Are you ever plagued by hard, painful bumps on your face? Cystic acne develops for different reasons, including genetics, stress, hygiene. "It's important to understand that cysts are part of the total spectrum of acne," says New York City dermatologist Heidi A. Waldorf, M.D. "Comedonal acne—typically referred to as blackheads and whiteheads—occurs when the follicles and pores on your skin get clogged. Your skin naturally produces oil to lubricate and hydrate, but when your pores are clogged, the oil becomes viscous. The change in texture stops the oil from turning over, so it builds up bacteria and develops into a blemish." Cystic acne is slightly different. The bacteria live further down the follicle and multiplies as more debris gets trapped in. Your body sends white cells to fight the bacteria, but then those cells actually create an even larger walled-off pustule beneath the skin filled with a combination of skin cells, oil, white cells, and bacteria. Some people have comedonal acne, some have cystic, and some have both—it depends on the makeup of the individual.
Cystic acne is a sore spot for many who've been long-time sufferers, and many factors can cause daily or monthly breakouts. "All acne is somewhat hormonally-related because you go through these massive biological changes during puberty," says Dr. Waldorf. "However, women can still suffer from cystic acne into their twenties and beyond. Adult cystic acne could be associated with high testosterone levels, or an imbalance in estrogen and progesterone levels." And it's not solely hormones that can trigger cystic acne—stress can strongly affect the condition of your skin! "If you're already breaking out, stress will only make things worse," admits Dr. Waldorf. "That's why women typically get big cysts right before their wedding or a big event."
What to do if she suffers from these large and painful bumps? "If you get only one cyst here or there, you can go to a dermatologist for a tiny steroid injection to reduce inflammation. For at-home treatment, put a warm compress on the blemish then rub in a corticosteroid to calm it down. Over-the-counter 1% hydrocortisone should work."
It's trickier for those who get cystic acne on a monthly basis (usually around their period). "Cystic acne around the chin and mouth is usually a hormonal and menstrual-related issue—visit your dermatologist and get your hormone levels checked," suggests Dr. Waldorf. "But whether it's a daily issue or a monthly breakout, my number one tip is do not pick! I tell my patients who can't stop picking that they must cut the habit cold turkey, no matter what. Do whatever you can to stop the habit, because your popping-fest will cause more issues later. I especially recommend extra sunscreen for those with damage already. Acne scars with sun damage will fall inward as you age—not a pretty look."
"To treat scarring, Dr. Waldorf typically uses several types of lasers. For at-home scar healing, she recommends using a topical retinoid specifically designed to help with acne, not a generic scar medication."
For help with cystic acne and inflammation, Dr. Waldorf recommends:
- Aveeno Ultra-Calming Foaming Cleanser with Feverfew
- Skinmedica Redness Relief Calmplex
- Eucerin Redness Relief Daily Perfecting Lotion SPF 15
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Comments
Feb 06, 2013
Anne F.
I use the AHA skin peels and they help, but do not remove cystic acne completely, nor do they prevent them from returning a few weeks later. They do dramatically reduce my acne scars, however.
Aug 25, 2011
Kay B.
Does anybody know if the AHA Skin peels work or microdermabrasion to get rid of the cycts? I don't have many but at least once a month I get a couple on either side of my nose and they last for about a week. My beauticianist has told me to alternate between skin peels and microderm as these will get right down to the 'heart' of the cyst and remove them for good? Anyone know or tried this??
Aug 22, 2011
Meghan O.
antibiotics helped me with them a few years ago (my dermatologist gave me doxycycline) but i don't like taking medication. i didn't think it was worth it, since i get only one or two around my period... but they stay for awhile. i just starting supplementing my diet with apple cider vinegar, which i heard helps.its been 3 days, so i can't really tell yet, but it seems promising.
Aug 22, 2011
Lindsay K.
i had terrible cysts on my chin & on my neck for a few months and my friend told me about Acnepril it's basically a vitamin with all kinds of good antioxidants added & I started taking it last tuesday (the day i started my period) & it has been clearing my face up wonderfully with no side effects (dry skin, redness, etc.) i love it so far!
Aug 31, 2011
Lady M.
Aug 18, 2011
Jane A.
For this whole year, I was using Differin and Duac and it helped a lot. With some other changes in my skin regimine, makeup... stress level (I graduated college in December). Well on Saturday I went to get my brows wax (something I haven't done in years -- so I kind of forgot the 101 of Waxing -- and not to mention in the past, I was never on these toicals). Anyway, I didn't relay that to my esthetician (sp?) so a piece of skin ripped right off. =(
So I stopped both topicals for about 4 days... and what do I see... a little bump on my forehead. Granted it's just one... versus the multiple ones I got at different places on my face -- all at once, I went back to the topicals last night.
I guess I might have to really stick to threading my eyebrows.
Aug 18, 2011
Christine G.
Great article on cystic acne! I've always battled with acne ever since I hit puberty. I took Accutane in the middle of high school which helped considerably. After using Accutane, my acne was under control, but I would get some breakouts here and there, especially right before my period and when I would stress to no end. Now that I'm older, it seems that it has turned into cystic acne, just like the article described. I am considering going back on Accutane, but that will be my last resort if it continues to be untreatable. I know it's related to hormones, but I was unaware that the levels could be checked. Hmm... I will have to try some of the products mentioned. Hydrocortisone? Who knew! I've been using benzoyl peroxide, but all it does is dry out the top layers. The "heart" of the cystic acne always seems to stay behind, which leads to another one popping up later on. I need to find a treatment that is effective down to the core.
Aug 18, 2011
Meera I.
Thanks for addressing this problem, Beautylish! I've only ever had cystic acne - I used to just get one or 2 bumps a month but in the past year it's become much more frequent and now I have 5 or 6 at any one time. Like the article says, they always leave unsightly marks that take months or even years to fade. I'm due for a hormone test soon, but I'll try the products you've recommended. I've also found Mario Badescu's Buffering Lotion and Healing Cream to be helpful in reducing inflammation and scarring.
Aug 18, 2011
Latoya P.
Wow this is great!! love this article i suffer from both acne issues but my cystic acne only occurs randomly but it really hurts !! when one or two come up
Aug 18, 2011
Amanda L.
I suffered from acne all my life but I began getting cystic acne at the age of 19. It was horrible and I got it so bad around my chin area it hurt to smile. I tried every topical treatment and nothing helped. Finally my dermatologist and I decided I go Accutane, which is a serious pill and can have lots of side effects. Doctors will not prescribe this to anyone...its basically the last hope if nothing else works. My skin is now clear and free of all cysts :)