Cystic acne is different from other mild types of acne because it is deeper down in your skin and it’s painful.

With Americans, acne is the most common skin condition. Some develop cystic acne which is the most severe form of acne. It is characterized by large, swollen acne lesions that grow deep within the skin – and it’s painful and visible from the surface. It can grow on the face, back of your neck, chest, and back. This acne is difficult to treat, although there are available options to help ease the pain and psychological effects associated with this skin problem.
Generally, adolescent acne goes through some stages where each stage needs a particular treatment. This skin condition begins with whiteheads which may develop to blackheads. By not picking, popping, and manipulating, they rarely cause scarring. But several of these will develop into acne which may progress to pustular acne. These pustules tend to turn into a scar, especially if they are “popped.” Cystic acne is the last state of the development of acne. If this is left untreated, it can cause acne scarring.
Cystic acne can become part of a syndrome characterized by a combination of acne on the face with draining lesions and boils on the scalp, axilla, groin, or chest. Conglobate acne is a severe type that may look like severe cystic acne on the face and trunk. This may have systemic manifestations like arthritis and other musculoskeletal problems.
How do we identify cystic acne?
Cystic acne tends to be larger and deeper within the skin, while all other types seem to be on the surface of the skin. They look like boils characterized by a large pus-filled cyst, large white bump, redness, tender or painful to one’s touch. They tend to appear on the face, although they also develop on the chest, neck, arms, shoulders, behind the ears, and arms.
What are the causes of cystic acne?
We have to know and understand the causes of acne to know the right treatment. When skin pores are blocked by excess sebum, dead skin cells, and bacteria, infection is inevitable. Severe forms of pore blockages may result in cystic acne. Those with cystic acne will experience painful lesions under their skin. They are deep within the epidermis, and unlike pimples and pustules, they do not come to a head on the skin’s surface. There is cystic acne that comes with several comedones, which can be open or closed or even both. Open comedones are known as blackheads, while the open comedones are commonly known as whiteheads.
There are many factors that can cause cystic acne, including genetics, hormonal changes, and even lifestyle like stress and certain diet. When comedones are clogged and infected, the swelling can result in papules, pustules, nodules, and cysts. And cystic acne comes with painful, deep lesions growing under your skin and can develop into permanent scars.
What can worsen cystic acne?
Medications
Some treatments can worsen the growth of acne, including birth control meds that contain progesterone only. We recommend consulting your doctor before taking any medication for acne.
Sweat
Hot and humid climate promotes the growth of acne. The skin forms sweat to help fight the heat, and it is normal to wipe it away. However, wiping it with our hands may spread oils and promote bacteria that can cause or worsen acne.
Dairy
More studies and consultations are continuously conducted to prove the link between diet and acne, specifically between acne inflammation and dairy. The link has been noted, but no strong evidence points to dairy as a direct cause of acne.
Stress
Some individuals felt that high-stress level had caused their acne. Stress does not necessarily cause acne, but it can worsen a pre-existing acne condition. Some studies could not point the direct connection between stress and acne lesion, but researchers suspected that stress could signal sebaceous glands to the growth of oil production. This leads to more oil making it easier to develop acne. There are some individuals who are stressed out and unconsciously pick at the skin that may worsen acne and scarring.
And without proper treatment, cystic acne can turn into scars and skin blemishes like the ice pick scars, large pits in the skin, shallow depressions, and red raised scars. Some psychological effects are associated with cystic acne. Therefore, it is essential to treat this skin problem soonest possible to avoid more damaging and long term consequences.
Over The Counter products to treat cystic acne
1. Amara Organics Vitamin C Serum
This Amara Organics Vitamin C Serum is formulated to make your skin brighter, tighter, clearer, and smoother. Contains 20% Vitamin C, Hyaluronic acid, and Vitamin E. It helps clear up the skin and prevent a breakout, shrink pores, and reduce the growth of acne scars. Fits all skin types, except sensitive skin type. This Vitamin C serum does not contain parabens, no harsh chemicals, and artificial colors, without dyes and annoying scent.
Pros
- Contains 20% vitamin C that acts as astringent and helps remove excess oil, dead skin cells, and bacteria from your skin.
- It has aloe vera extract that helps in keeping the healthy moisture level of your skin; the substance also has antibacterial properties that help disinfect your skin with fluid-filled nodules and cysts.
- The witch hazel in the product also helps in drying out blemishes and pimples by shrinking skin pores.
- Glycerin helps in skin hydration and prevents the skin from drying out.
- Vitamin E oil helps balance free radicals that may damage your skin that may result in acne.
- The hyaluronic acid helps in preserving the softness of your skin and minimizes the signs of aging and dryness.
- Alcohol-free and fragrance-free
Cons
- Witch hazel and vitamin C may cause skin dryness if used and applied frequently.
- Witch hazel can cause an allergic reaction on sensitive skin.
- This Vitamin C serum has Phenoxyethanol that can be harmful to skin
- It is not completely organic and natural.
