Considered the most severe type of acne, nodulocystic acne, or cystic acne, is painful and leaves permanent disfiguring scars on its victims. It is an inflamed breakout that develops on the face and other areas of the body that leaves behind large blemishes measuring up to several centimeters across. Cystic acne derives its name from the cyst that develops deep within the skin following infection. The cyst is filled with puss and locates itself under the swollen pustule.

Not all severely inflamed acne can be considered as cystic acne. The existence of a cyst distinguishes cystic acne from the common acne known as acne vulgaris. A person suffering from nodulocystic acne not only develops cysts but also nodules. Unlike cysts which feel soft, nodules are hard lumps under the skin's surface. Nodules can also be painful. Since nodules form deep within the skin, they take a long time to heal. The term nodular acne refers to a particular type of acne that develops nodules but do not have cystic lesions.

Teenage boys and young men are more prone to cystic acne. Women are likely to suffer from this type acne during their menstrual cycle or post pregnancy. Nodulocystic acne can actually occur at any age, but it is more common during teenage years when various hormonal changes take place in the body. Experts agree that the main cause of cystic acne is the hyperactivity of the sebaceous glands. Extra oil is secreted by these glands when they are hyperactive. The extra oil clogs the pores on the skin surface which then combines with external bacteria to form an infection in the clogged pores. When left unchecked, the infection could affect the deepest tissue of the skin thereby causing the painful nodulocystic acne. The presence of dead skin cells within the pores causes cystic acne as well.

The likelihood of developing scars following nodulocystic breakouts is extremely high because of the severe damage to surrounding skin tissues. In order to prevent the development of permanent scars, pricking and scratching the affected portions of the skin should be avoided.

Those who are suffering from cystic acne are advised to seek professional help. This type of acne requires systematic medication that only doctors can provide. Unlike common acne which can easily be treated with topical bactericidal, nodulocystic acne requires a combination of more aggressive treatments which include oral antibiotics, intralesional corticosteroid injections, and surgical excision and drainage.