February 4, 2022
5 min. read

Cystic Acne: Causes, Diagnosis, and Treatment


Compared to smaller pimples, whiteheads, and blackheads, cystic acne can be particularly tough to navigate—this severe kind of acne can be painful, and when left untreated, can cause visible scarring. Luckily, there are a number of treatments and methods for managing your cystic acne—read below to find out more.  

What is cystic acne? 

Cystic acne is a type of inflammatory acne that causes painful, pus-filled pimples to form deep under the skin. Acne is a skin condition that occurs when your skin pores become clogged with oil or dead skin cells. 

What are some signs and symptoms of cystic acne? 

Cystic acne is the most severe form of acne, and it produces cysts and nodules alongside inflammatory papules and pustules. It can also cause visible scarring, especially if you try to pop or pick at the acne. The signs and symptoms of cystic acne can be tough on your mental health, so finding some solutions and relief can go a long way. 

cystic acne definition

What does cystic acne look like? 

Cystic acne can present in the following ways: 

  • A red lump under the skin
  • Painful or tender to touch
  • Small as a pea or big as a dime
  • Oozing pus from a whitish-yellow head
  • Crusty

How is cystic acne diagnosed?

A dermatologist, a doctor who specializes in skin conditions, can examine your skin and make a cystic acne diagnosis.

How is cystic acne treated? 

Because cystic acne can scar if not treated or managed properly, it’s important to seek out the advice of a dermatologist for your care. Treatment usually involves taking oral antibiotics, and applying prescription-strength topical gels or creams to the skin, which can take up to three months or more to clear up the skin. 

Treatments commonly include: 

  • Isotretinoin. Isotretinoin, also known as Accutane, is a powerful prescription medication and is considered to be the most effective treatment option for those with cystic acne. Isotretinoin is a powerful deritivite of vitamin A, which you take daily in tablet form. Most people see results from taking isotretinoin in about ten days, with 4 out of 5 users experiencing clear skin after four months of use. Possible side effects of isotretinoin include skin dryness, sun-sensitivity, and muscle or joint pain. You also will need monthly pregnancy tests while on isotretinoin because of the severe birth defects it can cause. 
  • Oral antibiotics. If your cystic acne covers a large area of skin, you may be prescribed oral antibiotics. These work by reducing the amount of bacteria on or in the skin, but they should be used for the shortest amount of time possible in order to reduce the risk of antibiotic resistance
  • Topical retinoids. Topical retinoids come as creams, gels, or lotions, and are often useful for moderate to severe acne. To use, you’ll apply this topical medication a few times a week, at nighttime, until your skin adjusts to the product and you can begin using it daily. You’ll want to use sunscreen while using this product, as it will increase your skin’s sensitivity to the sun. 
  • Oral contraceptives. If you tend to develop acne cysts during hormone fluctuations related to your menstrual cycle, you may consider treating your acne with oral contraceptives. Birth control pills contain estrogen, and can reduce hormonal flare-ups by regulating overall hormone levels. There are, however, side effects to oral contraceptives, including weight gain, breast tenderness and nausea. 
  • Spironolactone. The drug spironolactone, also called Aldactone, is an anti-androgen agent that can be considered for the treatment of acne in women and adolescent girls if oral antibiotics aren’t helping. It works by blocking the effect of androgen hormones on the oil-producing glands, though possible side effects include breast tenderness and painful periods.

acne treatment

What are some tips for living with acne? 

The best way to prevent and treat cystic acne is to take care of your skin. Try a few of these lifestyle changes to support your skincare journey: 

  • Wash your face regularly. Aim to wash your face once a day with a cleanser that isn’t too harsh and drying, but that will remove excess dirt and oil. Be cautious of exfoliating scrubs—they can irritate cystic acne and make it worse. You might want to get into a routine of washing your face at night, so that you can avoid going to bed with makeup on. 
  • Resist the temptation to pick and pop. We know it’s tempting, but picking at your acne, even less severe pimples, blackheads, adn whiteheads, often leads to cystic buildups. 
  • Know what goes into your makeup. Look for makeup products that are labeled “non comedogenic” and “oil-free.” They’re less likely to clog your pores. 
  • Wear sunscreen daily. If you are using a medication to treat your cystic acne, your skin will be more sensitive to the sun, and sunscreen is a must. It’s also just good skincare. Try to go for an oil-free sunscreen that won’t clog your pores. 


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