Of all the types of acne, cystic acne and nodules are by far the most severe. Contrary to other types of acne, such as hormonal acne or whiteheads, cystic acne is painful to the touch and is rooted deep in the skin. “It occurs when sebaceous material clogs the pores and causes bumpy texture, inflammation, and infection under the skin,” explains Lara Devgan, MD, a board-certified plastic surgeon and Chief Medical Officer at RealSelf .
Unfortunately, cystic acne can expand to the body and can persist as adult acne. These lesions can linger under the surface of the skin for weeks, or even months, and may leave deep acne scars as in the aftermath, explains Dendy Engelman, MD, a New York City-based dermatologist.
What causes cystic acne?
Genetics are largely to blame (ugh), but your diet and lifestyle also affect your skin’s condition. “Food that’s high in fat and unhealthy oils can trigger inflammation in your skin, which can lead to clogged pores,”explains Dr. Engelman. However, Dr. Devgan dispels the misconception that it is caused by chocolate, nuts, greasy food, or bad hygiene. That being said, there are ways to mitigate your acne-triggering DNA with the help of proper preventative care and treatments.
What is the best treatment for cystic acne?
Oftentimes, a combination of topical treatments, prescribed medication, and over-the-counter products render the best results. “The typical rule of thumb according to dermatologists is [to see a doctor] if a drugstore treatment hasn’t cleared up acne after two weeks,” recommends Dr. Engelman.
Dermatologist treatments: As far as in-office treatments go, “intense Pulsed Light treatments can be used to kill the bacteria that causes acne and quickly clear the skin,” says Dr. Devgan. “Topical products, chemical peels and intralesional steroids can sometimes assist in clearing active cystic acne, and ablative resurfacing lasers and microneedling can be helpful with scarring once the cystic acne has cleared.”
Melissa Kanchanapoomi Levin, MD, a New York City-based dermatologist also recommends getting a diluted corticosteroid injected directly into the cyst for a quick-fix (it will start to minimize in six hours). “Cortisone is an anti-inflammatory that shrinks the swollen wall of the cyst,” she explains.
Medication: Apart from the minimally invasive procedures above, a dermatologist can also work with you to find medications that will help treatment in the long-run. “Nodular acne often requires treatment with systemic medications such as oral antibiotics, and hormonal medications (oral contraceptives, spironolactone),” says Valerie Harvey, MD, a dermatologist based in Virginia. “Isotretinoin, a derivative of vitamin A, is also very effective.”
What products can you buy to prevent and treat cystic acne?
The responsibility to clear cystic acne also lays in the upkeep of professional treatment, and there are many over-the-counter products available on the market to keep acne under control. “Relevant products ingredients include benzoyl peroxide, salicyclic acid, glycolic and alpha-hydroxy acids, and gentle cleansers,” shares Dr. Devgan. Another tried-and-true ingredient to seek is a retinoid, which de-clogs pores by normalizing skin cell turnover and acts an a powerful anti-inflammatory.
We know that navigating the countless acne-treating products on the market and treatments offered by professionals can be overwhelming, and since cystic acne is so severe it often requires a combination of treatments and systemic therapy to help eliminate current lesions and prevent future ones from forming. That’s why we rounded up the best products to treat and eliminate cystic acne.