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What Is Cystic Acne – Causes, Symptoms And Treatment Options

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It is not unusual to have a pimple or two especially if you are in your teens. We pray for them to disappear within days and they usually do. But think about painful breakouts that occur deep within your skin and refuse to go away on their own. They may last for weeks and haunt us even after they are gone. These breakouts can get severe and usually leave a scar. This form of severe acne is known as cystic acne and can linger for years if not treated properly.

Cystic Acne Meaning

Cystic acne is the most severe type of acne. Its caused when pores get blocked with oil, dead skin cells and bacteria leading to infection and inflammation. Cystic pimples develops from cysts deep within the skin and is characterized as large, red and painful bump on the skin. It usually affects the face but it can also affect upper arms, trunks and back. The risk of getting a cystic acne is high in people with oily skin type. Generally, it leaves a permanent scar on your skin.

Also Read: Effective Treatment For Cystic Acne

Causes Of Cystic Acne

Hormonal imbalance is the primary cause of getting cystic acne. However, there are other factors involved as well. These include –

  • Hormonal Changes Hormonal changes during puberty, pregnancy, menstruation, and menopause can lead to an increase in certain hormones called androgens in the body. The androgens lead to changes in the skin resulting in clogged pores and acne. Hormonal changes can also be brought about by using birth control pills and the presence of a condition called Polycystic Ovarian Disorder (PCOD). These changes can trigger cystic acne due to overproduction of androgens in the body.
  • Humidity and Sweating High levels of humidity and sweating can lead to an overproduction of sebum (oil) by the skin cells. The pores get clogged with excess oil, dirt and bacteria leading to painful cystic acne.
  • Genetics Cystic acne is linked with the genetic predisposition. If one of your parents had cystic acne, then you are more susceptible to getting them.
  • Certain medications – Certain drugs and chemicals present in the medicines such as corticosteroids, lithium, isoniazid etc. can cause eruptions similar to cystic acne.
  • Stress Stress leads to physiological changes in the body and overproduction of hormones named cortisol and testosterone. The testosterone causes the oil glands to produce more oil leading to cystic acne.
  • Wrong Skin Care Routine Using wrong skin care products or greasy make-up products that can block the pores may trigger cystic acne.

Signs & Symptoms Of Cystic Acne

Cystic acne symptoms are more visible than that of regular acne as they are often large, red and filled with pus. Most people suffering from cystic acne do not experience any physical symptoms except for changes in the skin’s appearance. The major signs and symptoms to help you determine the occurrence of cystic acne are listed below –

  • A large boil-like structure filled with pus
  • Redness at the affected site
  • Inflammation and acute infection
  • Tender or painful to touch
  • Swollen acne
  • Harder than regular pimples or acne
  • Scarring on the skin
  • Small, deep pits that may look like shallow depression in the skin

Also Read: What Are The Signs And Symptoms Of Acne?

Who Is At Risk? 

You are most likely to develop cystic acne due to hormonal imbalance and since that starts in the teens or early 20s, the people in this age are more susceptible to getting hormonal cystic acne. But adult men and women can also get affected by it equally. In fact, people in the age 50 might get cystic acne.

Severe cystic acne is more common in men. Cystic acne usually affects the face, neck, arms, forehead, chest, back and shoulders. In women, cystic acne usually affects the lower half of the face such as chin and jawline area as these areas have the most oil glands.

Cystic Acne Treatment

Usually, over the counter cystic acne medications are prescribed by the dermatologist as the first line of treatment. Other treatment options include –

