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Severe Acne: A Deep Dive into Its Causes and Management

Updated: Mar 11

Acne is a common skin condition that affects millions of people worldwide. While it's often associated with the teenage years, it can strike at any age and range from mild to severe. Severe acne, in particular, can be significantly distressing, impacting both physical health and emotional wellbeing. This article aims to provide a comprehensive understanding of severe acne, its causes, and the available treatment options.


A confident woman posing with her facial acne

Understanding Severe Acne

Adolescent acne, also known as acne vulgaris, is a complex condition that can be influenced by various factors, including genetic and hormonal factors. Severe acne is characterized by the presence of numerous large, painful, solid lumps (nodules) and pus-filled lumps (cysts) beneath the surface of the skin. These can lead to significant scarring and emotional distress. The severity of acne can be influenced by skin type, with oily and seborrheic skin being associated with more severe acne. Individuals with more severe acne are also more likely to have higher sebum production and high usage of drugs to treat their acne.

Acne and the Microbiome

The microbiome, specifically the bacteria Propionibacterium acnes, plays a crucial role in the development of acne. This bacterium thrives in environments with high sebum levels, such as oily and mixed skin types, increasing the risk of acne presentation.

Dietary Factors and Acne

Dietary factors can also influence acne presentation and severity. High intake of dairy and chocolate has been associated with increased risk of acne. This is hypothesized to be due to the sugars in these foods triggering insulin secretion, which can lead to increased keratinocyte proliferation and the formation of acne lesions. High fat intake has also been suggested as a potential dietary risk factor for acne. On the other hand, high intake of fish, fruits, and vegetables may lower the risk of acne, possibly due to the omega-3 fatty acids found in fish and the high fiber content in fruits and vegetables, which can lower the levels of Insulin-like growth factor 1 (IGF-1), thus reducing acne risk.

A bowl of white rice with raw salmon on the top

Treatment Options for Severe Acne

Treatment for severe acne often involves a combination of topical treatments (creams, gels, lotions), oral medications (antibiotics, hormone therapy), and in some cases, a form of vitamin A called isotretinoin. In addition to these, lifestyle modifications, such as a balanced diet and good skincare routine, can also help manage acne. However, acne scar treatment is much more complex, click here for more about acne scar treatment.


Understanding the various factors that contribute to the development and severity of acne can help in the effective management and treatment of this condition. Further research is needed to fully understand the complex interactions between these factors and their impact on acne.

Schedule a consultation today and start your acne recovery journey today.

This blog post was medically reviewed by Dr Summer Zhang.


1. L. Oge, A. Broussard, M. Marshall. (2013). Acne Vulgaris: A Review of Causes and Treatment Options. Nurse Pract.


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