Cysts are not uncommon in acne but in this chronic disease, the cysts measure up to a few centimeres in diameter. Like the conglobata, they are also widespread and cause a lot of pain.
The nodular cyst of acne is not a true cyst—an abnormal dilatation of a normal skin structure. Acne cysts are nodules of inflammation. The cysts may arise from a papule or nodule form of acne lesion, or occasionally from a type of cyst that develops in the outer layer of the skin—not usually associated with acne. A cyst appears to be filled with thick, yellow pus-like fluid. This is usually an inflamed and infected cyst. If an attempt is made to drain such a cyst, it should be done in a physician’s office under sterile conditions, not by oneself with regular apparatus in the bathroom.
Cysts occurring close together may join together, producing soft areas under which there are tunnels, cell destruction and inflammation, and that may set in the acne conglobata, which is also very severe.
Treatment. Nodulocystic acne usually requires an regular and particular treatment course that may include isotretinoin and antibiotics, or intralesional corticosteroids that “melt” the cyst in a matter if a week.Some very large follicular cysts that do not respond to medications may require drainage and surgical excision.

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