can also see a dermatologist for professional treatments and you should adopt a daily skin care routine to look after your skin and make spots less likely.