What is Cystic Acne and How to Get Rid of It

Learn what causes cystic acne and discover effective treatments to manage and reduce this severe skin condition.

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Author Mads Timmermann

Mads has 14+ years of experience as a skin expert and has written/read this article.


Cystic acne is a severe form of acne characterized by large, inflamed, and painful breakouts that can occur deep under the skinโ€™s surface. These breakouts often lead to unsightly and lingering scarring, making it a particularly troubling and difficult-to-treat skin condition. Understanding the underlying causes and effective treatment options is crucial for those who suffer from cystic acne in order to manage and alleviate symptoms.

The primary cause of cystic acne is the overproduction of oil, known as sebum, by the sebaceous glands in our skin. When this oil combines with dead skin cells and bacteria, it can lead to clogged pores and inflammation, resulting in the development of nodules and cysts. Hormonal changes, genetics, and certain lifestyle factors can also contribute to the development of cystic acne.

In order to effectively treat cystic acne, it is essential to address the root cause of the problem by targeting the bacteria and reducing inflammation. This can often be achieved through a combination of over-the-counter treatments, prescription medications, and improved skincare practices. Adopting a consistent and comprehensive skincare regimen that includes proper cleansing, exfoliation, and moisturization is vital for improving the overall health and appearance of the skin and preventing future breakouts.

What is Cystic Acne?

Cystic acne is a more severe form of acne, characterized by the formation of large, painful, and inflamed nodules or cysts beneath the skin. It is caused by a combination of factors, such as excess oil production, bacteria, and dead skin cells that clog the hair follicles, leading to inflammation and infection. Cystic acne often affects the face, but it can also appear on the chest, back, and upper arms.

Unlike common acne, which usually consists of smaller pimples and whiteheads, cystic acne presents with much larger and deeper blemishes. These large, inflamed lesions can be quite painful and are more likely to leave scars or cause skin discoloration. This type of acne tends to be more persistent, and it often requires specialized treatment to manage and prevent scarring.

Several factors can contribute to the development of cystic acne, including genetics, hormonal imbalances, and certain lifestyle habits. Stress, lack of sleep, and poor diet can also play a role in exacerbating cystic acne. Furthermore, certain medications, such as steroids or hormone-based therapies, may trigger or worsen the condition.

Treatment options for cystic acne often involve a combination of medications and lifestyle changes. Topical treatments, such as benzoyl peroxide and retinoids, can help unclog pores and reduce inflammation. Oral medications, such as antibiotics, may also be prescribed to treat the underlying bacterial infection. In severe cases, oral isotretinoin, a potent acne medication, may be used to effectively decrease oil production and prevent new cysts from forming. Additionally, maintaining a consistent skincare routine, eating a healthy diet, managing stress levels, and avoiding irritants can help improve cystic acne and minimize the risk of scarring.

Causes of Cystic Acne

Cystic acne is a more severe form of acne that occurs when hair follicles become clogged with oil, dead skin cells, and bacteria. This deeper type of acne is more painful and is characterized by larger, more inflamed breakouts. Letโ€™s explore some of the factors that contribute to the development of cystic acne.

Hormonal Changes

One major cause of cystic acne is hormonal changes in our bodies. Hormones called androgens can cause an increase in sebum production in the skin, leading to clogged pores. These hormonal imbalances may occur during puberty, menstruation, pregnancy, or polycystic ovary syndrome (PCOS).

Genetic Factors

Our genetic makeup can also play a role in the development of cystic acne. If a family member has experienced severe acne, it may increase our likelihood of developing it as well. Although the specifics of how genes contribute to acne are not fully understood, it is clear that genetics can predispose some individuals to this skin condition.

Diet and Lifestyle

Various aspects of our diet and lifestyle can contribute to cystic acne. Some studies suggest that a high consumption of processed sugars, refined carbohydrates, and dairy products may exacerbate acne. Additionally, a lack of sleep and poor skincare habits can lead to clogged pores and inflammation, subsequently increasing the chances of developing cystic acne. Maintaining a healthy diet and proper skincare routine may help in managing acne symptoms.

Stress and Anxiety

Lastly, stress and anxiety may worsen cystic acne. When we are stressed, our bodies release hormones, such as cortisol, which can increase sebum production and lead to acne breakouts. Managing stress levels through relaxation techniques, exercise, and getting adequate sleep can help in preventing cystic acne flare-ups.

Symptoms of Cystic Acne

Cystic acne is the most severe form of acne and, as the name suggests, it involves the development of cysts. These cysts are inflamed, pus-filled, and painful lesions that form deep within the skin. They take longer to heal than other types of acne and often leave scars. In this section, we will discuss the symptoms of cystic acne that differentiate it from other forms of acne vulgaris.

One of the primary symptoms of cystic acne is the presence of large, red, and painful bumps or nodules on the skin. These nodules can occur on the face, but they also commonly develop on the chest, back, and shoulders. The nodules can be quite tender to touch and may sometimes itch.

