If you’ve struggled with cystic acne, you know why it’s considered the most severe and hard to treat kind of acne. 

These hard, painful, inflamed lumps are in a totally different league than your regular, everyday pimples. Instead of small whiteheads or blackheads that can be easily covered up or popped (not that you should!), acne cysts are deep, often prominent, and can be painful and even itchy – which is just rude, honestly.

The reality is, these zits can be tough to treat and tough to live with. It can feel unmanageable. But don’t despair, we’re here to help! We’ve gathered the top advice on treating and preventing cystic acne so you can finally start kicking those stupid cysts to the curb.

What is cystic acne?

But first things first, what exactly is cystic acne, and how is it different from other types of acne? Cystic acne is what we call deep, pus-filled pimples deep in your skin. Acne occurs when bacteria gets trapped with oils and dead skin. With cystic acne, this happens underneath the surface layer of your skin, and because everything is trapped down below with no escape, the infected pores can become very swollen and inflamed. Instead of a topical acne nodule, these cysts are filled with fluid and embedded deep in your skin.

Cystic acne is ultimately rooted deep in your skin’s layers beneath the surface, meaning these zits aren’t directly treatable the way regular pimples are. This is part of the reason cystic acne is so stubborn and difficult to treat. 

All this means that cystic acne typically takes a long time to clear up, plus it often leaves scars, which is why it is considered the most severe form of acne. 

What causes cystic acne?

Honestly, that’s not exactly clear, and different people may develop it for different reasons. Doctors agree that there are many factors at play, but there is no clear cut answer to why cystic acne affects some people so much more than others. Some of these factors include: 

• Hormones (including increased hormones from puberty, pregnancy, and menopause)
• Genetics
• Age
• High humidity
• Certain skin products
• Clothing that’s too tight
• Certain medications

Some people have developed cystic acne wearing masks over the past couple years, so mask-ne, while less common, is another possible culprit.

Not knowing the specific cause of acne can be so frustrating, but there are a few things you can do. Let’s look at how to combat the spread and recurrence of cystic acne, plus some things you can incorporate into your skin care routine to minimize the appearance and effects of cystic acne.

What can I do to get rid of cystic acne (and make sure it doesn’t come back!)?

If only we could just snap our fingers and make this dastardly skin issue disappear. Alas, there is no miracle treatment for cystic acne – but there are some things that you can do to help speed up the recovery process. Let’s look at what you can do to help heal cystic acne and discourage its return.

Use over-the-counter topical treatment

Unfortunately, topical treatments can’t penetrate deep enough to really fight your cystic pimples. But, while topical treatments may not be the holy grail answer, they can still help alleviate the swelling and the look of the cysts – and some can help start the purging and healing process.

Hydrocortisone can help reduce inflammation, which will in turn cause the cysts to flatten and calm the redness. Once a day, apply a small amount of hydrocortisone to help reduce the appearance of cystic pimples.

You can also try using a topical retinoid, which is a vitamin A derivative.There are only a few retinoids available over the counter, so you may need to see a dermatologist, but they can help. Retinoids encourage skin cells to shed and regrow, helping your pores to regenerate. 

Similarly, an exfoliant like a scrub or topical products that include salicylic can help slough away old skin to bring the infection toward the surface where it can be treated topically. Just beware – some of these products can overdry the skin, so you’ll want to also use a gentle moisturizer to avoid causing more trouble. Incorporating a daily moisturizer that locks in moisture but locks out dirt and bacteria is always a great step to add to your routine, regardless of whether or not your acne is flaring up.

Put some ice on it

Applying an ice cube wrapped in a paper towel to your cyst for one to two minutes can help reduce swelling and inflammation. As with topical treatments, reducing inflammation will reduce redness and encourage the cysts to flatten. 

Applying heat to the cysts is common advice that is given, but some dermatologists warn against this. Heat is a double-edged sword here – it increases blood flow to the area, so it can help bring the zit toward the skin’s surface (which is good), but it can also encourage further inflammation (which is bad).

Try to discover irritants and make changes

This can be a hard one, but if your cystic acne will not keep away, you may want to switch from oil-based makeup to water-based makeup. Oil-based makeup tends to trap bacteria and dirt more than water-based makeup. The oil in these products can also aggravate cysts and inflame them even further. Water-based makeup is less irritating and allows your skin to breathe.

Get into good daily habits

As the saying goes, an ounce of prevention is worth a pound of cure. Maintaining a good skin care routine is key to ensuring acne doesn’t return.  Use a gentle, antibacterial face wash every day to keep dirt, oil, and dead skin cells at bay. Antibacterial washes will kill any bacteria that may cause further inflammation. 

Cystic acne can happen to anyone, and it doesn’t mean you aren’t cleaning your face. But it may mean you should reassess the products you’re using and how frequently you use them. Some people with especially acne-prone skin find that cleansing twice a day with a gentle cleanser and/or adding double cleansing to their routine helps reduce recurrences of acne, cystic and otherwise. 

Adding a skin care supplement can also be beneficial in maintaining clear and healthy skin. Ensuring you have the right vitamins, minerals, prebiotics, and probiotics will help keep your skin healthy from the inside out.

And for flip’s sake, don’t try to pick or pop a cystic zit! That’s how they develop and spread in your subcutaneous layer of skin. In fact, popping zits in general is one of the things that can drive bacteria deeper and create a cystic acne problem.

Call a dermatologist

If all these steps aren’t touching your cystic acne, don’t hesitate to call in the big guns. Dermatologists have a number or different treatments that can help you clear up your acne cysts.

1. Antibiotics: Your dermatologist may recommend putting you on an oral antibiotic, which will help get rid of the underlying bacteria that is causing your cysts. 
2. Hormone Regulators: If your hormones are acting up, they may be the cause of your cystic acne. Your doctor may recommend a hormone regulator, like birth control, to help keep your hormones in check.
3. Cortisone Shot: A cortisone shot is a low dose of steroid that is injected into the acne cyst. This will reduce inflammation and encourage cell regeneration.

There are pros and cons to each treatment and your dermatologist may recommend one or a combination of all of them, depending on the severity and your lifestyle. But if your acne is getting in the way of your life or happiness, make a change. You deserve to feel great and enjoy your clear, healthy, happy skin.

Those are our top tips for giving cystic acne the boot

Starting and maintaining good habits is the key to healthy skin from the inside out. But good skin care isn’t always enough when it comes to cystic acne. While it can be tough to treat, there are options and there is hope. Try these tips and don’t be afraid to find a dermatologist who can help you address concerns.