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Unusual And Rare Acne: Triggers, Characteristics And Treatment

Millions of Americans are affected by acne. Knowledge about the condition still varies, and there are still several misconceptions about acne.

Acne is most common during the adolescent years and puberty, though it can strike at any time of life, even after the age of 40 years.

Unusual and severe acne can affect many aspects of a person’s life, causing a great deal of embarrassment and stress. Rarer acne may significantly limit social life and even interfere with normal life behaviors.

Five Common Triggers For Unusual Adult Acne


Inflammation carries many health problems and acne is just one of them. Chronic inflammation is also responsible for cancer, Alzheimer’s Parkinson’s disease, and other lifestyle diseases, and to combat inflammation, one needs to eat antioxidants.

You should also stop eating red meat, dairy products, grains and other foods that provoke inflammation. Eat more fruits and vegetables of different colors, and drink more water and green tea daily. Green tea has anti-inflammatory properties,  StressExperts have stated that stress can lead to acne by signaling the release of cortisol (a hormone that tells your body to produce more pore-clogging oil).

A Good way to fight stress is to get up and move and exercise is enough to send sensitive hormones, such as dopamine and serotonin through the body and improve mood. It does not matter what you do, as long as you raise the heart rate, and Jacks or squats are two examples of heart-pushing movements that are easy to do anywhere.


Acne around the mouth and chin is invariably caused by hormones, and hormone replacement therapy can give you an acne-free skin, without wrinkles by increasing collagen and elastin.

Despite this, the opinion on HRT among professionals is divided due to unpleasant side effects. Exercise, eat antioxidant-rich food and control stress through mind-body practices like yoga to keep your hormones in check.

The Sun

The sun is a blessing and a curse, being that we need vitamin D from the sun, but too much of its exposure can produce shoots in our skin. The sun is also the number one cause of acne stains. Fight UV radiation from the sun with the following methods:

  • Use a moisturizer with SPF 30, and limit artificial sun tanning.
  • Avoid going outdoors at peak sunny hours,
  • cover up with a cap, hat or umbrella at the beach
  • Drink plenty of water and green tea to fight UV radiation from inside

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Rarer Acne

Papules And Pustules

Papules and pustules appear in larger numbers, and, in addition to the face, may affect other regions, such as the neck, chest, shoulders, and/or upper back.

The risk of scars developing is higher because the infection spreads and affects deeper layers of the skin. Papules and pustules are usually treated with both topical and systemic (oral medication) therapies available only with a doctor’s prescription.

Acne Rosacea

Rosacea means ‘redness’ of the skin, and is similar to normal acne. However, it is characterized by extreme redness of skin especially on the cheeks, nose, forehead etc. It is sometimes mistaken with ‘blushing or sunburn’, and the main difference between normal adult acne and acne rosacea is that acne rosacea has no blackheads.

Many people in the age range of 30 and above are known to suffer from acne rosacea, and the exact cause of this skin disease is still unknown. However, dermatologists believe that the cause is inflammation of the tiny blood vessels situated just beneath the skin owing to sun damage, and certain inflammatory foods.

Gram-Negative Folliculitis

The Gram-Negative Folliculitis is seen in patients already having acne vulgaris or acne rosacea and is caused by a gram-negative bacterium. The gram-negative bacterium is a class of bacterium that is usually highly resistant to several commonly prescribed antibiotics and does not stain when exposed to ‘Gram’.

This type of rare acne flare-up is seen in patients suffering from HIV/AIDS, and can also be seen in people who undergo hot tub immersion. Gram-negative folliculitis is characterized by a red rash which is similar to acne vulgaris. It is also typical in patients being treated using tetracyclines or other antibiotics given for acne.

The lesions accompanying such a rash are often deep, circular and pus-filled, and the Proteus species of organisms causing Gram-negative folliculitis is also able to penetrate deep within the dermis of the skin. This usually results in abscess and cysts.

Drug-induced Acne

This types of acne will flare up as a result of drugs taken either for medical conditions or illegally for other purposes. For example, lithium will often trigger acne in patients, and for those who need the benefits of a drug such as lithium, any resulting acne should be easy to manage by taking anti-acne medication.

Similarly, Steroids are also taken illegally by body-builders who will commonly source them to help ‘bulk-up’ their muscles quickly, and people who get caught in this dangerous substance are risking their health and wellbeing.

Cystic Acne

The most serious form of acne is often called cystic or nodulocystic acne. The usual signs of acne, such as red and yellow spots and comedones, will be present, but far more widespread and very angry looking.

Someone with this type of acne will often have large cysts that are filled with pus. There are numerous comedones, papules, pustules, and nodules, in addition to the cysts, and there is also a pronounced degree of inflammation, and breakouts are severe.

Cystic acne is very painful, the infection is deep and widespread and usually extends beyond the face, and may affect the entire back, chest, shoulders, and upper arms. Most cystic acne sufferers develop scarring.

Pyoderma Faciale

Pyoderma faciale is a rare form of acne called Rosacea Fulminans. It affects more women than men, typically in the age range of 20 to 40.

This acne outbreak comes on rather suddenly; it can cause a great deal of havoc in the patients.

Pyoderma Faciale skin condition closely resembles acne vulgaris but is different because there is no formation of lesions, comedones or sores. There is even no presence of infective bacteria causing them.

Cosmetic Acne

Various cosmetic ingredients can induce comedones, and hair pomades can also produce a monomorphic, low-grade acne.

Infantile Acne

In this condition, patients develop inflammatory lesions, particularly on the cheeks, usually after 3 months of age. It can evolve into deep-seated nodules and sinus tracts, but topical therapies and/or oral erythromycin (125 mg twice daily) or trimethoprim (100 mg twice daily) can be used safely to treat this type of acne.

Note: Severe cases of blisters and pimples in babies must not be ignored. They could be signs of Herpes Simplex or other medical conditions that may need immediate medical attention


SAPHO is the acronym for synovitis, acne, pustulosis, hyperostosis, and osteitis, which is a group of overlapping joint diseases. It occurs in conjunction with palmoplantar pustulosis and, less frequently, with psoriasis, acne, and inflammatory bowel disease.

Nodules and cysts are deeper pimples that should be treated by a dermatologist, as they are usually very large, painful, and solid, and can be hard to control.

It nearly always requires potent systemic drugs (such as isotretinoin  Accutane) in addition to topical medications.



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