Cystic acne is generally seen as the most severe type of acne. Also known as nodulocystic acne, cystic acne can have a significant impact on someone’s self-esteem and overall quality of life. Let’s explore what the condition is, what it’s caused by, and crucially, what the best treatment options are for cystic acne.
What is cystic acne?
Cystic acne is characterised by deep, inflamed cysts that form under the skin. These cysts are often filled with pus, a fluid made from sebum (the oil produced by skin), bacteria, debris, and dead skin cells. Other forms of acne usually occur on the skin’s surface, however, with cystic acne, cysts can burst and spread through deeper layers of the skin. This makes it a more difficult condition to treat, and can cause long-term scarring if left untreated.
What is cystic acne caused by?
Pus-filled acne cysts occur when pores and hair follicles in the skin get clogged with excess sebum, bacteria, and other debris. A range of factors influence the likelihood of this occurring, including:
- Hormones and age: Puberty can greatly increase the production of sebum, meaning teenagers are more likely to experience cystic acne. Other hormonal fluctuations during menstruation, pregnancy, menopause, or various health conditions can also increase the likelihood of acne.
- Genetics: Some individuals may have a family history of acne which can contribute to cystic acne development.
- Lifestyle factors: Although the underlying cause is normally due to an underlying hormonal imbalance, lifestyle factors like stress, lack of sleep, diet, and some supplements may contribute to cystic acne.
- Medications and cosmetics: Certain medications including steroid medications and lithium may exacerbate or start acne. Other cosmetic or beauty products may also contribute to acne development, especially oily moisturisers or cleaners.
Symptoms of cystic acne
So, what does cystic acne look like?
The condition is usually marked by inflamed cysts which can occur anywhere, but are most common on body parts with more oil glands, including the face, neck, back, shoulders, and chest. Blemishes are usually larger in this condition than in other forms of acne. Other symptoms include:
- Itching and discomfort at the site of cysts
- Red lumps and bumps under the skin known as ‘nodes’, which are usually the size of a pea of larger
- Oozing or crusty cysts
- Skin sensitivity to touch and various temperatures
- Scarring or hyperpigmentation where previous cysts have healed
Treating cystic acne
Treatment for the condition can be challenging and may require various therapies to address multiple causes and also minimise scarring. Finding the best treatment for cystic acne usually requires working with an expert like a dermatologist to identify the right solution based on individual needs.
This might involve exploring treatments which are commonly used in milder acne such as topical solutions or oral medications (like antibiotics), but these treatments alone usually aren’t effective. Instead, cystic acne generally requires more extensive treatment, such as:
Prescription Isotretinoin (Roaccutane): This oral medication, commonly known by its former brand name Roaccutane or Accutane, works to reduce the size of the skin’s oil glands and the amount of sebum produced by these glands. Roaccutane also slows the speed at which pores become clogged and reduces inflammation under the skin. These factors combined mean it is a very effective treatment for cystic acne, however, it can take some time and cause several side effects. Your dermatologist should talk you through what to expect and provide advice around aftercare.
Light and laser therapies: Both LED light and lasers can be used to help with the redness, and inflammation that comes with cystic acne. The lights break down the bacteria responsible for acne, leading to reduced swelling and pain. These non-invasive options offer less side effects than other treatments.
Steroid injections: In severe or treatment-resistant cases of cystic acne, a corticosteroid injection can be administered into cysts to help promote healing and reduce inflammation.
Other treatments may also be used alongside the above options to further the healing of scars, such as laser treatment, derma roller, facial peels, and soft tissue augmentation. Experiencing cystic acne can feel really challenging, but there are treatments that can help. Request a consultation with our team at LINIA Skin Clinic today to get started on your journey and find out how our experts can best support you.