2. TreeActiv Cystic Acne Spot Treatment
The TreeActiv Cystic Acne Spot Treatment works by unclogging pores, neutralizing oil production, removing harmful bacteria thriving in your skin, treating acne scars, banishing irritation. With continued use of this product helps remove existing acne while preventing future breakouts. It fits those with combination to oily skin types.
Pros
- Contains bentonite clay that removes impurities from your skin pores and unclogs them.
- Gets rid of acne bumps by giving oxygen to the skin cells for a healthy skin complexion.
- Has tea tree oil that acts as astringent and antibacterial and helps treat acne.
- The pink grapefruit oil aids in producing collagen that minimizes inflammation.
- Aloe vera boosts the skin keeping it hydrated and calms irritation
- Peppermint and witch hazel help minimize excess oil and remove bacteria in your pores.
- Lemon oil helps to balance the production of sebum and eliminate dead skin cells giving clear skin.
Cons
- Witch hazel and tea tree oil can irritate sensitive skin and cause redness and irritation
- The formula gets dry quickly, so you have to apply it correctly on the acne-affected areas only.
- Expensive
3. Differin Acne Treatment Gel
This Differin Adapalene Gel Acne Treatment is an FDA-approved acne product that contains prescription-strength retinoid 0.1% adapalene which is dermatologist recommended retinoid even without a prescription. This acne treatment gel works with mild to moderate acne and occasional breakouts. Also suitable for those with combination to oily skin types.
Pros
- Has 0.1% adapalene as an active ingredient
- Clears breakouts from deep inside the pores and prevents future blemishes
- Targets two skin problem areas – clogged pores and inflammation that helps treat acne lesions
- Water-based formula that can easily be applied and does not need any rinsing off
- An oil-free formula, alcohol-free
Cons
- Contains paraben that can cause an adverse reaction to individuals with sensitive skin type and those who have suffered reactions in the past
- Adapalene should only be applied once every day; using this gel more will not give any instant results, but may irritate your skin
4. Mario Badescu Drying Lotion
The Mario Badescu Drying Lotion is an award-winning solution that targets pimples and other blemishes while you sleep. All you have to do is dab some amount on your face, particularly on the acne-affected areas, let them dry, and wash in the morning. This lotion contains isopropyl alcohol, aqua, calamine, zinc oxide, titanium dioxide, sulfur, camphor, talc, glycerin, and salicylic acid. It is suitable for those with oily skin type.
Pros
- Contains salicylic acid that helps clear dead skin cells and accumulated sebum making your pores shrink
- Sulfur helps draw out oil from the pores and the blemish areas
- Calamine helps balance the drying effects with its soothing and cooling properties
- Zinc oxide aids in drying out oil and calming inflammation surrounding the acne affected spots
- Paraben-free, fragrance-free
- Affordable product
Cons
- Alcohol may be harmful to acne-prone skin
- Talc and titanium dioxide that may irritation skin that result in more breakouts
5. SkinCeuticals Blemish + Age Defense
The SkinCeuticals Blemish + Age Defense is an oil-free treatment for adult acne and signs of aging. It blends 2% dioic acid with alpha- and beta-hydroxy acid formula to prevent the formation of acne and minimize hyperpigmentation and wrinkles. It helps promote smoother and evenly-toned skin. This formula is good for blemish-prone skin and suitable for all types of skin.
Pros
- Dioic acid as an active ingredient is still rare but effective for acne because it helps remove excess oil and fight formation of acne
- The salicylic acid and glycolic acid helps unclog pores and removes dead skin cells making your skin clear and clean
- Citric acid helps boost skin collagen and acts as an astringent giving you a cyst-free skin complexion
- The formula helps improve the appearance of uneven and spotty skin
- Fragrance-free, paraben-free
Cons
- Has denatured alcohol that may irritate, burning sensation, and redness, especially for individuals who suffered an allergic reaction in the past
- The high acid concentration may cause skin dryness
- Very expensive
6. Neutrogena Rapid Clear Stubborn Acne Daily Leave-On Face Mask
The Neutrogena Rapid Clear Daily Leave-On Face Mask is clinically proven that helps minimize the size and redness of existing breakouts in just 4 hours! This lightweight gel formula contains benzoyl peroxide that helps instantly banishes into the skin and allows this acne medicine to absorb deep down the skin. It kills acne-causing bacteria that causes existing stubborn acne and the acne that is just forming under the surface of your skin. Different from traditional face masks, this is not a wash-off product. When applied in the morning and evening, this dermatologist-recommended benzoyl peroxide formula helps treat acne around the clock, so you can keep fighting acne all day. It does not overdry, burn your skin, sting, and therefore, you can use this product under moisturizer or makeup. This face mask is suitable for individuals with combination to oily skin types.
