How to Clear Cystic Acne

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If you have it, you likely know it. Cystic acne not only causes deep-seated scars on your face, but internal scars as well since many who have the skin disorder suffer from emotional distress. In fact "it is associated with long-term psychological issues including low self-esteem and depression," says West Palm Beach, FL, dermatologist Kenneth Beer, MD

However, there is no reason to throw in the towel. There are treatment options available and it is possible to get rid of cystic acne for good. You just have to know the right techniques. First it's important to know that while cystic acne is a type of acne, it can't be treated in the same way as blackheads and whiteheads. "[It] affects deeper skin tissue than common acne," says San Diego, CA, dermatologist Susan Stuart, MD.

 So while regular acne can be managed with topical medications, cystic acne can not, advises Dr. Beer. Due to the fact that cystic acne is usually a result of hormones, birth control pills are often recommended by dermatologists as a way to fight the problem. Other internal medication can be used as well. Antibiotics help to kill bacteria and reduce inflammation, says Dr. Stuart. 

Isotretinoin, the active ingredient in the drugs Accutane and Claravis, is also typically prescribed for patients suffering from this type of acne. Your dermatologist may also treat it with procedures that can be performed during an office visit, says Dr. Stuart. She recommends:

Lasers and other light therapies: These devices reduce the p. acne bacteria (the cause of acne). Your dermatologist can determine whether this type of treatment can be helpful.

Chemical peels: Dermatologists use chemical peels to treat 2 types of acne—blackheads and papules.

Acne removal: Your dermatologist may perform a procedure called “drainage and extraction” to remove a large acne cyst. This procedure helps when the cyst does not respond to medicine. It also helps ease the pain and the chance that the cyst will leave a scar. If you absolutely have to get rid of a cyst quickly, your dermatologist may inject the cyst with medicine. 

If you're at home and have a painful cyst, but can't get to your dermatologist's office right away, Dr. Stuart says to apply a hot compress on your cystic acne. "The heat will help to pull pus out from beneath the skin's surface. It will also reduce swelling and help your cystic acne to be less noticeable. You can simply soak a washcloth in hot water and hold it on the affected area for approximately 10 minutes," she says.

Remember, when dealing with this type of acne, you have options, so visit your dermatologist and keep up the good fight. 

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  • Anonymous
    Posted on

    I get horrible cystic breakouts on one side of my jaw from time to time. Sometimes I'd go weeks with nothing then bam breakout. As a side, I also noticed I get sort of congested after eating cheese especially. So I started experimenting with my dairy intake to see if it's causing my congestion. Since cutting way back on dairy I've seen a few changes: I'm not congested, I've lost weight, and I haven't had a single cystic breakout. I realize there are other factors like stress, hygiene, hormones etc. so I religiously maintained the same routine twice a day exfoliating, toning, and moisturizing while tweeting my dairy intake both before and after my periods on different months. I know it's not scientifically perfect but I believe there's a strong correlation between dairy and breakouts. I haven't totally quit dairy because I love cheese (I'm not a psycho), but it's made a huge difference cutting out most dairy!

  • Kyryth Kessler
    Posted on

    I always seem to get one of these when something is wrong, and I have one now that is really stubborn. It's on my lower neck. I had a pimple like this each time I was in early pregnancy (before it was confirmed) and then each time I've had cancer or a blood disorder. Is this just coincidence or is this my body's way of telling me something inside is not right?

  • l. wright
    Posted on

    I turn 60 this year, and have endured acne break outs since pre-teen years. my face does not have the scars of my younger years, but I get these hard lumps that never seem to come to a head. they are lumps that take forever to go down. they don't ever come to a head.

  • iram
    Posted on

    I started to have cystic acne when I was 19. I would clear up and break again. I went to dermatologist for advice spent almost a 1000 dollars. I was put on spironolactone, retniod cream, birth control pill. Spironolactone helped for a while. I use to get on my back too but it stopped there. Now I only get on my cheaks. It not severe acne but more mild. Now I'm on another birth control med or tho tri cyclin lo and I want to take it for three months to see the results. Also I am getting chemical peel my 2nd treatment for mild scarring. I'm so tired of these cystic acne.

