Here’s the truth about cystic acne and how you can finally get rid of it

By: Dr. Corey Hartman, Skin Wellness Dermatology

Cystic acne is definitely the most severe form of subcutaneous acne that contributes to significant scarring. So when people talk about acne scars with the textural changes, like ice pick scars or rolling scars, this is the type of acne they typically have. 

Unfortunately, treating these types of acne scars can be hard. Improving their appearance can only be done using invasive, expensive, and often uncomfortable procedures like laser resurfacing. 

If you’re suffering from cystic acne, this is why I strongly encourage you to find a treatment that works for you as soon as possible. You definitely want to prevent or minimize the scarring as much as you can.  

Cystic Acne: All of your questions answered

What exactly is cystic acne?

Cystic acne isn’t just superficial; it’s a sign of more significant inflammation. It’s going deeper in the dermis under the skin where it’s involving more of the oil glands and starting to form nodules and cysts. 

What causes cystic acne?

There’s no one straight answer as to what causes cystic acne, but generally, it’s from inflammation that we don’t really understand. Still, there a few things that may contribute:

• Hormones. There can be a hormonal component to it as we see most cystic acne in teenagers and young adults.
• Genetics. It can be genetically determined. When I ask a patient if any family members have cystic acne, I usually get an answer like, “Yeah, my dad had this kind of acne and has scarring,” so there does seem to be a familial component. 
• Diet. We’re finding out more and more about the impact of diet on acne, but still, I wouldn’t say there’s slam dunk evidence. We do know that skim milk (the proteins in the milk, not the dairy per se) can contribute, as well as foods with a high glycemic index like bread and pasta. Some people swear that dairy in general makes their acne worse. I don’t fight them on it; I’m just not sure if the science really backs it up. 

How can you get rid of cystic acne? 

For this kind of acne, creams aren’t going to be enough. You’re going to have to do something to get into the system to really have an effect.

• Accutane. For the very reason above, Accutane is the best treatment option for cystic acne. It’s the only thing that can get in the system and get ahead of the acne and prevent that textural scarring. While I do say it’s the best treatment option, it’s still not something everybody’s going to need.
• Oral Antibiotics. Antibiotics can be helpful for some people with moderate to severe cystic acne. This just helps to get into the system and start fighting off that bacteria. 
• Retinoids. High potency retinoids are always going to be a part of any acne regimen, especially in cystic acne. This is mainly because it increases cell turnover and simply keeps things moving. This means oil and bacteria aren’t just sitting on top of the skin.
• Laser Treatments. There are some laser treatments that have been on the market that can play a role in treating cystic acne. They may not be as good as any of the other treatments we’ve listed above, but they can be helpful.
• Chemical Peels. Peels can also help to treat it, and some insurance actually pays for these. Like retinoids, these also just help to increase cell turnover.
• Photodynamic Therapy. Photodynamic therapy, along with levulinic acid that we use for the treatment of precancers, works very well for cystic acne. But the thing is, it’s not covered by insurance for acne so it doesn’t really get as much play as some of the other treatments. Plus, there can be some discomfort and also significant downtime when you do it the right way, and the fact is, we just have other options. 

Find the cystic acne treatment that works for you

Getting rid of cystic acne isn’t something most people can cure on their own at home. By seeking the help of a dermatologist, you’re much more likely to find the right treatment much sooner and greatly reduce your chances of having to deal with those pesky scars down the road. 

So don’t battle it alone. We have options when it comes to treating cystic acne; we just need to find the right one or combination for you.

Learn more about Cystic Acne Treatment from Skin Wellness Dermatology in Birmingham, AL

At Skin Wellness Dermatology, we offer cutting-edge skincare and dermatology services to our patients in the Greater Birmingham area, including Hoover and Homewood. At our offices in Birmingham & Chelsea, AL, our certified dermatologists are here to listen to your concerns and offer the individualized, high level of patient care you seek. We believe in making care accessible and affordable, and we will go out of our way to accommodate your visit. Give us a call today at 205-871-7332.