Pros
- Contains 2.5% benzoyl peroxide treatment that acts as an antibacterial agent that kills acne-causing bacteria in your skin pores
- Gently detoxifies pores and removes accumulated sebum to eliminates chances of getting blackheads and whiteheads
- Glycerin helps your skin hydrated
- Alcohol-free, fragrance-free, and paraben-free
Cons
- Benzoyl peroxide may irritate individuals with sensitive skin type, or those who are allergic to it
- May cause dryness and peeling of the skin, if you have dry skin
- Expensive acne treatment
7. TruSkin Naturals Tea Tree Clear Skin Super Serum
The TruSkin Naturals Tea Tree Clear Skin Super Serum contains tea tree oil as an active ingredient that acts as antibacterial, antiseptic, and antibacterial agents. This ingredient helps fight acne, blemishes, acne scars, blackheads, and other skin problems. The tea tree oil is believed to have the ability to unclog pores, reduce their visibility, and banish irritation and inflammation.
This serum also has retinol and niacinamide for skin health and beauty, improving complexion that gives a younger-looking you.
Pros
- Blends tea tree oil, niacinamide (B3), retinol (Vitamin A), 20% Vitamin C, and salicylic acid
- Affordable acne product
- Organic and natural
- Not tested on animals
- Formulated in the U.S.A. and manufactured in an FDA-registered laboratory
- Offers a 3-month, 100% money-back refund guarantee
Cons
- Serum with a high concentration that may irritate and dry your skin if it is applied every day
- Some users reported that they experienced breakouts and burning sensation after application
8. Claridad Glycolic Face Wash
This Claridad Glycolic Face Wash is a medical-grade skin care product using glycolic acid to help remove pore-clogging oils without removing your skin’s “good oils.” These “good oils” helps keep your skin hydrated and protected. It has an advanced formula exfoliating face wash that reaches deep within the pores to completely remove impurities and pollutants like makeup residue, oil, and dirt. This product was originally formulated for physicians and dermatologists through clinical research.
It also contains yucca extract that acts as an antioxidant to neutralize uneven skin tone by fading age spots, sun spots, acne scars, and other skin blemishes – gradually. The glycolic component is extracted from the sugar cane plant that helps exfoliate your dry skin, prevent oily buildup and deals with discoloration. Glycolic also acts as chemical peel that gently tightens and firms the skin to stop the appearance of wrinkles and fine lines. It is suitable for oily skin type.
Pros
- Contains a high concentration of glycolic acid that is required to treat severe acne
- The acidic nature of the product helps remove excessive oiliness that clogs your skin pores
- Deeply exfoliates by penetrating in the pores and removes all the dirt, dead skin cells, and sebum build up
- Also contains panthenol that gives a soothing effect and relaxes inflammation; yucca extract acts as an antioxidant that balances uneven skin tone caused by blemishes and acne scars; allantoin helps encourage healing and acts as an anti-irritant
- Alcohol-free, paraben-free
Cons
- Complete clearing out takes time depending on the skin type and severity of acne
- The high concentration of glycolic acid may dry your skin
- Has added fragrance that may irritate those with sensitive skin or may cause rashes
- If you are using this face wash, we recommend using SPF because the product may cause UV sensitivity
9. Humane Acne Wash
The Humane Acne Wash helps clear your skin and prevent future breakouts. This is a potent wash that kills acne-causing bacteria directly in your skin pores where pimples start.
Test on a small affected area for about two to three days. This product is not for those with sensitive skin type. You should expect redness, irritation, peeling and dry skin and if the case is severe, reduce use to once a day or every other day. Use an oil-free moisturizer after application to manage irritation. It contains benzoyl peroxide that can bleach fabrics. Use white or old towels and linens during the treatment period. Treatment may take up to six weeks before seeing some results. It is fit for all types of skin except sensitive skin type.
Pros
- Contains maximum strength of 10% benzoyl peroxide as an active ingredient which is known for treating acne
- Light formula with fewer ingredients
- The product works for all types of acne lesions including cysts and nodules by killing bacteria in your pores
- Has non-foaming lotion to penetrate easily and show instant improvements or results
- Alcohol-free, fragrance-free, paraben-free
Cons
- May cause dryness, peeling, and redness due to the high concentration of benzoyl peroxide
- Benzoyl peroxide can also cause hyperpigmentation in some cases
10. Is Clinical Pro-Heal Serum Advance+
The IS Clinical Pro-Heal Serum is an advanced form of Vitamin C which is called L-ascorbic acid combined with olive leaf extract and other pure vitamins like Vitamins A and E. The formula targets pre-existing signs of aging calms redness-prone and acne-prone skin types — fit for all types of skin including sensitive skin.
Pros
- Has vitamin C that helps rejuvenate skin and shed dead skin cells
- The vitamin C has astringent properties that help clear out pore clogs and prevent bacteria and acne formation
- Olive extract, Vitamins A and E act as an antioxidant that helps neutralize free radicals
- Also contains zinc sulfate to reduce inflammation and calm redness; kojic acid helps prevent further blemishes
- Alcohol-free, fragrance-free, and without other harmful ingredients for sensitive skin
Cons
- Very expensive
On a final note,
It may seem to be difficult to treat cystic acne. Good news is that there is the right treatment for you out there in the market. You just have to know what works for you and be persistent and patient. For any doubt, you can also consult with your dermatologist.
We are happy to hear from you!