While a regular PMS pimple can be zapped using spot treatment, there are some forms of acne that are extreme and need medical intervention. Cystic acne, the large, red, painful bumps that you can see under your skin, is one such extreme form of acne. Seen mostly as a result of hormonal changes, both teens and adult women can develop cystic acne. In teens, it is mostly genetic and with adult women, it is seen during the onset or an ongoing adult acne phase. They can be extremely severe and require oral medication from a dermatologist. Which is why, we got some insight from a dermat on this extreme form of acne and here’s everything we learnt in the process.

 

Causes of cystic acne

Causes of cystic acne

 

Cystic acne - in the words of a dermatologist

Cystic acne - in the words of a dermatologist

Dr. Sravya C Tipirneni, “Cystic acne is classified as grade 4 acne and is the most severe form of acne. As the name suggests, it consists of very hard, nodular, painful and inflamed cysts which are mostly found under the skin. Patients suffering from cystic acne come with a common complaint of pimples under the skin which they cannot see or pop and are extremely painful. So, this is the worst form of acne to have and has numerous causal reasons behind it. It almost always requires prescription medication which is oral, because it cannot be just treated with over-the-counter products like the other grades of acne.”

Before we get into how to deal with cystic acne, let’s see how to differentiate it from the other forms of acne.

 

How does cystic acne differ from other types of acne?

How does cystic acne differ from other types of acne?

Cystic acne differs from all other grades of acne in the following manner - other forms of acne are polymorphic, which means they occur in different stages. They can be red papules and pustules - which is the medical term for the small, white, pin-pointed, reddish or pus-filled lesions you see on the face. Most patients are always very tempted to pop this type of acne and cause it to scar.

Comparatively, cystic acne is not on the surface of the skin. It’s very deeply embedded under the surface of the skin, where the sebaceous glands form a cyst. These cysts are completely enlarged and there is a lot of pus in it, requiring dermats to sometimes actually drain out certain cystic lesions with a dermatosurgical procedure.

Also, all other grades of acne do not scar as much as cystic acne does. Cystic acne doesn’t restrict itself mostly to the face either, it can also occur behind the ears, on the neck, on the shoulders and other regions as well. So, this causes very bad scarring, which is also very difficult to treat and takes a long duration of treatment to get rid of fully.

 

What is the best way to treat cystic acne?

What is the best way to treat cystic acne?

Dermatologist-prescribed medication:

After examining your skin, a dermatologist will usually prescribe either isotretinoin right away, which is a form of vitamin A, or give oral antibiotics first which come in different categories. These groups of antibiotics are used to bring down the inflammation, work on eliminating bacteria, and inhibit pus formation to help reduce the occurrence of cysts. This can then be followed by isotretinoin to inhibit excessive oil secretions from the sebaceous glands and remove the dead skin cells that are actually clogging up your pores and causing acne in the first place.

Hormonal imbalance correction:

Adult women, or teenagers, who have been identified to have cystic acne because of hormonal changes or hormonal abnormalities, need to take anti-androgen and other hormonal pills in order to tackle the root cause. Otherwise, no matter how many OTC products you use, your acne is not going to come down unless your hormones are dealt with. The right skincare and makeup routine: Make sure your daily cleansing regimen is in place - you need to de-clog and cleanse your pores every single day with the right cleanser, followed by the right moisturiser. Using non-comedogenic, water-based, oil-free makeup products is of utmost importance. “I always tell my patients to leave their skin free to breathe without any makeup as much as possible - that is the best advice I give them,” revealed Dr. Tipirneni.

Proper diet:

Diet also plays a huge role in dealing with cystic acne. Avoid high glycaemic index foods - mainly rice, pasta, carbs, breads, junk food, oily foods and sugary foods. They play a huge role in increasing the serum cortisol levels and in turn, increasing the oil secretion from the oil glands.

A healthy lifestyle:

Stress also increases acne, so managing it becomes a big part of dealing with cystic acne. Lack of exercise also aggravates the condition.

Adopt a good medical regimen with advice from your dermatologist, set your lifestyle right, consume a balanced diet, make an exercise plan and take time off for yourself to manage your stress the best possible way!

 

What are some of the mistakes people tend to make with cystic acne?

What are some of the mistakes people tend to make with cystic acne?

Dr. Tipirneni revealed that one of the biggest mistakes that people tend to make with cystic acne is not to consult a dermatologist and instead, try to deal with it on their own. “The best methods to deal with cystic acne is point number one - visit a dermatologist, and point number two - follow the dermatologist’s advice. That is the only thing I can say, honestly. Cystic acne cannot be cured with over-the-counter creams or what you see on social media. The solutions cannot be prescribed by pharmacy chemists either, you cannot, and should not, go get a cystic acne solution for yourself. It has to be treated according to the root cause,” said Dr. Tipirneni, and honestly, it is the best advice anyone will give you today!

 

Expert recommended tips to help deal with cystic acne

Expert recommended tips to help deal with cystic acne

Apart from the medical advice detailed above, here are some of the tips can help deal with cystic acne: Lead a healthy lifestyle

  • Get your skincare and makeup products in order
  • Have a self-care regimen
  • Cleanse properly and always follow up with a moisturiser
  • Do not stress about it
  • Do not go on touching your face multiple times a day
  • Don’t get tempted to experiment with your skin in terms of “trendy” products you see online
  • Trust medical science, the solutions suggested by it are fact-based, evidence-based and extensively research-based that will help you achieve a glowing, smooth and acne-free face!
 

FAQs about cystic acne

FAQs about cystic acne

Q. What does cystic acne look like?

A. Cystic acne looks like large pus-filled cysts, has a lot of redness, is often accompanied by inflammation in the affected area and is very painful and tender to the touch.

Q. Where does cystic acne occur on the face?

A. Since hormonal imbalance is one of the major causes of cystic acne, it usually shows up on the lower half of the face. It is also very common in the areas of the skin that struggle with excessive oiliness.

Q. Do home remedies work on cystic acne?

A. Some of the common home remedies that are touted as effective in treating cystic acne are ice, white vinegar, turmeric, tea tree oil and crushed aspirin and water masks. But home remedies will do you more harm than good. The only way to treat cystic acne is to visit a dermatologist and follow their recommendations. Home remedies can make your cystic acne even worse.