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This article was medically reviewed by Sarah Gehrke, RN, MS. Sarah Gehrke is a Registered Nurse and Licensed Massage Therapist in Texas. Sarah has over 10 years of experience teaching and practicing phlebotomy and intravenous (IV) therapy using physical, psychological, and emotional support. She received her Massage Therapist License from the Amarillo Massage Therapy Institute in 2008 and a M.S. in Nursing from the University of Phoenix in 2013.
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Cystic acne may be frustrating and painful, but it is treatable. Most cystic acne won't disappear overnight, but you can take steps to reduce it in a matter of weeks. Your dermatologist can offer creams, pills, and procedures that may offer dramatic results. A good daily skincare routine and healthy practices might also help. Scars can result from cystic acne, but these can be reduced through proper treatment. Keep in mind that while some people may see results quickly, others may need more time to heal.
Steps
Method 1
Method 1 of 4:
Treating the Acne Medically
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1Make an appointment with your dermatologist. The fastest and most effective way to fight cystic acne is through medical treatment from a dermatologist. Your dermatologist can prescribe the medications or perform non-invasive procedures.[1]
- If you don't have a dermatologist, ask your primary care physician for a referral. You can also look up a dermatologist online.
- Tell your dermatologist if you are pregnant or breastfeeding.
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2Ask the dermatologist to drain and extract the cyst. In this procedure, your dermatologist will drain the cyst with a sharp needle. This is the fastest way to remove a cyst. When done properly, it can reduce pain, swelling, and scarring as well.[2]
- Never try this at home or without the supervision of a licensed professional. Improper lancing may result in scarring or infection.
- In some cases, your dermatologist may also inject the cyst with medication.
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3Get a prescription for an antibiotic. Antibiotics work by killing the bacteria that causes acne. Your dermatologist may prescribe you a pill to swallow daily or a cream to apply directly to the acne itself. These require a prescription.[3]
- Side-effects of antibiotics include increased sensitivity to the sun, liver damage, and complications with pregnancy.
- Follow your dermatologist's instructions regarding the use and dosage of antibiotics.
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4Get a topical retinoid to apply to your skin. Topical retinoids unplug clogged pores, allowing other medications to come in and fight the acne-causing bacteria. Apply the retinoid to your face once a day.[4]
- Most retinoids require a prescription. Weak doses are available over the counter, but these may not have as dramatic an effect.
- Retinoids are usually reserved for moderate to severe acne, when other methods of treatment have not worked.
- Types if topical retinoids include Adapalene, Tazarotene, and Tretinoin.
- Topical retinoids may initially make your acne worse before it gets better. It can take a few weeks to see results.
- Talk to your doctor about possible side-effects. Side effects include increased sensitivity to the sun, dryness, redness, and peeling of skin.
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5Take a systemic (oral) retinoid for severe cystic acne. If other treatments haven't worked, a retinoid pill, such as isotretinoin (also called Accutane), may be your best option. Take the retinoid by mouth according to your dermatologist's instructions.[5]
- Isotretinoin may cause some very serious side effects. These include depression, birth defects, miscarriage, deafness, and bowel disease, among others.
- Only the worst cases of cystic acne may warrant prescription of this very strong drug.
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6Undergo hormonal treatments for women. Acne is affected by our body's hormones. A birth control pill or anti-androgen medications may help stem outbreaks. Talk to your doctor about medications that may limit the severity of your cystic acne.[6]
- Understand the possible side-effects. Side-effects include irregular menstrual cycle, fatigue, dizziness, and breast tenderness.
- Women with a high risk or previous history of high blood pressure, stroke, heart disease, blood clots, or breast cancer should not go on hormonal medication.
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7Zap off cysts with laser therapy. Traditionally used to remove scars, laser therapy may now be used to treat acne itself. Laser therapy burns away the follicle sac, by burning away the sebaceous gland (which produces oil), or by oxygenating the bacteria, and thereby killing them.[7]
- Moderate to severe cases of cystic acne may require multiple sessions in a 4 week spa, but you may see results after the first treatment.
