Cystic acne involves painful, pus-filled pimples deep under the skin, often lasting for years and leaving scars. Dermatologist intervention is crucial, with symptoms including inflammation, tenderness, and persistent cysts.
Treating cystic acne is not quite the same as treating other types of acne due to its severity. Here’s what to do & what not to do for cystic acne treatment.
What is Cystic Acne?
Cystic acne is a serious form of inflammatory acne that goes deep under the skin, resulting in painful, pus-filled pimples. It occurs when skin pores are blocked by dirt, oil, and dead skin cells. Also known as nodulocystic acne, it forms swollen bumps filled with pus, causing discomfort and itching. If a cyst bursts, it can spread, leading to more breakouts. [1]
Bacteria can also be trapped in the pores, intensifying the condition and creating red, swollen, and painful cysts filled with fluid. This severe type can last for years, affecting large skin areas and leaving scars.
Cystic acne primarily affects adolescents and young adults, with approximately 80% of individuals aged 11 to 30 encountering blemishes at some stage. [2]
Timely treatment is crucial. Dermatologists can provide effective plans to manage cystic acne, preventing long-term consequences.
Symptoms of Cystic Acne
- Painful, deep pimples
- Raised, red scars
- Inflammation and itching on the skin
- Tenderness or pain to the touch
- Nodules and cysts beneath the skin surface
- Persistence, with some lasting 1 to 4 weeks or more
- Bacterial involvement leading to fluid-filled cysts
What Causes Cystic Acne?
Dermatologists do not fully understand the exact causes of cystic acne, but several factors contribute to its development. [3] Some common causes include:
- Sebum Overproduction: The skin’s sebaceous glands produce oily sebum. While normal sebum protects skin and hair follicles, excessive production can lead to clogged pores. The clogged pores cause inflammation and swelling.
- Hormonal Fluctuations: Changes in hormone levels, like those that happen during puberty, pregnancy or menopause, have an impact, too. When teenagers go through hormonal changes during puberty with increased androgen hormones, it can lead to more oil production on the skin.
- Medical Conditions: Certain medical conditions that affect hormones, like syndrome (PCOS), can also play a role in causing skin issues.
- Continuous Stress: Persistent stress is accompanied by the release of androgens in the body, which correspond to the occurrence and development of a situation favorable to pimple production.
- External Factors: Different external factors, like the usage of cosmetics, cleansers, moisturizers, and clothing, are attributed to the prevalence of blocked pores and cystic acne formation.
- Skin Microbiome: The presence of bacteria species on the skin can lead to inflammation and contribute to acne development by affecting blemishes.
- Genetics: Some people might have a genetic predisposition and, therefore, it may be in their genes to have such skin problems.
- Drugs: There are some medicines and chemicals, including corticosteroids, phenytoin, lithium, and isoniazid, that either cause eruptions or stimulate them.[4]
It’s important to note that these factors may not individually cause cystic blemishes, but their combination or presence in specific individuals can lead to occasional or persistent breakouts.
Common Misconceptions About the Causes of Acne
Many misconceptions exist regarding the causes of cystic acne, attributing it to factors that lack scientific support. Contrary to common belief, the following factors do not contribute to skin breakouts:
- Inadequate face cleansing
- Sexual activity, including masturbation
- Various dietary choices
- Consumption of chocolate
- Intake of greasy or spicy foods
How Long Does a Cystic Pimple Last?
The duration of a cystic pimple, resulting from blocked and inflamed pores colonized by bacteria, can vary. If left untreated, these cysts can last for 1 to 4 weeks (typically one month), with the body eventually resolving inflammation. However, some cysts may stay longer and leave lasting scars.
Seeking professional treatment from a dermatologist is recommended, as it may take 2 to 3 months for a noticeable improvement in cystic acne. [5]
Popping Cystic Acne
The urge to pop cystic acne, given its size and pus-filled nature, can be strong but Do Not pop your cystic acne. Popping cystic acne is not only painful but also counterproductive—it delays the healing process and increases the likelihood of scarring.
Cysts are deeper under the skin and thus cannot be squeezed like blemishes, blackheads, or whiteheads whose cores can be pushed out. Trying to pop cysts is futile and results in a lot of trauma and inflammation, leading to even more severe scarring and discoloration.
Appropriate judgment toward better management and minimizing long-term skin damage include seeking proper dermatological intervention and avoiding self-induced trauma.
Treating Cystic Acne
When it comes to cystic pimple treatment, it often requires more than using over-the-counter solutions like cleansers, moisturizers, masks or regular acne skincare products. Given the severity of cystic acne, it is recommended to seek advice from a dermatologist who can provide you with prescription medications tailored to your condition. According to the American Academy of Dermatology (AAD), dermatologists have a high success rate in treating cases of skin breakouts. [6]
Retinoids
Retinoids stand out as highly effective treatments for all types of acne, spanning from mild to severe cases. These are a form of vitamin A and include topical products with ingredients like retinol, tretinoin, or adapalene. For more severe cases, oral isotretinoin is a potent cystic acne treatment, as according to AAD, 85% of individuals experience permanent clearing after completing a single course of isotretinoin. [7]
It works by unclogging hair follicles to prevent and treat severe acne. Available as creams, gels, or lotions, topical retinoids may cause temporary redness and peeling, which typically subside within four to six weeks.
Daily use of topical retinoids may initially cause redness and peeling, but it typically diminishes as the skin adjusts, usually within four to six weeks (one skin cycle). The result is fresher, clearer skin.
Oral Antibiotics
Doctors often recommend using antibiotics for a short period to avoid concerns about resistance. Possible side effects of antibiotics may include increased sensitivity to sunlight, digestive issues like diarrhea and feelings of nausea. The use of antibiotics in treating the breakouts on the skin should only be done under close monitoring and with a recommendation by a dermatologist.
Dermatologists may suggest taking oral antibiotics. These medications work by targeting bacteria and reducing the inflammation that leads to breakouts. Though antibiotics may find application in killing bacteria and other problems, they do not deal with issues like excessive oil production and dead cells from the skin.
Oral Contraceptives
This medication may solve hormonal changes that women experience each month during their menstrual periods and are associated with cystic acne. These birth control pills have estrogen to help suppress sebum from its production and regulate hormones in the body. Combining this approach with spironolactone may be recommended in some cases. [8]
However, oral contraceptives may not be suitable for everyone, particularly if one smokes or is actively trying to conceive.
Cystic Acne Treatment at Home with Phototherapy
Dealing with acne from home can involve using light therapy, which focuses on light wavelengths to target acne-causing bacteria, reduce inflammation and regulate oil production. [9]
Get familiar with the basics: Blue Light fights bacteria, while Red Light aids healing. Opt for a device specifically designed for acne treatment, whether a tool or a mask. Adhere to the instructions diligently, keeping your sessions brief and consistent—typically ranging from minutes to 20 minutes times per week.
If using a mask, remember to wear eyewear as advised. You can also integrate therapy with medications recommended by your dermatologist. Watch out for any redness or irritation as side effects. Before you start any home treatments, consulting with a dermatologist is wise to ensure they suit your type and severity of acne.
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Summing Up
Don’t let cystic acne leave its mark! By resisting the temptation to touch or pick one can prevent scarring and further infection. One should approach a dermatologist, as they will ascertain preventive strategies and effective treatment options in the form of antibiotics, topical agents, etc.
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