What is a defining characteristic of cystic acne in the grading system?

Cystic acne is characterized by the presence of cysts, which are large, inflamed, and painful lesions that arise deep within the skin. In the grading system for acne, cystic acne represents a more severe form of the condition. It typically includes not only cysts but also other elements such as comedones (both open and closed), papules, pustules, and significant inflammation.

The defining feature of cystic acne is the deep and often painful nodules or cysts that can lead to scarring if not treated properly. The inflammation associated with cystic acne is prominent, and it often requires a different treatment approach compared to milder forms of acne. This characteristic combination of various lesions, including both non-inflammatory and inflammatory types, distinguishes cystic acne from other forms of acne that may present with fewer or less severe lesions.

Understanding this characteristic helps in proper diagnosis and treatment planning, as cystic acne often necessitates interventions such as prescription medications or clinical treatments that target inflammation and the underlying causes rather than simple topical treatments that might be effective for minor breakouts or non-inflammatory acne.