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Method 2
Method 2 of 4:
Developing a Daily Skincare Routine
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1Wash your face twice a day with benzoyl peroxide cleanser. Benzoyl peroxide helps fight acne by reducing oil and bacteria. Wash your face in the morning and evening by dampening your face and applying the cleanser. Rinse off thoroughly and pat your face dry with a clean towel.[8]
- If you wear makeup, be sure to remove it completely before washing your face. Use makeup removing wipes or solution to help remove all of your makeup.
- You can buy cleansers containing benzoyl peroxide at grocery stores, beauty stores, and pharmacies.
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2Apply a toner with salicylic acid after you wash your face. Your toner will help remove any last particles of dirt while fighting the acne. Dampen a cotton pad with the toner and gently wipe across your face to apply the toner.[9]
- Salicylic acid can help unplug pores and may prevent clogged hair follicles.
- If you're pregnant, you might try products that contain azelaic acid instead. These may be safer for pregnant women, though salicylic acid is unlikely to be a risk.[10]
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3Apply a spot treatment with benzoyl peroxide. Once your face is clean, dab some benzoyl peroxide cream or gel onto your acne. This can help reduce the acne more quickly. You can get spot treatments from your dermatologist or over the counter at pharmacies and grocery stores.[11]
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4Moisturize after each wash with a non-comedogenic moisturizer. Your skin needs moisture after you strip it of oil and water. Use non-comedogenic moisturizers that won't block your pores. These should be marked as “non-comedogenic” on the label.[12]
- Common ingredients in non-comedogenic moisturizers include hyaluronic acid, glycerin, and aloe vera.
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5Avoid touching or picking your acne. As hard as it is, try not to touch your face or feel your pimples. Cystic acne can get inflamed when touched, producing more redness and irritation. It may also increase scarring.[13]
- Try sitting on your hands if you feel the urge to touch your face. Distract yourself by chewing gum, taking a walk, or squeezing a stress ball.
- Cystic acne is much harder to pop than normal acne, and doing so will possibly make it worse. Trying to pop cystic acne will also be more painful and more likely to leave a scar.[14]
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Method 3
Method 3 of 4:
Adjusting Your Lifestyle
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1Eat a low-glycemic diet. What you eat may contribute to acne. A low-glycemic diet can help reduce the severity of your acne. Eat plenty of whole grains, beans, and veggies. Cut back on processed carbs, white bread, pasta, dairy, and refined sugar.[15]
- Instead of drinking soda or juice, drink water or herbal tea when you're thirsty.
- Watch out for dairy in particular. Dairy may worsen acne in some people.
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2Quit smoking. Smoking can worsen or cause acne in adults. Talk to your doctor about quitting smoking. They can prescribe you pills or patches to help make the process easier.[16]
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3Cut down on alcohol. If you're a regular drinker with cystic acne, reduce how much you drink. In general, men should have no more than 2 alcoholic drinks a day. Women should limit themselves to 1 drink.[17]
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4Reduce your stress. Stress can worsen acne, especially for men. While stress is notoriously difficult to control, you can try to incorporate some relaxation techniques to keep your stress more manageable. [18]
- Exercise can relieve stress. If nothing else, take a walk or stretch.
- Meditation can help bring a sense of peace back in your life. If you're busy, squeeze in 5 minute meditation sessions at work, school, or during a lunch break.
- If you feel yourself becoming overwhelmed, pause and breathe deeply for 10 seconds.
- Make sure to get between 7-9 hours of sleep a night. Sleep deprivation can cause you to feel more stress, which can cause more acne.
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Method 4
Method 4 of 4:
Reducing Acne Scars
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1Identify any scarring left over from the acne. Scarring is more common in cystic acne because of the collagen-damaging infection of deep tissue. The best treatment for scars depends on the type of scar. These types include:[19]
- Hypertrophic scars are raised up from the skin. These can be treated with creams.
