Deep under the skin, pus-filled acne cysts, or pimples, are the hallmarks of cystic acne. Large and frequently painful acne cysts can occur. To lower the risk of infection and scarring, cystic acne should be treated by a dermatologist. Your skin may clear up with antibiotics and topical (skin) treatments with prescription strength.
What is cystic acne?
Inflammatory acne that forms painful, pus-filled pimples deep under the skin is called cystic acne. When skin pores are clogged by oil and dead skin cells, acne develops.
Bacteria that enter the pores and cause swelling or inflammation also cause cystic acne. The most severe kind of acne is called cystic acne. Cysts of acne are more likely to leave scars and are frequently uncomfortable.
What’s the difference between an acne cyst and an acne nodule?
Cystic acne and nodular acne are really similar. Both result in painful, deep pimples beneath the skin. Additionally, both can leave scars. Variations consist of:
- Purse is the fluid that fills acne cysts.
- Since acne nodules don't contain fluid, they are firmer and more substantial than acne cysts.
Symptoms and Causes
What causes cystic acne?
Excess oil and dead skin cells can clog pores in the skin, forming pimples. Along with oil and skin cells, bacteria can get caught in the skin's pores. Deep in the dermis, the middle layer of skin, the skin reaction results in swelling. This red, bloated, infected bump is an acne cyst.
Causes of cystic acne include:
- Age (teenagers are more prone to cystic acne).
- Family history of cystic acne.
- Hormone fluctuations occur during adolescence, menopause, and stressful situations.
What does cystic acne look like?
Acne cysts are similar to a skin illness called boils. An acne cyst could be:
- Small as a pea or big as a dime.
- Oozing pus from a whitish-yellow head.
- Crusty.
- A red lump under the skin.
- Painful or tender to touch.
Where do acne cysts develop?
A vast region of skin may be affected by a breakout of cystic acne. The face, which has a large number of oil glands, is where cystic acne usually appears. However, acne cysts can also develop on your
- Chest.
- Neck.
- Shoulders.
- Upper arms.
- Back.
- Butt.
Diagnosis and Tests
How is cystic acne diagnosed?
Diagnosing cystic acne can be done by a dermatologist or a medical professional who focuses on skin diseases.
Management and Treatment
How is cystic acne managed or treated?
Treatment for acne cysts might be challenging. You should consult a dermatologist rather than use over-the-counter acne products because they can leave scars. You can learn how to treat cystic acne from a dermatologist.
Acne cysts may take up to three months to go away. Oral antibiotics and topical gels or creams with prescription strength are frequently used as treatments.
Treatments for cystic acne include:
- Lotions, gels, and creams including antibiotics help eradicate bacteria and reduce inflammation.
- Salicylic acid or azelaic acid (Azelex®, Finacea®) helps eradicate extra dead skin cells and fight microorganisms.
- Use benzoyl peroxide to reduce skin bacterial counts.
- Retinoids are vitamin A derivatives that aid in shedding dead skin cells. Examples of these include tretinoin, adapalene, and tazarotene.
What are other cystic acne treatments?
Other treatments for cystic acne include:
- Corticosteroid injections: used to reduce huge, uncomfortable acne cysts quickly.
- Incision and draining: aids in clearing the pus from an acne cyst by opening it.
- Birth control pill or spironolactone: used by females to reduce hormone levels responsible for cystic acne.
- Isotretinoin: an oral retinoid (Accutane, most widely used).
What are the complications of cystic acne?
Picking or popping acne cysts raises the risk of cellulitis and other bacterial skin infections as well as scarring.
After the skin clears up, some people see pigment changes (light or dark spots) near the location of the acne cyst. These patches could be brown, black, red, purple, or pink. It can take longer than a year for them to disappear.
Prevention
How can I prevent cystic acne?
By following these guidelines, your risk of developing acne can be reduced:
- After you get up, before going to bed, and after working out or perspiring, wash your face with tepid water, a gentle foamy cleanser, and your fingers—not a washcloth or sponge.
- If you feel dry, use a moisturizer without oil.
- Make use of water-based, noncomedogenic face and cosmetic products.
- Don’t sleep in makeup.
- Throughout the day, avoid touching your face with your hands.
- Avoid popping or picking at scabs or pimples.
- Regular hair washing and avoiding touching your face with oily hair are important.
- Sometimes working in an oily environment, like a fast food restaurant, might exacerbate acne flare-ups.
- Additionally, diets high in dairy and simple carbohydrates, sometimes referred to as high glycemic index diets, may exacerbate flare-ups.
Outlook / Prognosis
What is the prognosis (outlook) for people who have cystic acne?
Most persons with cystic acne can avoid having severe breakouts or heal acne cysts rapidly enough to avoid permanent damage. As hormones normalize with age, cystic acne typically resolves or is less severe.
Untreated or severe cystic acne can cause anxiety and depression due to self-perception issues. If you're bothered by cystic acne, discuss with your doctor how to develop a positive self-image.
Living With
When should I call the doctor?
You ought to contact your physician if you encounter:
- Swollen, red, painful pimples.
- Scarring or acne that causes self-consciousness.
- Signs of a skin infection.
What questions should I ask my doctor?
You ought to inquire with your healthcare provider:
- What are the treatment side effects?
- How can I lower my chances of getting acne cysts?
- How can I prevent scarring or other complications?
- What causes cystic acne?
- What is the best cystic acne treatment?
A note from Cleveland Clinic
It might be quite tempting to pick or touch painful, swollen acne cysts. However, compared to ordinary zits, cystic acne is more likely to leave scars or become infected. A dermatologist can provide advice on how to avoid cystic acne. Additionally, by treating uncomfortable acne cysts, this practitioner can reduce the likelihood of scarring. Effective treatments for cystic acne include topical (skin) lotions and antibiotics.
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