How to Get Rid of Cystic Acne: Tips from a Dermatologist

By Claudia Shannon / Research Scientist / ishonest

Acne is a normal part of life, and not just for teenagersthese common skin blemishes can affect anyone of any age. But if you've ever had to deal with cystic acne, you know just how unpleasant it can be. Unlike whiteheads or blackheads, cystic acne occurs deep under the skin, resulting in large, painful bumps on the face, back, or chest. These stubborn bumps can stick around for days or even weeks at a time, and getting rid of them isn't as simple as washing your face every day.

In this blog, Dr. Lisa M. Diaz, a board certified dermatologist at ishonest, explains how to get rid of cystic acne and prevent future breakouts. Keep in mind that acne treatments are not one-size-fits-all, so it can take some time to find a treatment that works for you with minimal side effects. But rest assured you are not alone, and effective treatments are available.

Causes of Cystic Acne

Cystic acne occurs when bacteria, dead skin cells, and sebum (the substance that makes your face feel oily) get trapped beneath the skin's surface and become infected. This leads to a large, swollen cyst (bump) that can hurt just to touch. There are a number of different reasons why this condition might occur more frequently or more severely in some people but not others. Understanding the different factors that contribute to cystic acne flare ups will help you and your dermatologist devise a custom treatment plan together.

Bacteria & Oil Buildup

Cystic acne is the result of a buildup of bacteria and sebum, but this does not occur because someone doesn't wash their face enough. Instead, cystic acne can be triggered by other environmental factors, including the products we use on our skin. Wearing makeup or tight clothing for long periods of time can exacerbate cystic acne by trapping moisture, sweat, and oil.


Despite popular belief, there is no evidence to confirm that eating chocolate or greasy foods like french fries or potato chips cause acne.

That being said, diet should not be overlooked as a potential acne trigger. If you notice that your cystic acne flares up when you eat certain foods, bring that up with your dermatologist. They may suggest that you exclude that food from your diet for a period of time and keep a food diary to monitor how your skin reacts.


Hormonal changes, including those caused by menopause, menstruation, pregnancy, and certain medical conditions like polycystic ovarian syndrome (PCOS), can be triggers for cystic acne. Furthermore, patients undergoing androgen replacement therapy (ART) or another type of hormone therapy may suffer from cystic acne as a side effect. If you find that your cystic acne only appears with your menstrual cycle or while pregnant, or after you started hormonal therapy, it may be caused by hormonal fluctuations. A dermatologist can prescribe medication to better stabilize your hormones, or help you find other solutions if you're unable to take hormone regulating medications.


If one or both of your parents struggled with cystic acne, scientists agree that you have an increased risk of developing the condition as well. This relationship is even stronger when it comes to adult acne, which is defined as acne that occurs after age 25. Genetic acne tends to be very stubborn, but that doesn't mean there's no hope. Instead, it may just take a combination of different methods to successfully control genetic acne.

Home Remedies for Cystic Acne

Don't use homemade remedies like toothpaste, baking soda, honey, or sugar on your skin. These substances can irritate and clog your pores, and do not work at combating cystic acne.

How a Dermatologist Can Help You Get Rid of Cystic Acne

If at-home remedies aren't helping to treat your cystic acne flare ups, it's time to see a dermatologist for treatment. A dermatologist can prescribe medications that are stronger than what you can find over-the-counter or do at home. Depending on what's causing your acne flare ups, a dermatologist can prescribe the following:

  • Antibiotics to fight infections and reduce inflammation
  • Isotretinoin (also known by the brand name Accutane) to treat severe cases
  • Spironolactone to regulate oil production
  • Steroid shots injected directly into cysts to reduce inflammation and lessen pain

Not all treatments are appropriate for all patients, and some medications may come with unpleasant side effects. Your dermatologist will talk with you about which option is best for you depending on the cause(s) of your cystic acne. You may have to try a few different treatments to find the one that's most effective for you.

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