Unlike other forms of acne, which typically involve blackheads, whiteheads, or small pimples, cystic acne is characterized by large, pus-filled cysts. These cysts form deep within the skin and can feel like hard, thick lumps beneath the surface. The pus content within the cysts is what gives them their distinctive white or yellow appearance.

Another symptom of cystic acne is the increased inflammation and redness surrounding the affected areas. The skin may appear swollen and feel warm to touch. This inflammation exacerbates the pain experienced by individuals with cystic acne.

Lastly, one of the unfortunate consequences of cystic acne is scarring. Due to the depth and severity of the lesions, damage is caused to the surrounding skin tissues, resulting in the formation of scars. These scars can be raised or depressed and might be pink, red, or brown in color. They can persist long after the acne has resolved, sometimes even permanently.

To recap, cystic acne is distinguished by the presence of large, inflamed nodules or cysts that form deep within the skin. The affected areas are typically red, painful, and swollen, and due to the severity of the lesions, scarring is common.

Treatments for Cystic Acne

Cystic acne can be a persistent and frustrating skin condition. Thankfully, there are several treatment options available to help alleviate symptoms and improve the appearance of your skin. In this section, weโ€™ll discuss three main approaches for managing cystic acne: topical treatments, oral medications, and dermatological procedures.

Topical Treatments

Topical treatments are applied directly to the skin and can help in treating mild to moderate cases of cystic acne. These include over-the-counter (OTC) creams and gels that contain benzoyl peroxide or salicylic acid, which have antibacterial and anti-inflammatory properties. Prescription topical treatments, such as retinoids, can also be effective in reducing acne inflammation and unclogging pores.

To get the best results from topical treatments, itโ€™s essential to:

  • Gently cleanse your skin
  • Apply medication as directed
  • Use a non-comedogenic moisturizer
  • Avoid picking or squeezing the acne lesions

Oral Medications

For more severe cases of cystic acne, oral medications may be necessary. Commonly prescribed medications include:

  • Antibiotics: These can help reduce bacteria and inflammation.
  • Isotretinoin: This powerful medicine is used for severe, treatment-resistant cystic acne, and has been shown to reduce anxiety and depression associated with the condition according to a study.
  • Hormonal therapies: Birth control pills or anti-androgens may be prescribed to women experiencing hormonal imbalances contributing to their acne.

Itโ€™s important to follow your healthcare providerโ€™s advice and complete the full course of prescribed medications to achieve the best results.

Dermatological Procedures

Dermatologists may recommend certain procedures to treat severe or persistent cystic acne. Some of these options include:

  • Photodynamic therapy: In this procedure, a photosensitizing agent like aminolevulinic acid is applied to the skin and activated by a specific wavelength of light to help reduce acne inflammation as demonstrated by a study.
  • Chemical peels: These treatments involve the application of a mild chemical solution to the skin in order to remove dead skin cells and unclog pores.
  • Corticosteroid injections: In severe cases, a dermatologist may inject corticosteroids directly into inflamed acne cysts to help reduce inflammation and prevent scarring.

Always seek the help of a qualified dermatologist before considering any dermatological procedures to treat cystic acne, and be sure to discuss the potential risks and benefits involved.

Preventing Cystic Acne

Cystic acne is a severe form of acne characterized by large, painful, and inflamed nodules or cysts that form deep within the skin. Preventing cystic acne is essential for maintaining clear and healthy skin. In this section, we will discuss several measures one can take to prevent the development of cystic acne.

Maintaining a consistent skincare routine is crucial for preventing cystic acne. We recommend gently cleansing the face twice a day with a mild cleanser designed for acne-prone skin. This helps remove excess oil, dirt, and bacteria that can contribute to breakouts. Additionally, applying a non-comedogenic moisturizer can help keep the skin hydrated without clogging the pores.

Exfoliating the skin regularly can also help in preventing cystic acne. This process removes dead skin cells and unclogs pores, reducing the chances of acne formation. However, itโ€™s essential to be cautious with exfoliation, as over-exfoliating can irritate the skin and lead to more breakouts. We suggest using a gentle exfoliating product two to three times a week.

Another critical aspect of preventing cystic acne is paying attention to your diet. Consuming a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can promote healthy skin. It is also essential to stay hydrated by drinking plenty of water throughout the day. Avoiding high-glycemic foods, such as sugary drinks and processed foods, can help reduce inflammation and lower the risk of developing acne.

Managing stress levels is another important factor in preventing cystic acne. High stress levels can cause hormonal imbalances and trigger acne breakouts. Incorporating relaxation techniques like meditation, yoga, or deep breathing exercises can help in managing stress and promoting overall health.

In some cases, over-the-counter treatments may not be sufficient in preventing cystic acne, and visiting a dermatologist for a professional evaluation might be necessary. Dermatologists can prescribe medications, such as isotretinoin, which can effectively treat severe cystic acne in some individuals.

By following these preventative measures, we can help keep our skin clear and reduce the risk of developing cystic acne. Remember, consistency is key in maintaining a healthy skincare routine and preventing breakouts.

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