- Atrophic scars are sunken but mostly shallow. These can be treated with peels, dermabrasion, or laser treatments.
- Boxcar-shaped scars are shallow and broad with jagged edges. These can be treated with lasers, dermabrasion, or excision (surgery).
- Ice pick-shaped scars are narrow and deep. Lasers, dermabrasion, and excision are effective treatments.
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2Apply cortisone cream to reduce inflammation in hypertrophic scars. Once a day, pat the cream onto any scar that is red and swollen. The cream may reduce the appearance of the scar. It works best on red, swollen, and raised scars.[20]
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3Rub fading creams onto the scar to help reduce their appearance. There are many creams that can help reduce the appearance of scars after acne. These usually contain ingredients like hydroquinone, kojic acid, arbutin, or licorice extract.[21]
- These creams can be bought at pharmacies, beauty stores, and grocery stores.
- Apply these creams once or twice a day to your acne scars. This is most effective with raised or red scars.
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4Get a chemical peel at a dermatologist's office or spa. Chemical peels use potent acid formulas to lift off the top layer or layers of skin, minimizing the appearance of scars. These offer dramatic effects in a short time. The doctor will apply an acidic solution to your face.[22]
- Types of peels include glycolic acid, salicylic acid, and Trichloroacetic acid (TCA).
- Always wear sunscreen after getting a peel, as your skin will be more sensitive to the sun.
- You may feel burning or irritation during the peel. If it is too much to handle, tell your dermatologist. Stronger peels may cause peeling, redness, or swelling after the procedure. Your dermatologist will give you lotion to help reduce the discomfort.[23]
- Weaker peels can be done at home, but be careful. Ask your dermatologist for advice before trying a home peel.
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5Go to a spa or dermatologist for dermabrasion. Dermabrasion sloughs off top layers of skin with a wire brush. Blemishes on the surface of the skin are usually removed, and deeper scars are minimized.[24]
- Dermabrasion can cause changes in skin pigmentation for patients with darker skin
- For a less intense procedure, try microdermabrasion. Your dermatologist will apply small crystals onto the top layer of skin and vacuum them up, along with dead skin cells. Results are generally less pronounced than dermabrasion.
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6Undergo laser treatments to remove deep scars. Lasers blast the outer layer of skin (epidermis) and heat the layer of skin just beneath it. As the skin heals, so do the scars. Sometimes, multiple laser treatments are needed to lessen the visibility of scars.[25]
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7Get surgery to fix large scars and lesions. These surgeries are usually non-invasive. Your doctor might cut out the scar with a punch excision and replace it with stitching or a skin graft. Alternatively, they may use a needle to relax the muscle fibers under the skin.[26]
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Expert Q&A
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QuestionWhat if I can't tell if its an acne cyst or a pimple? I have had one for a week now and can't seem to get rid of it. It had no head so I tried to lance it, but failed, and all that came out was blood. Help?
Sarah Gehrke, RN, MSSarah Gehrke is a Registered Nurse and Licensed Massage Therapist in Texas. Sarah has over 10 years of experience teaching and practicing phlebotomy and intravenous (IV) therapy using physical, psychological, and emotional support. She received her Massage Therapist License from the Amarillo Massage Therapy Institute in 2008 and a M.S. in Nursing from the University of Phoenix in 2013.
Registered NurseCystic acne is larger, painful, and often difficult to get rid of. You may feel a throbbing pain from the nodule. A deep acne cyst in the skin often won’t come to a “head” by itself. -
QuestionWhat can your doctor do about melasma and cystic acne?Sarah Gehrke, RN, MSSarah Gehrke is a Registered Nurse and Licensed Massage Therapist in Texas. Sarah has over 10 years of experience teaching and practicing phlebotomy and intravenous (IV) therapy using physical, psychological, and emotional support. She received her Massage Therapist License from the Amarillo Massage Therapy Institute in 2008 and a M.S. in Nursing from the University of Phoenix in 2013.