  • Oral Antibiotics – Dermatologists prescribe oral antibiotics to treat adult cystic acne. This helps in a visible reduction in swelling. However, the bacteria may develop resistance over time and not respond to the antibiotics. Therefore, the course of treatment is limited here.
  • Isotretinoin – The dermatologist prescribes Isotretinoin for treating severe cases of cystic acne such as cystic acne on scalp and back. Isotretinoin is very effective and is used as the first line of treatment by the dermatologists to treat a severe form of cystic acne. Also, it should never be taken during pregnancy as it may lead to birth defects in the unborn child or cause premature birth.
  • Topical Retinoid – Prescription-strength creams, lotions or gels that contain retinoid are used as a potential cystic acne remedy. Retinoid belongs to the family of Vitamin A. They can effectively unplug the pores and remove the blockage. These creams may cause the skin to peel and make it more susceptible to sun damage so it is recommended to be used upon prescription by the dermatologist.
  • Benzoyl peroxideBenzoyl peroxide is a great treatment option to treat acne of any severity. It is easily available in a chemist store as an active ingredient of a number of formulations that can be applied directly to the skin. It works by killing bacteria that causes cystic acne. Most common products containing benzoyl peroxide include cleansers, soaps, lotions, creams, gels etc. But for safety purpose, any such product must be chosen after consulting with a dermatologist.
  • Spironolactone – Spironolactone is a synthetic steroid that is used to treat edema and high blood pressure. It is an androgen receptor blocker that can also be used to treat cystic acne caused due to elevated levels of androgens in the bloodstream. It may be used alone or combined with other lines of treatment such as birth control pills. The dermatologists have been successfully using Spironolactone to treat cystic acne in women as it doesn’t work well in men. Men may experience dosage related side effects such as loss of libido and gynecomastia.
  • Contraceptives – Birth control pills help women regulate their hormones and help clear up cystic acne. Birth control pills contain hormones such as estrogen and progesterone that help to down-regulate the production of androgens. Since cystic acne and hormonal fluctuations are interrelated, these contraceptive pills are useful in treating PCOS cystic acne.
  • Steroid Injections – Injecting a corticosteroid medication directly into the cyst can help in treating cystic acne can breakout and prevent scarring. The procedure is performed by the trained dermatologist on large cysts to reduce the inflammation instantly.
  • Laser Skin ResurfacingLaser Skin Resurfacing is a great option for reducing the appearance of scars. The aftermath of cystic acne includes pits, scars or raised bumps that are often difficult to get rid of. Laser treatment helps to smooth out the skin and also stimulate collagen production to effectively control leftover acne marks.

How Much Does Cystic Acne Removal Cost In India?

The cost of cystic acne removal in India varies between Rs. 2000 to Rs. 4000 per session. However the overall cost varies from person to person based on their skin type, choice of treatment opted, size and depth of the acne, experience of the dermatologist and underlying health condition.

Also Read: How Much Does Laser Treatment For Acne Scar Cost?

Nodular Acne Vs Cystic Acne

Nodular acne and cystic acne are both severe forms of acne. Nodular acne involves inflammation caused by bacteria called P.acne when it gets trapped in the skin pore alongside dirt, sebum and dead skin cells. The resulting infection can cause the pore to become red and swollen like a nodule without a head. Nodular acne may be skin toned or red and remain intact deep under the skin for weeks or even months.

Cystic acne looks like large, red boils and reside deep within the skin’s surface. They may burst open unlike nodular acne and spread infection. Cystic acne gets filled with pus due to the body’s immune reaction and may be painful to touch.

How To Prevent Cystic Acne?

Whether you have milder acne or severe, these practical measures are useful for anyone with cystic acne and help reduce the risk of developing them or making them worse –

  • Follow a proper skin care routine according to your skin type. Make sure to clean your skin thoroughly twice a day with a gentle cleanser. Clean your skin especially after a strenuous exercise.
  • Don’t touch or pick the cysts. You may push the infection and spread it further.
  • Men should follow proper grooming routine while shaving or keeping the beard. Ensure that you shave properly and clean the beard with soft cleanser to maintain hygiene.
  • It is important to maintain hair hygiene and shampoo properly as people with oily hair tend to develop cystic acne on back.
  • Avoid using heavy makeup products. Always pick oil-free, non-comedogenic and water-based formulations for the skin.
  • Try to relax as much as possible. Stress causes the body to release more hormones and it may worsen the acne.
  • Adopt a healthy lifestyle while getting plenty of sleep and exercise. A low-glycemic diet which limits sugar intake can prevent cystic acne or acne in general.

Also Read: 11 Best Home Remedies For Acne


What Is The Difference Between Cystic Acne And Pimples?

Cystic acne is a term used to define a severe type of acne where pimples form cysts beneath the skin. Cystic acne is a skin disease whereas a pimple is a symptom for the same. The onset of cystic acne is brought by accumulation of sebum, dirt and bacteria in the clogged pores. When these plugged pores form cysts and appear as large bumps, they are known as cystic acne.

Pimples are inflamed and infected pores that are relatively small and sometimes filled with pus. Pimples are the most common symptom for acne. However, when acne gets severe and comes with large, painful and inflamed lesions, they are termed as cystic acne.

How Long Cystic Acne Last?

Cystic acne may take weeks or months and in rare cases even years to disappear if left untreated. Cystic acne can be tough to heal but with the right treatment option, they may take 1-4 weeks to heal.

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About The Author

Kushneet Kukreja

Kushneet Kukreja

A postgraduate in Biotechnology from Kingston University and an ISSA Certified Specialist in Fitness & Nutrition, Kushneet Kukreja is a passionate writer who works in close association with the dermatologists at our head office to generate valuable and scientifically accurate content for our blog.

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