What You Need To Know About Cystic Acne

Pimples are always troublesome, but the most painful and long-lasting kind are cystic. Cystic acne, also known as acne conglobata or nodulocystic acne, is classified by the following:

  • large, red, and painful bumps that commonly don’t have a whitehead
  • Usually found on the face, back, chest, upper arms, or shoulders
  • you feel pain even before redness appears, regardless of whether you’ve touched it or not

Bruce Robinson, a dermatologist and clinical instructor of dermatology at Lenox Hill Hospital, explains that because it forms deeper in the skin than most types of acne, cystic acne most often results in scarring.


When oil glands produce excessive amounts of oil, pores become clogged with dead skin and grease. This traps the bacteria P Acnes within the skin. As a defense mechanism, the body’s immune system tries to get rid of the harmful agent. This immune response results in swelling and is the catalyst for a long, frustrating cycle.

While cause behind cystic acne is still not entirely understood, researchers have identified some common factors found in most people suffering from cystic acne:

  • Genetics. Cystic acne can run in families. If one, or both, of your parents had cystic acne, you have a greater chance of getting it.
  • Hormonal fluctuations/changes. When testosterone levels rise, oil glands are activated to secrete more oil, which increases the chances of clogged pores. 85% of the time, cystic acne appears during puberty when the body goes through drastic hormonal changes. It may continue throughout adulthood for both men and women. For women, it often happens at a certain phase in their menstrual cycle or during pregnancy.
  • Polycystic ovarian syndrome (for women). PCOS is caused by an imbalance of reproductive hormones. The female body produces more hormones similar to testosterone. Cystic acne caused by hormones usually appears on the jawline or around the mouth.
  • Extreme humidity. Increased moisture in the air causes pores to open up and makes them susceptible to trapping dirt and grime.
  • Comedogenic, or pore-clogging, hair care and skin care products. Certain ingredients from your conditioner, moisturizer, to facial cream can end up clogging your pores. Dr. Loretta Ciraldo, dermatologist and co-founder of Dr. Loretta Skincare, advises avoiding thicker, creamier products or products with a rich consistency. Karen Asquith, national director of education at G.M. Collin Skin Care, lists common ingredients that are likely to clog your pores:
    • Isopropyl Myristate
    • Acetylated Lanolin Alcohol
    • Cetearyl Alcohol when combined with Ceteareth 20
    • Isostearyl Isostearate
    • Isopropyl Isostearate
    • Isocetyl Stearate
    • Myristyl Lactate
    • Myristyl Myristate
    • Isopropyl Palmitate
    • PEG 16 Lanolin
    • Propylene Glycol Monostearate.
  • Some drugs and chemicals may aggravate, or trigger acne. Art of Skin Care lists down drugs and chemicals likely to cause acne, including marijuana (produces an imbalance in hormones), bromides in cold and flu medications, topical and oral steroids, vitamins B1, B6, B12, D, some antidepressants, some antiepileptics (mood stabilizers), and sedatives. If you have any of these as a prescribed medication or supplementation, do not stop taking them without consulting your doctor first. There may be non-acne-inducing alternatives.

Cystic Acne Treatments

Because cystic acne is one of the most severe forms of acne, it’s generally advised to consult a dermatologist for a safe and effective treatment. Your usual skincare routine might not suffice.

Rachel Nazarian, a dermatologist at Schweiger Dermatology Group in New York City, observes that some people opt for quick cortisone injections to get rid of cystic acne within hours.

For worst cases, dermatologists recommend Accutane (isotretinoin) as a last resort. Isotretinoin is a drug derived from Vitamin A designed to shrink pores. While it is effective for some people, it comes with severe potential side effects. Among these are skin sensitivity to the sun, rashes or peeling, headaches, fatigue, and mood changes.

However, not everyone can afford such treatments. Here are some tips from dermatologists on how to get those pesky pimples under control, without breaking your bank:

  • Don’t pop it. Repeat: do not. Dermatologist Scott Dunbar explains that cystic acne is made of a deep pocket of white blood cells, so you can't pop it like your usual pimple.
  • Ice it before it gets worse. You can usually feel cystic acne forming before it fully appears. Nazarian explains that applying cold compress will constrict the small blood vessels feeding the cyst, thus reducing its redness and size.
  • Make Salicylic Acid your best friend. Joshua Zeichner, director of cosmetic and clinical research at Mount Sinai Medical Center, advises his patients to use a Salicylic Acid cleanser. Salicylic Acid is a type of Beta Hydroxy Acid which can be sourced from Willow Bark Extract. It exfoliates, unclogs pores, and prevents the formation of dark spots. To ensure safety and potency, choose a product with naturally-derived Salicylic Acid (like our Acne Eliminating Face Spray). Zeichner suggests giving the cleanser enough contact time with your skin so the ingredients can do their work - sing the alphabet while you’re at it!
  • Choose an oil-free, non-comedogenic moisturizer. Even if you have oily, acne-prone skin, you still need to keep your skin hydrated. Moisturizing with the right product helps maintain your skin’s natural barrier, your first line of defense against bacteria, dust, and grime. As mentioned above, it’s important to avoid rich and creamy products because these may clog pores.
  • Use a spot treatment to target particularly pesky spots. Choose one with Salicylic Acid or an acne-fighting essential oil, like Tea Tree Oil or Lavender Oil. Tea Tree Oil is anti-inflammatory, anti-microbial, and antiseptic. This means it can relieve itchy skin, heal infections, and help shrink pores. Lavender Oil has a soothing effect that numbs the pain caused by inflammation. It has also been found to speed up skin tissue repair. Bonus points, you can find these ingredients in our Cystic Acne Spot Treatment.
  • Ensure that whatever comes in contact with your skin regularly is non-irritating. Frequently change your towels and pillowcases to prevent excessive bacteria growth. Wash your fabrics with unscented laundry detergent designed for sensitive skin. Washing with strong products may aggravate skin irritation.

We understand the toll acne takes not just on our skin, but also on our confidence and mental health. We want to assure you that you’re not alone in this. Reach out to us and let us know how we can help!

If you have tips to share with fellow cystic acne warriors, please comment them below. We’ll be happy to hear from you.











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