Here's a blog post I wrote about this skin condition - don't let it fool you into thinking that you are treating acne!

 

Acne Skin Care Blog

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Laura that looks and sounds a lot like what I get sometimes...I just thought it was cystic acne.  I don't get them often but when I do, nothing treats them, they are not extractable, and they stay a long time.  They are painful at first, but then they shrink down a bit and don't hurt anymore, but they don't go away completely for months.  Since I made dietary changes and switched to my current product line I have had almost no breakouts except these...very weird.
@Rachael - yes, they are very weird.  I worked my fingers to the bone with these clients until I found out what it was.  It's so frustrating because there's not alot of options out there.  I wish I knew if that method done in Korea has been expanded upon....or is done in other countries.
Well please update me if you find out anything further about it...maybe I'll check with my editors at my healthcare publisher to see if they know anything...I have one who deals in skin and wound healing so you never know.

Very interesting, Laura...for those of us who are newer to treating acne, what are the defining distinctions between SM and a cyst or nodule that's going through the last stages of healing?  Wouldn't both be deep and not painful?  We can only extract cysts or nodules when they are inflamed (with a pus head) anyway, yes?  Once the inflammatory process has ceased, don't we just have to wait until they resolve themselves?  If not, if non-inflamed cysts or nodules can be extracted (I'm not sure how that would be done), then of course we want to make sure what we are seeing isn't SM looking like cysts...which brings me back to my first question - telling them apart.

 

Thanks so much for all the knowledge you share with us!!!

@Mary Lou I think how much we can do as esties depends on state laws...in PA, where I am we are not allowed to even touch cysts or anything under the epidermis...we also cannot extract anything with lancets or needles, including milia.  A cyst or nodule also would not get inflamed and form a white head...that's a pustule.  In PA we can extract pustules, but we cannot touch cysts or nodules because they are typically under the skin and may be solid masses that have nothing to extract.  We are not allowed to even render a guess as to what type of lesion it is.  We have to make a referral to a dermatologist if someone comes in with lesions that appear to be cysts, nodules, or anything else that is not an easy extraction.
It is tricky to tell them apart - that's why they fooled me for so long.  There tends to be alot of SM when someone has it (see the pics) whereas cysts and nodules don't proliferate as much.
As far as I know,Steatocystoma Multiplex is an uncommon, inherited condition. A dermal cyst, that is found in areas concentrated w/sebaceous glands.
I have recommended healthy diet, and products for cystic acne, to deal with SM (I can't say to treat it ), but CO2 laser treatment is supposed to treat it (I have heard).
@ Rachael, I'm showing my lack of knowledge, aren't I?  Yes, I do remember learning that cysts and nodules don't develop a pus head, but aren't they inflamed nonetheless?  Isn't that what accounts for the heat and pain?  So since they cannot be extracted due to the lack of a pus head, is the best approach to healing them just aggressive use of products like Acne Med?
@ Mary Lou I didn't mean to imply a lack of knowledge. Sorry if it came out that way. In PA we don't treat them at all, doctors have to treat them.  To my knowledge, cysts can certainly be painful especially if they are filled with infection like staph...which would be likely treated with an antibiotic. It can be drained of the infection, but unless the sac is surgically removed it will eventually fill back up and possibly get bigger. Other types of cysts can be filled with other types of matter, sometimes inflammatory sometimes not.  Nodules, on the other hand are usually solid, and are considered small tumors, and are often not painful at all depending on the type of nodule.  And of course there are other similar lesions, which sometimes resemble each other.  PA state laws feel that it is a doctor's job to diagnose what type of lesion it is (if it is under the skin, including severe cystic acne or SM) and treat it accordingly. From my holistic perspective, I don't necessarily support the immediate and aggressive use of steroids and antibiotics; so while I can offer suggestions as to certain holistic measures to reduce inflammation internally and externally, I cannot actually treat these types of lesions. I would have to make a referral to a physician or other medical professional who would then treat it. Once the situation has been properly diagnosed and is under control, I can intervene with the aesthetic issues that are present on the surface.
@ Rachel, I took no offense at all.  And, no, I didn't feel you implied I lacked knowledge, but the fact is that I DO lack knowledge.  So thank you for your lengthy response.  In Utah, master estheticians are allowed to treat deep acne (whether we should or not in another matter), and I am hoping for some guidance in the best way to do so.  Case in point is a couple of 40-something clients of mine who have what seem to be benign lumps (one or two only) under their cheeks.  No pain, no heat, so probably a nodule...they have asked me if there is anything I or they can do about them.  Suggestions, please?  Thanks!

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