  • Penny
    Posted on

    This is to "Hopeless" above... I'm not a dermatologist, nor am I a Psychologist, but I do want to comment on what you said up there. You mustn't let your skin condition make you a hermit, at the age of 50. If others have a problem with the condition of your skin, let them! They aren't worthy of your friendship and sweet heart any way! A true, good person would never be so shallow as to see your skin and place judgment on you for that. It's easy for me to say, I know, but as a Special Education teacher for many years, one of the hardest but most important things I've taught my kids is THEY ARE AS BEAUTUFULLY MADE AND IMPORTANT AS ANYONE ELSE IN THE WORLD. I wish you all the best, and that you find a solution to your problem. You have a lot to offer this world, and please don't ever think that you are not valuable, BECAUSE YOU ARE.

  • comment
    Posted on

    I too used to have painful cystic acne. I had one on my nose when I was 15 that was the size of my nose :o I found that diet is very important when controlling acne. Also supplements work wonders. Eat a lot of fresh fruit and veggies, limit your processed food intake and take supplements such as nac, l-lysine, fish oil, spirulina etc. (Most of these are anti-inflammatories) Try it, it works! :) Forget about prescription drugs and doctors. They are all nonsense. They only want your money. Eat fresh and take supplements.

  • mayora
    Posted on

    I get the occasional painful cyst-type acne (I am in my mid 20's and this is a recent development).I have pretty sensitive dry/normal combo skin and other treatments I have tried have just made me peely and flaky. I have been using Citrus Clear Control products for a month. At first the treatment was a little drying so I went to using it every other night and now I am applying it every night following it up with the moisturizer. My skin is DEFINITELY clearer. It is still a little irritating every once in awhile but I have not had any peeling/redness. It definitely stops the cyst-type acne from coming back.

  • Lola
    Posted on

    I regret using the Accutane. I'm almost 40 yrs old and I still have cystic acne but now I also have very dry skin and lots of wrinkles bc the accutane dried up my oil glands. To hell with all of you doctors who prescribe Accutane, that medicine should not be prescribed to anyone. I didn't sweat for 15 years and now I sweat in buckets. My eyes,nose, mouth, skin is always dry yet I still suffer from cystic acne. Nowadays I also have cysts on my scalp; It's as though I never took the Accutane yet I have all the awful, long term side affects from taking the drug. What gave anyone the idea that oil is what caused acne? Figure out a way to prevent the pores from getting plugged up and infected. I was desperate at the time and I know that others may feel the same way but it's not worth it. NOT AT ALL. And quit telling us not to drain our cysts, until you have the time bombs on your face with all the pressure and pain they cause, you can't talk at all. That throbbing and pain are intolerable.

  • Tripzz
    Posted on

    I had suffered with cystic bacne for quite a long time. Even doctor prescribed me medication but it didn't help. But then i went to a different dermatologist and he prescribed me 400 mg of Nizral tablets per week in combination with some other antibiotics and sulpher lotion. It did help but the recovery was bit slow and i wasn't patient that much to wait. So then I went to parlor and then my beautician applied some sort of chemical peel i guess that was BHA peel and it did wonders to my skin. My cystic acne started to get dry and in couple of weeks most of them dried out. Not to forget I have a sensitive skin but along with BHA peel I also used some Lemons to rub on my back on weekly basis to get rid from scars. It has improved a lot. And now I am almost 75% cured.

  • FeelYourPain
    Posted on

    to MidddleSchooltoAdulthood, I had acne like you describe, with the same resistance to those same treatments. One thing that worked wonders for me was spironolactone (I think I got up to 100mg daily) and periodic chemical peels. I had never had better skin in my life. I was on Yaz at the time too, but had been on it for a long time with no results prior to the spironolactone (I was on it primarily for birth control). Good luck.

