Severe Cystic Acne

People with cystic acne develop pus-filled acne cysts (pimples) deep under the skin. The acne cysts are often painful and can be large. A dermatologist should treat cystic acne to reduce the risk of scarring and infection. Antibiotics and prescription-strength topical (skin) creams can help clear up your skin.

Cystic acne is a type of inflammatory acne that causes painful, pus-filled pimples to form deep under the skin. Acne occurs when oil and dead skin cells clog skin pores.

With cystic acne, bacteria also gets into the pores, causing swelling or inflammation. Cystic acne is the most severe type of acne. Acne cysts are often painful and more likely to cause scarring.

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Nodular acne and cystic acne are very similar. Both cause deep, painful bumps under the skin. And both can scar. Differences include:

Pores in the skin can clog with excess oil and dead skin cells, causing pimples. Bacteria can enter the skin pores and get trapped along with the oil and skin cells. The skin reaction causes swelling deep in the skin’s middle layer (the dermis). This infected, red, swollen lump is an acne cyst.

A cystic acne breakout may cover a large area of skin. Cystic acne tends to appear on the face, which has a lot of oil glands. But you can also get acne cysts on your:

Cystic Acne: Causes, Symptoms, And Treatments

Acne cysts can be difficult to treat. Because they can scar, you should seek help from a dermatologist instead of trying over-the-counter acne products. A dermatologist can teach you how to treat cystic acne.

It can take three months or more to clear up acne cysts. Treatment often involves taking oral antibiotics and applying prescription-strength topical gels or creams to the skin.

Opening up acne cysts — by popping or picking them — increases the risk of scarring and bacterial skin infections like cellulitis.

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Some people develop pigment changes (light or dark) spots at the site of the acne cyst after the skin clears up. These spots may be pink, purple, red, black or brown. They eventually fade away, but it may take more than a year.

Most people with cystic acne can prevent severe breakouts or quickly treat acne cysts to prevent scarring. Often, but not always, cystic acne clears up or diminishes with age, as hormones settle down.

Severe or untreated cystic acne can affect how you feel about your appearance, making you anxious or depressed. If cystic acne bothers you, talk with your healthcare provider about getting help with fostering a positive self-image.

Things That Will Actually Treat Cystic Acne

It’s tempting to want to touch or pick at painful, swollen acne cysts. But cystic acne is more likely than other zits to scar or develop infections. A dermatologist can offer suggestions to prevent cystic acne. This doctor can also treat painful acne cysts, lowering the chances of scarring. Antibiotics and topical (skin) creams are effective cystic acne treatments.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. PolicyStruggling with those large, red and painful breakouts on your skin? Cystic acne, which is the most severe form of acne, must be dealt with seriously. The inflammatory condition requires medical intervention.

Our skin consists of sebaceous glands, which produce sebum (natural oil). When excess sebum is produced, it leads to clogged pores. This creates an environment for bacteria (P. acnes) to thrive, which in turn leads to the development of cysts in the deepest layers of the skin. [1]

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Although most acne is related to adolescent age, it can develop at a later stage in life too. The following factors trigger cystic acne: [2]

Cystic acne is most common in people with oily skin. It is also common in teens, women and anyone with hormonal imbalances.

The condition can affect your face, chest, back, upper arms and shoulders. It is prevalent in the lower half of women’s faces.

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Since cystic acne is the most severe kind of acne, it requires a dermatologist intervention. According to your condition, your doctor may suggest a treatment method or combination therapy. Here are some medical treatment options:

Benzoyl peroxide functions by reducing the bacteria causing cystic acne and thereby reducing inflammation [3]. It can be used in concentrations of 2.5 - 10 %. It comes in the form of cleansers and bars, lotions, creams and gels.

Benzoyl peroxide has a tendency to dry out your skin. Make sure you know your skin type and then use the right concentration of benzoyl peroxide.

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A derivative of Vitamin A, Isotretinoin can be taken in the form of tablets [4]. This is one of the most effective forms of treating cystic acne. Isotretinoin shows results in 6-8 months of usage.

