Severe acne can affect many facets of a person's life, causing a great deal of embarrassment and stress. Severe acne may significantly limit one's social life and even interfere with opportunities for employment. They are extremely disfiguring and can cause psychological effects on the sufferer. Five types of severe acne acne conglobata , acne fulminans , gram negative folliculitis , nodulocystic acne and Pyoderma faciale. Acne conglobata is a chronic and severe form of acne vulgaris (common acne). It is usually characterized by deep abscesses, severe inflammation, severe damage to the skin, scarring, blackheads are usually conspicuous and widespread. It often appears on the face, chest, back, thighs, upper arms and buttocks. It usually affects those whose age is between 18-30 years old.

Acne fulminans is a sudden onset of highly hurtful inflammation. It appears suddenly in a person with inflammatory acne. Symptoms of severe acne nodulocystic, often ulcerating acne, aching joints and fever are apparent. A person who develops acne fulminans may have had unsuccessful treatment for another form of severe acne, acne conglobata. Another types of Acne gram-negative folliculitis. Gram-negative folliculitis is a complication of abused and long- term use of antibiotic. Patients with this type of acne are usually treated with accutane since it is known to be effective against gram- negative bacteria. Pyoderma faciale is the type of acne that affects females mainly belonging to the 20-40 age groups. Physical methods and prescription medications that dermatologists use to treat severe acne

Antibiotic gels and lotions are applied directly onto the skin (eg, Clindatec, Eryacne, Dalacin). Isotretinoin is the usual treatment of choice for acne conglobata. Isotretinoin is a synthetic (man-made) retinoid (form of vitamin A) that comes in pill form. It is usually taken once or twice a day for 16 to 20 weeks. Corticosteroids or non-steroidal anti-inflammatory medications may be given to reduce inflammation. Nodulocystic acne usually requires an aggressive treatment regimen that may include isotretinoin and antibiotics, or intralesional corticosteroids that "melt" the cyst over a period of 3 to 5 days. Spironolactone anti hypertensive drug has anti androgenic activities and can be used by both males and females to treat severe acne. Oral contraceptives have been shown to effectively clear acne in women.