Cystic Acne

By Claudia Shannon / Research Scientist / ishonest

What Is Cystic Acne?

Pimples start when a pore in your skin gets clogged, usually with dead skin cells. Bacteria can also get trapped, causing the area to become red and swollen.

Cystic acne happens when this infection goes deep into your skin, creating a bump that's full of pus. It may hurt or itch. If a cyst bursts, the infection can spread, causing more breakouts.

You can treat these breakouts. Don't try to wait them out. Cystic acne can last for years. It can affect large areas of your skin and leave scars. A dermatologist can help you with a treatment plan.

Cystic Acne Causes

Doctors aren't sure exactly what causes cystic acne.

Hormones called androgens play a role. When you're a teenager, your androgen levels go up. This leads to changes in your skin that can result in clogged pores and acne.

Other things that can cause acne include:

  • A woman's menstrual cycle
  • Pregnancy
  • Menopause
  • Polycystic ovary syndrome
  • Certain medications
  • Some skin products
  • Clothing that's too tight
  • High humidity or sweating

Despite what you might have heard, these things don't cause acne:

  • Not washing your face enough
  • Sexual activity, including masturbation
  • Chocolate
  • Greasy or spicy foods

Cystic Acne Risk Factors

You're most likely to get cystic acne in your teens or early 20s. But it can happen to children as young as 8 or adults as old as 50. Your face, chest, back, upper arms, or shoulders can be affected.

If one of your parents had severe cystic acne, you have a higher chance of getting it. Severe cystic acne is more common in men. Women who get it often have cysts on the lower half of their face.

Cystic Acne Complications

The cysts can leave permanent marks on your skin, including:

  • Deep, tiny holes (icepick scars)
  • Wider pits
  • Large, uneven indents

Cystic Acne Treatment

Over-the-counter medicines that treat mild acne don't usually work on cystic acne. Your doctor will probably recommend one or more of these treatments:

  • Oral antibiotics to help control bacteria and lower inflammation
  • Birth control pills to regulate a woman's hormones
  • Benzoyl peroxideto kill bacteria on your skin and fight inflammation
  • Retinoid, a form of vitamin A, in a cream, lotion, foam, or gel. It can unplug your pores and help antibiotics do their job.
  • Isotretinoin (formerly Accutane, now Absorica, Amnesteem, Claravis, Myorisan, Sotret) attacks all causes of acne. Women should not get pregnant while taking this drug.
  • Spironolactone to reduce excess oil. Doctors don't prescribe it to men because of side effects such as breast growth.
  • Steroids injected into cysts at your doctor's office

Cystic Acne Home Remedies

You can take some steps to help prevent acne or keep it from getting worse:

  • Wash your skin twice a day and after you sweat. Use your fingertips and a gentle cleanser. Rinse with lukewarm water.
  • Don't scrub your skin or use irritating products like exfoliants.
  • Don't touch cysts or pick at blemishes. You might push the infection deeper and make it spread. Let blemishes heal on their own, instead of popping or squeezing them, to lower your risk of scars.
  • Stay out of the sun and away from tanning beds, which can damage your skin.
  • Try to relax. Stress can make your body release more hormones, which can make acne worse.
  • Keep a healthy lifestyle. Get plenty of sleep and exercise. Some research suggests that a low-glycemic diet, which limits sugar, can help ease symptoms.

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