Most of the time, acne goes away on its own, but persistent, reappearing acne is a problem for some people. If you have chronic acne, you may be dealing with physical repercussions, like unattractive breakouts and scars, as well as with emotional challenges, like low self-esteem and social embarrassment. Chronic acne is a serious problem for some people, but it can be effectively treated.
Technically, you could argue that all acne is chronic acne since acne is by definition a chronic condition. Like all chronic conditions, acne is both recurring and long-lasting, so whether your breakouts are limited to occasional zits or take the form of serious cysts, your acne could be considered chronic. Most people, however, use the term chronic acne to refer to acne that is severe, ongoing and does not respond to over-the-counter treatments or remedies.
If you have tried over-the-counter remedies without success; have painful, pus-filled acne; dark patches on your skin after acne breakouts; or if you have depression, embarrassment or social discomfort because of your acne, your acne is probably chronic and warrants a consultation with a professional, says the American Academy of Dermatology on its acne resources website AcneNet.
Chronic acne, like all acne, is the result of three factors: excess oil production in your skin, irritated hair follicles as a result of irregular skin cell shedding and bacteria build-up in the affected area. Your hormones, genes, bacteria and even some medications can contribute to the factors that cause acne. Contrary popular belief, chronic acne isn't caused by eating greasy foods or chocolate or by poor hygiene.
Though over-the-counter treatments with benzoyl peroxide or salicylic acid as the active ingredient work well for some forms of acne, chronic acne usually requires dermatologist-prescribed treatments. Your dermatologist may prescribe topical treatments with high concentrations of benzoyl peroxide or salicylic acid or vitamin A derivatives. She may also recommend oral medications including antibiotics to fight infection; oral contraceptives, which can help clear up acne for some women; or isotretinoin, a powerful acne-prevention medication.
Isotretinoin can be effective for treating chronic acne, but it comes with a list of serious potential side effects, including severe birth defects and depression. You should not take isotretinoin if you're pregnant or planning to become pregnant, and let your doctor know immediately if you experience any periods of depression while taking isotretinoin.