How to Remove Cystic Acne: Here’s the Truth 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. Acne cysts pose additional risks, as popping them can lead to scarring and infections.
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. Early treatment is crucial to prevent acne scarring, as severe cystic acne is highly inflammatory and likely to cause significant skin damage and scars.
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. Excess oil can contribute to the formation of cystic acne by clogging pores. 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 severe acne, also known as cystic acne, but generally, it’s from inflammation that we don’t really understand. Still, there are a few things that may contribute:
- Hormones. There can be a hormonal component to it as we see most severe acne in teenagers and young adults.
- Genetics. It can be genetically determined. When I ask a patient if any family members have severe 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. Consulting a dermatologist is crucial to treat cystic acne effectively, as they can provide tailored treatment options.
- 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. Topical acne treatments should also be considered as an initial line of defense for treating various forms of acne.
- 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 acne, 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. Treating acne cysts can be particularly challenging due to their potential for scarring, making personalized treatment plans essential. 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.
Skincare Routine for Cystic Acne
A consistent skincare routine is essential for managing cystic acne effectively. Here are some tips to help you create an effective skincare routine:
- Cleanse Twice Daily: Use a gentle cleanser containing salicylic acid or benzoyl peroxide. These ingredients help to unclog pores and reduce inflammation, which is crucial for treating cystic acne.
- Balance with Toner: Apply a toner that balances your skin’s pH and removes any remaining impurities. This step ensures your skin is prepped for the next steps in your routine.
- Spot Treatment: Use a spot treatment with sulfur or tea tree oil on individual cystic pimples or areas of congestion. These ingredients can help reduce the size and severity of cystic acne breakouts.
- Moisturize: Choose a non-comedogenic, oil-free moisturizer to hydrate your skin without clogging pores. Hydration is key to maintaining a healthy skin barrier.
- Exfoliate Weekly: Exfoliate once or twice a week with a gentle exfoliant containing alpha-hydroxy acids (AHAs) or beta-hydroxy acids (BHAs). This helps to remove dead skin cells and prevent clogged pores, reducing the likelihood of cystic acne breakouts.
Preventing Cystic Acne Breakouts
Preventing cystic acne breakouts involves a combination of good skincare habits, a healthy lifestyle, and avoiding triggers that can cause flare-ups. Here are some tips to help you prevent cystic acne breakouts:
- Hands Off: Keep your hands away from your face to avoid transferring bacteria and oils that can clog pores and cause breakouts.
- No Picking: Avoid picking or popping pimples, as this can lead to further inflammation, infection, and scarring.
- Hair Care: Keep your hair clean and away from your face. Oily hair can transfer oils to your skin, leading to clogged pores and cystic acne.
- Wear Loose Clothing: Avoid tight clothing that can cause friction and irritation on your skin, which can exacerbate cystic acne.
- Stay Hydrated: Drink plenty of water to keep your skin hydrated. Dehydration can lead to dry skin, which can increase the risk of acne breakouts.
- Healthy Diet: Eat a balanced diet rich in fruits, vegetables, and whole grains. A healthy diet supports overall skin health and can help reduce the frequency of cystic acne breakouts.
Cystic Acne Scars and Hyper-Pigmentation
Cystic acne can leave behind scars and hyper-pigmentation, which can be challenging to treat. Here are some tips to help you manage cystic acne scars and hyper-pigmentation:
- Topical Treatments: Use a topical treatment containing retinoids or vitamin C. These ingredients can help stimulate collagen production and reduce the appearance of acne scars and hyper-pigmentation.
- Chemical Peels and Microdermabrasion: Consider chemical peels or microdermabrasion treatments. These procedures help exfoliate the skin and reduce the appearance of scars and hyper-pigmentation.
- Sun Protection: Use a sunscreen with at least SPF 30 daily. UV rays can darken hyper-pigmentation and make scars more noticeable, so protecting your skin from the sun is crucial.
- Laser Therapy: Laser therapy can be an effective option for reducing the appearance of cystic acne scars and hyper-pigmentation. Consult with a dermatologist to see if this treatment is right for you.
- Patience is Key: Treating cystic acne scars and hyper-pigmentation takes time and may require multiple treatments. Be patient and consistent with your skincare routine and treatments.
By following these tips and working with a dermatologist, you can effectively manage and reduce the appearance of cystic acne scars and hyper-pigmentation.
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. To effectively treat cystic acne, it is crucial to consult with a dermatologist who can provide personalized treatment options. 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.