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    Painful Cystic Acne lingering for weeks on my neck....
    rlsid21 posted:
    I have always had cystic acne anywhere on my body but I haven't had one this painful in a long time. The bugger is on the back of my neck and has been there for weeks. Just yesterday, it seems to swelled where it's hurting especially when I turn my head. I applied a small amount of 8% benzoyl peroxide this morning but it probably won't help much. I don't have health insurance so I can't see a derm for this to get an antibiotic shot as I would have in the past.

    I do have access to the student health center at school so I may opt for that if they can treat this. Is there anything that I can do at home to heal this on my own? Warm compresses? Ibuprofen for pain?
    Susan Evans, MD responded:
    Dear rlsid21,

    I really recommended that you visit your student health center as soon as possible. You may have a serious underlying infection. Acne may not be covered, but infections are generally covered by most insurance plans. A warm compress and ibuprofen may help temporarily, but if this is an infectious process that has been brewing for several weeks you should seek medical attention.

    Severe cystic acne that does not resolve with conservative measures may require surgical drainage and or prescription antibiotics.


    Dr. Evans
    rlsid21 replied to Susan Evans, MD's response:
    Hi Dr. Evans,

    I went to see my derm yesterday and had no choice but to break into my piggy bank full of cash to pay for the visit. I was in so much pain that I said, "I don't care, I'm paying for this visit out of pocket!" I was fortunate to have saved some emergency money in the apartment. I figured this was the time to use it.

    The PA took one look at my neck and said, "That is an abscess that needs to be drained as soon as possible to relieve the pressure." I was scared but kept telling myself that this was the best thing. She was as gentle as possible when she cut it open, squeezed it a few times, and than bandaged it up. It was extremely painful walking out of my doctor's office. She said that most abscesses are not infected that it should be fine without antibiotics. I insisted that she prescribe me some just in case because I have had abscesses before with ugly infections. It feels much better than it did the last few days and I was finally able to sleep last night without being in pain.

    A sample was taken to the lab for testing so I will find out about those results tomorrow morning for my follow-up appointment.

    What are the chances that this could be infected? Was I right to insist on an antibiotic due to my history of abscesses? How can I prevent getting these in the future?

    I am a runner and sweat a lot on the back of my neck. Should I wash my neck as soon as I am done with my workouts?

    Thank you,
    Susan Evans, MD replied to rlsid21's response:
    Dear Rebecca,

    I hope that by now you have experienced some relief from your abscess. As a runner, you know that you sweat a great deal during your workouts. It is very appropriate to shower after each workout to minimize surface bacteria and oily buildup.

    As a patient, you have the right to access to the medical information about you and you should be presented with a diagnosis and a treatment plan. If you feel that the options are unsatisfactory, rather than insisting that your doctor adhere to your desires, you may wish to seek a second opinion. A doctor/patient relationship could be harmed and your medical care hindered if you insist on a treatment that your doctor does not agree with. I know you're a student and may not have a lot of choice right now, but in the future you want to find a physician who is willing to listen to your concerns and be willing to come up with a plan that is beneficial to you without going against your physician's recommendations.

    An example of this was the period of time when parents would insist on putting their children on antibiotics for a cold. The doctor knew that the antibiotic would do nothing for the child, but the parents would insist. Take time to establish a good and honest relationship with your doctor. You'll get the very best care that way.
    Dr. Evans

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