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    Cystic acne is often considered one of the hardest types of acne to treat. It’s characterized by deep, painful cysts beneath the skin’s surface. Unlike other forms of acne, which can sometimes be managed with topical treatments, cystic acne typically requires a multifaceted approach involving both topical and oral medications. The challenge lies in the depth of the inflammation and the potential for scarring if not treated effectively.

    Another challenging type of acne is hormonal acne, which is linked to fluctuations in hormone levels, particularly androgens like testosterone. Hormonal acne often appears along the jawline, chin, and neck and tends to be more persistent than other types. Treating hormonal acne may involve hormonal therapies such as birth control pills or anti-androgen medications, making it complex to manage without addressing the underlying hormonal imbalances.

    Lastly, acne caused by underlying medical conditions or medications can also be difficult to treat. Conditions like polycystic ovary syndrome (PCOS) can contribute to persistent acne due to hormonal imbalances. Similarly, certain medications, such as corticosteroids or lithium, can trigger acne outbreaks that are resistant to typical acne treatments. Addressing the root cause of these types of acne is crucial for effective long-term management.

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