Acne is common, but when it involves deep, painful lesions like cysts or nodules, it’s considered a severe form that often leaves lasting scars unless treated properly. The article distinguishes between two main kinds in adults: late-onset acne, which begins after adolescence in people without a previous history, and persistent acne, which continues from teenage years into adulthood. Severe types demand the care of a dermatologist to prevent permanent damage and develop a suitable management plan.

Causes of severe acne include hormonal imbalances, genetic predisposition, stress, and external aggravators like comedogenic skin products or certain medications. In women, adult acne is often sensitive to hormonal fluctuations—many notice worsening around the menstrual cycle. Studies show that in these adult cases, inflammatory lesions (pimples, pustules, nodules) are more common than blackheads or whiteheads. The face—especially the jawline and chin—is often most affected. Adult acne is also harder to treat, sometimes more persistent, and may require a multi-pronged approach.

Treatment strategies go beyond simply clearing active lesions: dermatologists often combine topical or oral medications (retinoids, antibiotics, hormonal therapies) with lifestyle adjustments—avoiding pore‑clogging products, reducing stress, and sometimes dietary changes. In severe cases, therapies like isotretinoin (Accutane) may be used, but require careful monitoring for side effects. The objective is not only to reduce present inflammation but also to prevent new outbreaks and minimize scarring, while enhancing quality of life.