Although it is very effective, it can have some side effects like mood swings, inflammatory bowel syndrome, bruising, skin inflammation, urine in blood, headaches and muscle pains.

Topical retinoids are also recommended for cystic acne, even though they do not carry the same power as oral retinoids. They come in the form of creams, gels and lotions.

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Topical retinoids can make your skin red and make it susceptible to sunburn. Using a sunscreen is a good idea when you are on topical retinoids.

Triamcinolone is a corticosteroid [6] that can be directly injected into the cyst to reduce inflammation and soothe cystic acne. This treatment is done by a certified dermatologist.

You can’t pop oral contraceptives to cure cystic acne if you are a smoker, have blood clots or are planning a pregnancy.

How To Treat Cystic Acne

Incision and draining the cyst is another way to treat it. Make sure you get it done under the supervision of a dermatologist.

A. Cleanse: Wash your face twice a day in the morning and night to remove all the dirt, makeup residue and excess oils from your face. Make sure to use a gentle cleanser and not scrub too much, which can aggravate cystic acne.

B. Moisturize: Hydrate your skin and let your oily skin repair its natural barrier with a good moisturizer. Make sure it is non comedogenic and oil free so that it does not clog your pores further.

Cystic Acne Treatments That Work

C. Never Sleep With Your Makeup On: No matter how tired you are, make sure to remove your makeup before hitting the bed. Also stick to non-comedogenic and oil-free makeup.

D. Sunscreen: Wear sunscreen before stepping out as this can protect your skin from sunburns. A lot of cystic acne medications tend to make your skin susceptible to sunburn.

E. Kick Away Stress: Practice yoga, meditation or some form of exercise to keep stress at bay. Stress is linked to acne breakouts.

The Treatment Of Cystic Acne

F. Healthy Diet: Avoid foods full of carbs, sugars and fats. Increase your intake of fresh fruits and vegetables. Pro tip: Do not touch, pick or squeeze acne. By doing so, you are only pushing the infection deeper and spreading it.

Normal acne comprises of a few pimples that are not usually painful. Cystic acne is the most severe form of acne and usually larger than normal acne. It is characterized by red and pus filled breakouts deep in your skin.

While cystic acne is stubborn, you don’t need to live with it. There are advanced treatment options to help you get rid of cystic acne. Visit your dermatologist to find out which of the above treatments might work for you.Acne conglobata (AC) occurs when acne cysts and nodules begin to grow together deep below the skin. It’s a form of nodulocystic acne, a rare but serious inflammatory skin condition that primarily forms on your face, back, and chest. Over time, AC causes significant, and sometimes disfiguring, scarring.

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Although AC can be severe, medical treatments may help treat the acne while also reducing your risk for scarring. Talk to your dermatologist about all the options available and whether you’re a good fit for some of the more powerful medications.

Nodulocystic acne, such as AC, is characterized by nodules with cyst-like characteristics. Acne nodules develop deep in the pores as a result of clogged bacteria, oil (sebum), and skin cells. The resulting plugs harden and form the nodules.

Nodulocystic bumps aren’t true cysts. Cysts are fluid-filled cavities lined by epithelium tissue. This type of acne doesn’t contain a lining of tissue. And unlike the occasional nodule or cyst, this type of acne involves multiple nodules that connect together.

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While nodulocystic acne is rare, the subtype AC is even less common. Not only will you see widespread nodules with AC, but the acne will also build up into large skin-colored comedones. These lumps may also turn into cysts that leak smelly pus when accidentally popped. AC outbreaks are typically worse on your back.

As AC outbreaks build up on your skin, you might develop significant scars. These are classified as thin (atrophic) or thick (hypertrophic).

AC is caused by linking nodules, abscesses, and cysts. It’s difficult to control this type of acne with over-the-counter medication because it spreads deep below your skin through the sinuses.

Repairing Cystic Acne Damaged Skin

According to Dermatology and Plastic Surgery, white men are more likely to develop AC. The onset usually occurs during your teens, and symptoms may continue for several years.

If you’re experiencing symptoms of AC or other nodulocystic acne, see your healthcare provider for diagnosis. They’ll look at your