A variant of acne called as cystic acne is a large cyst, pustules, scars, keloids, and these could be occurring on the chest, face, shoulder. This variant of acne is called grade 4 acne. Acne a s you know is divided into grades, mild, moderate, severe, or cystic acne and this kid of patients they have a lot of dysmorphism because of the cane itself, the acne is very large in size, it does not dissolve with regular antibiotic doses.This acne is probably a combination of genetics because these patients my have somebody in their family, who has this kind of cystic acne and they have a tendency to have too much of scarring, either deperessed scarring or hypertrophic scarring or called as keloid, such patients preferentially need oral isotretinoin. Oral isotretinoin is a vitamin A derived medicine which can be given to permanently reduce the effects of acne on your skin and this has to be give by a dermatologists because you have to have medical tests before you have this medicine and during this medicine you need to have regular monitoring of your liver tests and cholesterol tests. So fi you think you have scarring acne, please go to your dermatologist to give you the benefit of this medicine to give you long term cure form the acne.

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