  • MiddleSchoolToAdulthood
    Posted on

    I’ve had terrible cystic acne since I hit puberty- Mostly on my face with large pockets of very painful knots. It’s painful, it looks terrible, and no one really understands what’s going on with your face when they see you. All they see if a large welts that wasn’t there the day before- And then a scab that lasts for a few weeks. Covering up scabs with makeup is impossible- Again I’m 32 with a lumpy, scabby, swollen face. I have tried birth control (Ortho Tri-Cyclen, Yaz, and O-Ring), Benzyl peroxide (works great on my topical or typical acne), Salicylic acid, (upsets topical acne- I have to stay away from Salicylic acid), and prescription grade retinoid A. I stopped going to the dermatologist now- Cause I use to wait with hopeful anticipation for my 6 to 8 months for my appointment for a new Doc- Perhaps this new one would have an answer for me- But this was never the case, I would be prescribed retnold A and birth control once more- Even though these meds do not work for me. The time waited was useless. I have always had knots on my face- cheeks, chin, nose, eyes, forehead- This is a non-ending battle that leads to me calling out of work and wearing gobs of makeup to the gym. I am 32! When does this nightmare end? I envy teenagers with tons of puss filled topical acne cause they have treatments and solutions for this type- People with cystic are in a hopeless battle that effects every aspect of life.

  • Sharon
    Posted on

    I suffered from cystic acne on my jawline/chin/cheeks for years, using birth control for a good portion of the past 15 yrs As I have been trying to get pregnant in recent years, I stopped BC and, of course, the acne came back with a vengeance. I also take synthetic thyroid hormone for Hypo-thyroidism (also DX with PCOS at 22). I saw a dermatologist a little over a year ago who knew my desire to get pregnant meant nothing too harsh or dangerous, so she recommended NeoStrata's AHA series of lotions. I have been using the AHA15 one for over a year now, and very rarely break out anymore. Maybe 3 or 4 cysts in a year and probably one minor "regular" pimple per month, usually based on my cycle. I highly recommend NeoStrata!!

  • Posted on

    For the people that posted on this thread, I would suggest that "Hopeless" considers low dose isotretinoin (accutane, claravis). I know that this is a challenge logistically and financially but it would be worth it. Even though you had a hysterectomy, some of the male hormones produced by the adrenals or by other things may be problematic and this can be treated with Aldactone. I would suggest that, if possible, try to sit with a dermatologist to work out a program that can help

  • Hopeless
    Posted on

    I've had cysts on my face for over 40 yrs. I just recently found out that the virus that causes cold sores on my lips can also affect the cheeks, nose & chin so I can attribute some of the cysts & scarring to that. Now I'm getting large cysts around my eyes following application of eye cream which I use because I'm over 50. My skin now needs acne, wrinkling & sagging skin treatments. The acne treatments severely dry out my mature skin but the moisturizers & mature skin products make me break out with pustules & cysts. I have been doing everything I've been told, exfoliating, glycolic acid at home peels, salicylic acid treatments or benzoyl peroxide treatments, sulfur formulas, etc. I too cannot afford a dermatologist so my primary care doctor is trying different topical treatments at her disposal. None of which are covered by insurance. We have gone through several formulas. Some leaving my face extremely dry & crusty with continued acne. Some treating my skin's mature state are simply not effective on the acne it causes. I had a full hysterectomy years ago so my hormones don't seem to be the culprit. It's 100 times more embarrassing to have cystic acne & sores on my face at my age. What self esteem I had as a kid disappeared when I hit puberty & has long since gone over the yrs. It's hard to be a confident middle aged woman when people can't even look me in the eye due to the condition of my skin. I don't leave my home sometimes for weeks because I'm so ashamed. At this point I'm just waiting to die because there is no hope for me to ever recover from acne since there is no cure.

  • Bahtia Bilow
    Posted on

    I have cystic acne and I have found that using a galvanic spa from Nu Skin is extremely effective at removing these deep seated infections very quickly and it is painless for me at least. I get them around my jawline and behind my ears usually from stress and hormones at the same time. I also have severe allergies to a lot of different food including gluten. My skin is constantly erupting with one problem or another but I recently began using this spa that my Dad bought me. It is amazing, I can't afford a dermatologist and so I usually do my own lancing. I have a lot of scars but the spa helps diminish them and I also have seen a reduction in wrinkles because the spa requires the use of ageloc spa gels to work so I am also doing a wrinkle treatment at the same time as a facial. I love it. So glad I have one because they are next to impossible to get now. They used to be $360 but now the only way to get one is to purchase a business builder package with Nu Skin and then they give you a free spa package worth $360. The spa was recently classified as a medical device and is no longer available to the general public for purchase. Only trained medical professionals.

  • B. Wafer
    Posted on

    The wash cloth method absolutely works. I also apply topical Erythromycin 2% when I finish draining a keratin cyst at home.

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