3 Things Parents Need To Know About Acne Fulminans

Posted on: 3 May 2016

While all types of acne are distressing to sufferers, some types are worse than others. Acne fulminans is considered the most severe type of acne, and it can be disabling for teenagers that develop it. Here are three things parents need to know about acne fulminans.

What are the signs of acne fulminans?

Acne fulminans develops young teenagers who have had either mild or moderate acne in the past. This acne suddenly gets much worse, and painful lesions appear on the face, chest and upper part of the back. These lesions can be crusty, ulcerated or hemorrhagic.

Since this type of acne is so severe, it can lead to systemic symptoms, as well. Your child may have a fever or start losing weight. Myalgia (muscle pain) can also occur, and it can be so severe that it can impair movement.

What causes acne fulminans?

Researchers aren't sure why some teenagers with acne develop acne fulminans. One theory is that acne fulminans is an autoimmune disease; the immune system responds too strongly to the skin bacteria that cause mild or moderate acne, and this immune reaction causes the symptoms of acne fulminans.

Testosterone is also thought to be a factor, since this type of acne gets worse during testosterone therapy and also tends to be seen in younger teenagers. Genetics may also play a role, because this type of acne has been reported in monozygotic (identical) twins.

How is acne fulminans treated?

If your teenager has acne fulminans, they'll be treated with a combination of isotretinoin, a medication used to treat severe acne, and oral steroids. They'll need to take oral steroids for about six weeks; over time, the dose will be tapered to help prevent the damaging side effects of long-term steroid use.

Four weeks into their steroid treatment, an isotretinoin regimen will be started. The dose of isotretinoin will be small at first, but it will be increased gradually until their acne is gone. If the acne comes back after they stop taking isotretinoin—which is rare—a repeat course of the medication can be used.

Stubborn cases of acne fulminans can be treated with infliximab, a drug that's used to treat a number of autoimmune diseases. This drug can only be given intravenously, so your child will need to go to a clinic or hospital for treatment.

If your child's acne has suddenly become very severe, they may have acne fulminans and should be evaluated by a doctor.