If you break out in large, pus-filled pimples, you may have cystic acne. It is the most severe type of acne.
Cystic acne looks and feels different from other types of acne, such as whiteheads and blackheads. It doesn’t respond to the same kind of treatment either.
There’s no cure for cystic acne, but there are effective treatments. Here’s what you need to know.
What Is Cystic Acne?
Cystic acne is more than just a stray pimple here and there. Cystic acne refers to painful, inflammatory cysts that extend deep into the skin from the surface. They are usually red, filled with pus, and larger than other pimples.
People with acne cysts may also have acne nodules. A nodule is similar to a cyst, but it remains under the skin. A nodule doesn’t contain fluid, so it is harder and more solid.
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What Causes Cystic Acne?
When oil and dead skin block skin pores, pimples form. When bacteria also enters the pores, it can cause inflammation or swelling in the middle layer of skin. That swelling becomes cystic acne.
Risk factors for acne flareups include:
- Changes in hormone levels. Anytime there’s a hormonal change in the body (like puberty or pregnancy), you’re more likely to break out. Hormones cause grease-producing glands in the skin to make more oil, which can get clogged in skin pores.
- A family history of acne. If your mother or father had acne, it’s likely you will as well.
- Stress. There’s a relationship between stress and breakouts. Our bodies produce more androgens (a type of hormone) in response to stress. In turn, the hormones stimulate the oil glands to ramp up production, leading to breakouts.
- Hair and skin care products. If you use products that aren’t made for acne-prone skin, it can increase your chances of breakouts.
Where does cystic acne appear?
Cystic acne can cover your cheeks and forehead. You can also get cystic acne on the chin, jawline, and neck. Some people get cystic acne on their chest, back, and buttocks.
Side effects of cystic acne
Cystic acne is more than just a nuisance. It can cause other physical and emotional problems, such as:
- Low self-esteem. Feeling self-conscious about your appearance with acne can affect your social life and confidence.
- Acne scars. Because cystic acne goes deep into the skin, it damages both skin and underlying tissue. That can lead to scarring when the cyst heals.
- Depression. Teens with severe acne have a higher risk of developing depression. That’s one reason it’s important to get treatment for cystic acne rather than waiting for it to go away.
Cystic Acne Treatment
You may wonder how to shrink a cystic pimple. Over-the-counter treatments that may work for other kinds of acne have little effect on hormonal cystic acne. To treat cystic acne, you need to see a dermatologist.
Treating your cystic acne can help clear your skin, prevent new scars, and boost your self-esteem.
Your doctor may prescribe:
- An oral antibiotic. Usually this is the first treatment your dermatologist will suggest. An antibiotic can reduce the redness and swelling of cysts.
- Topical medicine. With the antibiotic, your doctor may also prescribe medicine you put directly on your skin to reduce bacteria and clogged pores.
- Birth control pills. If you’re a woman, your doctor may suggest birth control pills as part of your treatment. The pills balance your hormones. That helps clear acne by slowing down overactive oil glands in the skin.
- Isotretinoin. This strong medicine requires your doctor to monitor you closely. Side effects include dry mouth and eyes, light sensitivity, and birth defects should you become pregnant. Most people who take isotretinoin see permanent clearing after one four- to five-month course of the drug.
Once you start treatment, be patient. It may take up to three months to see improvement in your skin.
Can You Remove an Acne Cyst?
You should never pick at or squeeze your pimples. You’ll risk making the pimples worse and also increase your chance of scarring.
Your dermatologist can help remove a large cyst. Here’s how:
- Injecting it with a corticosteroid. This will quickly reduce the size and pain of the cyst.
- Incision and drainage. Your doctor can drain a large, painful cyst that doesn’t clear with medication.
To help prevent breakouts, use a mild cleanser, oil-free moisturizer, and water-based makeup. Ask your dermatologist about acne-friendly skin care products.
American Academy of Dermatology, What Can Clear Severe Acne? Link
American Academy of Dermatology, Isotretinoin: Overview, Link
American Academy of Dermatology, Acne Scars, Link
American Academy of Dermatology, Adult Acne, Link
NHS, Acne, Link
American Academy of Family Physicians, Acne, Link
Office on Women's Health, Acne, Link
Connect with UPMC
The UPMC Department of Dermatology diagnoses, treats, and manages numerous hair, skin, and nail conditions and diseases. We care for common and uncommon conditions, and our treatments include both surgical and nonsurgical options. We operate several specialty centers for various conditions. The UPMC Cosmetic Surgery and Skin Health Center is a comprehensive dermatologic laser facility, offering a full range of cosmetic services and procedures. With UPMC Hillman Cancer Center, we offer a Skin Cancer Program that provides complete care from screenings, diagnosis, treatment, and beyond. Find a dermatology provider near you.