Everything about Cystic Acne: Causes, Symptoms, Treatment

Most of us have experienced a breakout of whiteheads and blackheads sometime in our lives. A few pimples here and there can feel like the most severe acne, especially if the flareups happen at the worst times. But that’s not the case. There are many different types of acne, and the most severe one is called cystic acne, which unfortunately manifests itself far worse than the regular whiteheads and blackheads. In this article, we’ll be discussing all about cystic acne and how it can be kept under control.

What Is Cystic Acne?

Cystic acne is considered the most severe type of acne. As the name implies, it develops when large, red, painful cysts form deep underneath the skin. Unfortunately, this skin problem can last for years and can affect large areas of the body and may even leave long-lasting scars.

Getting cystic acne can seem unfair, and patients need to know that it’s no fault of their own. Anyone can develop cystic acne. Nonetheless, it tends to occur in individuals with oily skin and it’s more common in teens, women, and adults with hormonal imbalances.

What Does Cystic Acne Look Like?

When someone has cystic acne, they’ll most likely know. Cysts are large, pus-filled lesions that resemble boils. They look like nodules but are a bit different because they’re filled with pus. Consequently, they’ll feel softer to the touch but are just as (or even more, in some cases) painful.

Out of all types of acne, cysts are also most likely to leave unsightly scars on the skin. This is another sign that the type of acne you have is cystic.

Symptoms of Cystic Acne

Depending on the severity of your condition, you may experience the following:

  • Closed comedones, or whiteheads.
  • Open comedones, or blackheads.
  • Papules (tender bumps).
  • Pustules (papules filled with pus).
  • Nodules (painful lumps that are not filled with pus).

Cystic acne can appear anywhere on the face, chest, shoulders, and upper back.

What Are the Causes of Cystic Acne?

Cystic acne happens for the same reasons why other types of acne occur. The four main factors are:

  • Excess sebum production.
  • Bacteria.
  • Inflammation.
  • Hair follicles clogged by sebum and dead skin cells.

Why Am I Getting Cystic Acne All of a Sudden?

Cystic acne can occur in people who have always had skin issues, but it can also affect individuals who have never had any problems with acne. This can lead to a lot of confusion and frustration, especially if you previously had clear skin. However, our bodies go through a continuous set of changes throughout our lives, and there’s no way of telling what could happen next.

Certain things may trigger cystic acne:

  • Hormonal changes. In both boys and girls, androgens can cause the sebaceous glands to enlarge and make more sebum. But even if you are older, you can still experience hormonal changes. Your hormones can change during midlife, especially in women, and can lead to breakouts.
  • Obesity, which is linked to PCOS – a hormonal imbalance where the body produces too many testosterone-like hormones, can up the odds of cystic acne.
  • Certain medications, such as testosterone, lithium, or corticosteroids.
  • Diet. Carbohydrate-rich foods have been found to worsen acne in some patients.
  • Stress. If you already have acne, stress may aggravate it.

Myths about Cystic Acne

Over time, people have thrown the blame on a number of presumably acne-triggering factors:

  • Chocolate and greasy foods. In reality, there’s limited evidence that supports the idea that chocolate or greasy foods can give you pimples or make your acne more severe.
  • Hygiene. Despite what some uninformed people may think, acne is not caused by dirt. On the contrary, if you scrub your skin too hard or clean it frequently with harsh chemicals, you can irritate the skin and aggravate your acne.
  • Cosmetics. If you use non comedogenic makeup and skincare, there’s no reason why it should worsen your acne. However, it is always best to go makeup-free.

How Long Does Cystic Acne Last?

Since cystic acne is strongly linked to hormones, in most cases, it tends to hit around puberty and stick around until your 20s. Nonetheless, physicians notice a growing number of women in their 30s, 40s, and 50s developing acne. Furthermore, cystic acne can appear throughout the whole duration of a pregnancy. There’s really no way of telling how long you will have it for. Each individual is unique and responds differently to acne treatment.

How Can You Treat Cystic Acne?

If you have cystic acne, it’s crucial you consult a good dermatologist. Do not attempt to self-medicate because you may make matters worse.

A dermatologist may recommend treating cystic acne with one or a combination of the following:

  • Antibiotic. Taking an oral antibiotic can help reduce redness and swelling. Applying topical antibiotics to the skin can reduce bacteria and clogged pores.
  • Isotretinoin. When antibiotics fail to clear the skin, dermatologists may switch to isotretinoin, a potent medicine that attacks all causes of cystic acne: excess sebum, clogged pores, bacteria, and inflammation. About 85 percent of patients see permanent clearing after one course of isotretinoin. This is, however, a controversial drug that comes with quite a few health risks.
  • Spironolactone. This medication helps reduce excess sebum in women.
  • Birth control pills. Women are often recommended birth control pills for treating severe acne. They may be used along with an antibiotic or spironolactone.
  • Corticosteroid injections. A dermatologist may also inject cysts or nodules with a corticosteroid to reduce their size.
  • Incision and drainage. Painful cysts and nodules that medicine could not clear can be drained in a medical office.
  • Low-dose prednisone. Dermatologists prescribe this potent corticosteroid to treat a serious form of acne called acne fulminans.

After you clear your skin, you still need to continue with your treatment. Without treatment, acne can return quickly.


Even the most severe type of acne can be cleared. Thanks to advances in treatment, cystic acne can be successfully reduced or even fully cleared up with a dermatologist’s help. Keep in mind that it can take months before you see significant results.

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