Registered NurseSince cystic acne is an infection, your doctor will likely target the acne first! The plus side of this is that many acne treatments may also help your melasma. However, some acne medication, topical and oral, can cause sun sensitivity. The best thing to do is use sun protection with SPF 30 and protective clothing, such as hats, during your acne treatment.
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Warnings
- Try not to pop, squeeze, pick at, or lance cystic pimples. This could delay the healing process and create scars.⧼thumbs_response⧽
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References
- ↑ https://www.aad.org/public/diseases/acne-and-rosacea/acne#treatment
- ↑ https://www.aad.org/public/diseases/acne-and-rosacea/acne#treatment
- ↑ https://www.mayoclinic.org/diseases-conditions/acne/diagnosis-treatment/drc-20368048
- ↑ https://www.aad.org/media/news-releases/hormonal-factors-key-to-understanding-acne-in-women
- ↑ https://www.aocd.org/page/Accutane
- ↑ https://www.aad.org/media/news-releases/hormonal-factors-key-to-understanding-acne-in-women
- ↑ https://www.aad.org/public/diseases/acne-and-rosacea/lasers-and-lights-how-well-do-they-treat-acne
- ↑ https://www.mayoclinic.org/diseases-conditions/acne/diagnosis-treatment/drc-20368048
- ↑ https://www.mayoclinic.org/diseases-conditions/acne/diagnosis-treatment/drc-20368048
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114665/
- ↑ https://www.nhs.uk/conditions/acne/treatment/
- ↑ https://www.ncbi.nlm.nih.gov/pubmed/28678647
- ↑ https://www.mayoclinic.org/diseases-conditions/acne/diagnosis-treatment/drc-20368048
- ↑ https://www.aad.org/public/diseases/acne-and-rosacea/pimple-popping-why-only-a-dermatologist-should-do-it
- ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2836431/
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835905/
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/21710106
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/17340019
- ↑ https://www.dermnetnz.org/topics/acne-scarring/
- ↑ https://www.dermnetnz.org/topics/acne-scarring/
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921758/
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5429107/
- ↑ https://www.asds.net/ChemicalPeelsInformation.aspx
- ↑ https://www.mayoclinic.org/diseases-conditions/acne/expert-answers/acne-scars/faq-20058101
- ↑ https://www.aad.org/public/diseases/acne-and-rosacea/lasers-and-lights-how-well-do-they-treat-acne
- ↑ https://www.mayoclinic.org/diseases-conditions/acne/expert-answers/acne-scars/faq-20058101
About This Article
Sarah Gehrke, RN, MS
Registered Nurse
This article was medically reviewed by Sarah Gehrke, RN, MS. Sarah Gehrke is a Registered Nurse and Licensed Massage Therapist in Texas. Sarah has over 10 years of experience teaching and practicing phlebotomy and intravenous (IV) therapy using physical, psychological, and emotional support. She received her Massage Therapist License from the Amarillo Massage Therapy Institute in 2008 and a M.S. in Nursing from the University of Phoenix in 2013. This article has been viewed 2,593,570 times.
Co-authors: 33
Updated: November 25, 2022
Views: 2,593,570
Categories: Featured Articles | Acne
Article SummaryX
Cystic acne can be frustrating and even painful, but there are a few remedies you can try to help clear it up quickly. You can keep your skin healthy by washing your face twice a day with a benzoyl peroxide cleanser. This type of cleanser helps reduce oil and bacteria that contribute to acne. Once your face is clean, apply a toner containing salicylic acid to your skin. You can also use benzoyl peroxide cream to spot treat acne. Make sure to moisturize your skin after cleansing with a non-comedogenic moisturizer, since these types of moisturizers won't block your pores. Avoid touching your acne as much as possible, since doing so can irritate your skin and make your acne worse. To learn how to reduce your stress to help improve your acne, read more from our Medical co-author!
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