What is cystic acne? Is there cystic acne treatment?

Millions of young people develop acne but most cases consist of a few pimples that are only a mild nuisance. There are others, however, who develop a severe form of acne called cystic acne. Unlike mild acne, cystic can noticeably affect one’s appearance and generally doesn’t clear up on its own. If not properly treated, cystic acne can leave scars. Unfortunately, this condition is difficult to treat because of its stubborn nature and because people tend to wait too long before seeking treatment.

Typical acne involves a combination of oil, skin cells, and/or bacteria blocking a pore. Cystic is more severe; in addition to those criteria, the infection goes deeper into the skin, feels painful or itchy, and contains pus. If a lesion bursts, the infection can spread and the pore becomes permanently damaged. That potential damage is is why someone suffering from this condition should never attempt to pop their acne lesions.

Sufferers of cystic acne should seek professional medical help immediately. The longer one waits, the more likely the infections will end up scarring.

How does cystic acne develop?

The exact cause of this condition isn’t known, but hormones play a part, which is why cystic acne often develops in teens.

Cystic lesions begin as fairly normal pimples but continue to worsen beyond typical acne. Initially the pore becomes clogged with oil and dead skin cells. Often acne-causing bacteria get trapped inside the pore as well. These bacteria thrive on oil produced by the skin, which only encourages growth and infection.

With cystic acne, the infection grows deeper, becomes inflamed, and blocks the pore opening. If the lesion ruptures because of its size or because of squeezing, the infection spreads to surrounding areas and further infects skin.

Who usually develops cystic acne?

Since hormones are largely responsible for cystic acne, the condition usually appears in teens. The condition appears more with men than women.

n males, abnormal levels of androgen appear to play a role. Once a male passes the stage of puberty, the levels of androgen increase. These hormones cause change in skin texture and induce excess oil production from the skin glands. If for any reason the skin pore closes (eg due to the oil and other debris), this results in formation of pimples.

In females, abnormal levels of estrogen/progesterone seem to play a role. Women can experience a number of hormone changes which may contribute to cystic acne. Hormonal changes occur during the menstrual cycle, menopause, pregnancy, and/or if they have a medical disorder called polycystic ovarian syndrome.

The condition can appear in someone as young as eight years old, to as old as fifty. Cystic acne also runs in families. Hence, if one your parents had severe acne, then there is a chance that you may also develop the condition.

Cystic acne most commonly presents on the face but can also occur on the back, chest, upper arms and shoulders. Overall cystic acne is much more common in males but women can also develop this skin disorder. When it occurs in women, the cystic acne usually occurs below the cheeks and around the mouth and chin area.

Where does cystic acne appear?

Cystic acne most commonly forms on the face, but also appears on the back, chest, upper arms, and shoulders. Though women don’t often develop the condition, those who do usually have it on their lower face and neck.

What are symptoms of cystic acne?

Unlike typical, mild acne, cystic does not come to a head or disappear with regular care. Instead, it develops “under the skin” and stays there. Sometimes there’s minimal redness, but often these cysts are red, inflamed, and painful whether or not you actually touch them. Sometimes the pore opens enough at the top to release pus and reduce the swelling, and though it’s tempting, one should not pop (or attempt to pop) the pimple. Though this may be an effective method at releasing pus, it doesn’t get rid of the lesion or treat the infection. More often than not, it damages the pore and causes the infection to spread.

How is the diagnosis of cystic acne made?

In most cases, it’s easy to self-diagnose. But in order to receive an effective treatment plan and medication, a dermatologist can easily identify the condition by looking at the patient’s skin. In rare cases, a biopsy of the skin lesion is done. If there is pus, the doctor may also obtain cultures.

Can cystic acne be popped?

Never attempt to pop cystic. More often than not, the attempt won’t reduce the lesion or improve its appearance. Instead, the attempt pushes the infection deeper into the skin, which may damage the pore. If the pore becomes damaged, the infection can spread under the skin to adjacent cells, creating new cysts. Squeezing cysts tends to leave scars and if the lesion does rupture, it will likely be more difficult to cover with makeup.

How to get rid of Cystic Acne

Cystic acne is best treated early, when the condition is first noticed. At the first sign of a red and swollen pimple tha feels painful, see a dermatologist to determine if you should begin treatment for cystic acne. Treatments may be done with one of the following agents alone or in combination:

  1. Oral antibiotics, like minocycline and doxycycline, help kill acne-causing bacteria and decrease inflammation. Oral antibiotics don’t work well on their own and are usually paired with a topical retinoid. The combination of medications will be determined by a dermatologist.
  2. A number of contraceptive methods can improve cystic acne for women. Birth control can regulate hormones that may be causing the acne.
  3. Aldactone (spironolactone) is a pill that’s commonly used to reduce the amount of salt in the body. It’s also a last resort for women who haven’t responded to any other cystic acne treatments. Aldactone reduces the hormone androgen, which tends to cause excessive oil production. There are a number of side effects and contraindications that should be considered before using this drug. Effects aren’t usually noticeable for three or so months.
  4. Retinoids are derivatives of vitamin A and treat a wide range of acne. They come in the form of cleansers, topical gels, and pills. The pills are often combined with antibiotics to treat cystic acne. The strongest retinoid is isotretinoin, more commonly known by the brand name Accutane. It’s prescribed as a last resort because of the numerous severe side effects. However, it usually does clear up even the most severe cystic acne.

Related: Epiduo Gel, the Most Prescribed Acne Treatment

What are precautions when taking isotretinoin?

Anyone who uses Accutane (isotretinoin) needs to be fully informed of the complications, side effects, and risks involved. The iPledge program ensures that patients are well-aware of the risks and don’t become pregnant while using the treatment.

Does diet affect cystic acne?

Diet isn’t always responsible for acne but can certainly affect skin health. A well-balanced diet that doesn’t contain artificial ingredients, excessive dairy, or sugar will be most beneficial. That being said, diet alone won’t improve cystic acne completely if at all.

What can I do at home?
  1. The first thing to do is maintain good skin hygiene; do not pick or squeeze. Avoid perfume or perfumed cosmetics, as they tend to irritate acne further. Many facial products contain a large number of chemicals that can further irritate the skin.
  2. If the skin is swollen and painful, applying an ice pack for 20 minutes several times a day can reduce inflammation. Pain relievers like aspirin and ibuprofen can minimize pain and reduce swelling.
  3. Avoid stress and try to relax. Stress is known to increase the release of several hormones that can worsen acne.
  4. Adopt a healthy lifestyle: avoid smoking, eat well, get adequate sleep, and exercise regularly.
  5. Wear a sunscreen when outside to prevent sun damage and prevent acne from scarring.
  6. Always drink ample water to keep the skin hydrated. If urine isn’t clear or light yellow, that indicates the body isn’t getting enough water.
  7. For those using cystic acne medication, avoid use of other skincare agents unless approved by your dermatologist. Avoid chemical peels and exfoliating scrubs, as skin is highly sensitive while undergoing cystic acne treatment.
Do any cosmetic procedures treat cystic acne?

Treatments like dermabrasion, chemical peels, and lasers have been tried and failed. It’s more likely that these treatments will do much more harm than good.

Can cystic acne be cured?

Yes, if you seek treatment early, maintain good skin hygiene, avoid stress and with the right of prescription medication, you can get rid of cystic acne. Those who successfully undergo treatment don’t see a recurrence of cystic acne.