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How to Treat Cystic Acne

There is acne and then acne . Almost everyone occasionally had pimples or blackheads. In adolescence, you probably had the WORST DAY EVER because of a complete, both cheek-covering outbreak. However, simple pimples are not comparable to pain, severity, and potentially permanent damage caused by cystic acne, a type that penetrates the skin and causes cysts-particularly deep, painful, and prone to spreading lesions.

"Cystic acne is like little balloons under the skin," says Dr. Suzanne Friedler, dermatologist and clinical instructor at Mount Sinai Medical Center. "The skin is red and painful and pus-y." The compound oil, dead skin cells, and bacteria that accumulate under the skin through a pore clogging patchwork for cysts produce an inflamed appearance and the scarring associated with this skin strain can be permanent. Mostly it affects the face, but outbreaks can spread to the chest and back.

Cystic acne hurts and itches. A scratch continues the cycle and spreads the infection. "The oils in the skin are like food for the bacteria," says Friedler. Acne is often counterbalanced by high levels of testosterone; The hormone regulates and stimulates the glands. Therefore, cystic acne is most common in men from their late teens to the early 20s who are experiencing a hormonal flow.

Because of the scarring, Friedler says that the most important consideration in the treatment of cystic acne is timeliness as soon as it is diagnosed; They survive a cyclical worsening of the disease and permanent skin damage. Here are your options:


If you see a dermatologist for cystic acne ̵

1; and experts say over-the-counter remedies for cystic pimples are not enough – their first option is likely to be an oral antibiotic, says Adarsh ​​Vijay Mudgil MD, a New York City-based dermatologist. Antibiotics attack the underlined bacteria that can cause and sustain the acne.

The relief can be done immediately. "It works anti-inflammatory," says Mudgil. Tetracycline-type antibiotics – such as minocycline or doxycycline – are the most common options. Some dermatologists also use topical antibiotics.


Antibiotics are often effective in reducing inflammation and eliminating bacteria, but if that alone does not cleanse the skin, isotretinoin is the next remedy for the dermatologist. It is an oral drug that was originally sold under the brand name Accutane and is still commonly referred to as such and is now available as a generic.

Isotretinoin is a retinoid, a drug that acts as a synthetic version of vitamin A. It has a long list of side effects, including dry skin, itching, rash, eye irritation, anxiety and depression. Due to the possibility of birth defects, it is absolutely forbidden for pregnant women.

Its impact on mental health has been particularly studied due to a high-profile case. then-US. Rep. Bart Stupak's son. B. J. Stupak. Stupak and his wife accused the drug at the age of 17 in 2000 for their son's suicide and unsuccessfully tried to sue the manufacturer Roche Holding.

Friedler said, however, that it is usually safe as long as high-risk patients are examined and monitored. "Accutane gets a bad name," says Friedler. She said patients rarely experience strong mood changes. "I have patients with dry skin, dry lips, and high cholesterol," she said.

"We monitor the blood work at the beginning of the treatment, but are generally well tolerated," says dr. Erum Ilyas of Montgomery Dermatology, a multi-location clinic near Philadelphia. "We need to ensure that female patients do not schedule pregnancies during treatment and for six months after graduation. And we investigate the risk of depression before the start of therapy. There are mixed studies on this potential side effect. "In general, treatment with isotretinoin takes five to six months.


Topical treatment – either prescription or over-the-counter – will probably not resolve the depth effect. Sitting problems of cystic acne alone, but they can be helpful if they are prescribed with an oral drug.

The "[g] old standard therapy for inflammatory acne treatment is topical therapy with oral medications," said Melanie Palm, MD, San Diego dermatologist and clinical professor at Scripps Encinitas Memorial Hospital. Benzoyl peroxide and topical antibiotics (such as clindamycin) are often associated with antibiotics or retinoids.

Skin Hygiene

The population that suffers most from cystic fibrosis3 – men of school and college age – are not well known for their cleanliness and skin care routines.

"They exercise a lot and have sweaty clothes on their skin," says Friedler. She recommends that men of acne age change their workout clothes and use antibacterial body wash.

Management of Other Drugs

Palm said certain drugs could alter the testosterone system and lead to acne. These include anabolic steroids (inhaled steroids for the treatment of asthma) and hormone replacement (testosterone and progesterone).

Unconventional and New Treatments

For those who can not respond to isotretinoin or can not withstand these side effects, there are some new treatments. "Unconventional and new approaches to acne are exciting," says Palm.

This includes the blue light therapy for controlling bacteria; an injection of a diluted steroid to quickly reverse a cystic lesion; and photodynamic therapy, a type of drug that makes certain cells susceptible to intense light (more commonly used for cancer treatment). The insurance may not cover these treatments.


After you have already treated your cystic acne, it can cause scarring if the swelling or the lesions were severe enough. Few acne scars are heavy enough to justify an operation, says Larry Linkov of City Facial Plastics in Manhattan. "It's not very common," he says. "Only once was I asked to do acne."

There are several minimally invasive surgeries, says Linkov. He has used microneedles, a Dermaroller procedure that uses small needles to pierce the skin, smoothing out small scars and abrasions. "It's like sanding the area," says Linkov. Occasionally, cosmetic surgeons use dermal fillers in this advancement.

Chemical facial scrubs and laser resurfacing are also effective in eliminating patches caused by cystic acne. "Usually [acne leaves] a localized scar that does not go very deep," he says. "We do not have to make any massive cuts."

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