Cystic Acne

People with cystic acne develop pus-filled acne cysts (pimples) deep under the skin. The acne cysts are often painful and can be large. A dermatologist should treat cystic acne to reduce the risk of scarring and infection. Antibiotics and prescription-strength topical (skin) creams can help clear up your skin.

Cystic acne is a type of inflammatory acne that causes painful, pus-filled pimples to form deep under the skin. Acne occurs when oil and dead skin cells clog skin pores.

With cystic acne, bacteria also gets into the pores, causing swelling or inflammation. Cystic acne is the most severe type of acne. Acne cysts are often painful and more likely to cause scarring.

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Nodular acne and cystic acne are very similar. Both cause deep, painful bumps under the skin. And both can scar. Differences include:

Pores in the skin can clog with excess oil and dead skin cells, causing pimples. Bacteria can enter the skin pores and get trapped along with the oil and skin cells. The skin reaction causes swelling deep in the skin’s middle layer (the dermis). This infected, red, swollen lump is an acne cyst.

A cystic acne breakout may cover a large area of skin. Cystic acne tends to appear on the face, which has a lot of oil glands. But you can also get acne cysts on your:

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Acne cysts can be difficult to treat. Because they can scar, you should seek help from a dermatologist instead of trying over-the-counter acne products. A dermatologist can teach you how to treat cystic acne.

It can take three months or more to clear up acne cysts. Treatment often involves taking oral antibiotics and applying prescription-strength topical gels or creams to the skin.

Opening up acne cysts — by popping or picking them — increases the risk of scarring and bacterial skin infections like cellulitis.

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Some people develop pigment changes (light or dark) spots at the site of the acne cyst after the skin clears up. These spots may be pink, purple, red, black or brown. They eventually fade away, but it may take more than a year.

Most people with cystic acne can prevent severe breakouts or quickly treat acne cysts to prevent scarring. Often, but not always, cystic acne clears up or diminishes with age, as hormones settle down.

Severe or untreated cystic acne can affect how you feel about your appearance, making you anxious or depressed. If cystic acne bothers you, talk with your healthcare provider about getting help with fostering a positive self-image.

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It’s tempting to want to touch or pick at painful, swollen acne cysts. But cystic acne is more likely than other zits to scar or develop infections. A dermatologist can offer suggestions to prevent cystic acne. This doctor can also treat painful acne cysts, lowering the chances of scarring. Antibiotics and topical (skin) creams are effective cystic acne treatments.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. PolicyIf you’ve got tender, inflamed pimples rooted deep underneath the surface of your skin, chances are you have cystic acne. This type of inflammatory pimple is one of the most severe, with the potential to cause long term scarring. Acne cysts can be chronic or infrequent, and may or may not eventually emerge at the skin’s surface.

In order to learn more about why cystic acne develops — and exactly how to treat it — we talked to the expert: Dr. Sandra Lee, aka Dr. Pimple Popper.

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Figuring out what type of acne you’re experiencing is important for tailoring the most effective treatment. Cysts are a type of inflammatory acne — pimples that start out as clogged pores (aka non-inflammatory acne) but become infected with

Papules and pustules are more superficial, originating in skin's outermost layer (aka the epidermis). Nodules and cysts are deeper areas of inflammation located in the dermis.

Acne cysts resemble papules and pustules, though as we mentioned they’re deeper beneath the skin’s surface. They’re also much less common than papules and pustules. Here are the main characteristics of cystic acne:

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All acne begins when pores clog with excess oil and dead skin cells. This provides a breeding ground for acne bacteria that's normally present on the skin’s surface. Though scientists aren’t sure why, some people seem more susceptible to this bacterial infection than others.

According to Dr. Lee, there are a variety of treatments for cystic acne, depending on your individual circumstances. Though everyone’s skin is unique, here’s a rough guide. If you're experiencing frequent cystic breakouts, or any type of scarring, see your dermatologist.

Once-in-a-while painful, deep pimples are typically hormonal in nature and tend to pop up in similar spots along the jawline and/or T-zone. Keep breakouts in check by maintaining a consistent skincare routine that includes:

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Managing inflammatory pimples requires a comprehensive approach that addresses each stage of acne. Keep consistent with salicylic acid and retinol (plus a spot treatment when needed), but add one of these antimicrobial acne-fighters to your routine:

To take the guesswork out of managing acne, Dr. Lee created easy-to-follow skincare regimens formulated for all skin types. SLMD Acne System is a 3-step, twice-a-day routine that uses proven ingredients like salicylic acid, benzoyl peroxide, and retinol. If you’ve got sensitive skin, try sulfur instead, as part of SLMD Sensitive Skin Acne System.

If you’ve been diligently following a regimen like Acne System for at least 12 weeks and haven’t seen improvement (or if you're worried about scarring), it’s time to consult with a dermatologist. Inflammatory acne left unchecked can have long term repercussions — causing permanent scarring and psychological damage. Your doctor can prescribe more potent treatments, including:

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News flash: you should never pick or pop an acne cyst — even when they have that oh-so-tempting white head on them. These types of pimples are full of fluid, including bacteria and pus, that will just spread and create more acne. Irritating a pimple also encourages hyperpigmentation or even permanent scarring.

Cystic acne can be a source of frustration and discomfort for patients. Not only can it damage skin and leave permanent scars — it can also contribute to low self-esteem and depression. But there are solutions, from targeted spot treatments to over-the-counter regimens like my 

SLMD Acne System that uses potent dermatological ingredients. And if your acne persists, your dermatologist can help you with prescription options. Remember, be kind to yourself and know that your acne doesn’t define you.This type of acne causes visible scarring because of its depth and inflammation. This is formed when bacteria gets trapped in the pores and triggers an infection deep into the skin. It appears to be a red and tender bump filled with pus.

Cystic Acne Causes And Effective Treatments

Cystic acne is considered as the most severe kind of acne. It comes with pain that is impossible to ignore. This happens because there is no opening to release the pent-up bacteria and oil which causes pain and discomfort. A severe condition as this requires acne treatment to get rid of it effectively and safely.

Normal pimples are small inflamed bumps on the face. When these bumps become more infected, a large pus-filled cavity forms deep inside the skin. This results in cystic acne. If the cyst bursts, the infection may spread to the surrounding area and cause more breakouts.

For women, it’s usually the hormonal shifts that happen during their monthly period, which causes the glands to produce excess oil. This causes the oil glands to be filled with sebum that leads to breakouts.

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High levels of androgen and testosterone are also linked to causing breakouts. This causes high activity of the sebaceous glands which leads to overproduction of sebum. There’s a higher chance of pores getting clogged, leading to severe acne.

Acne tends to run in the genes. If one of your parents suffered from a severe acne breakout, it is possible you might get it, too. A family line with the genetic tendency to overproduce sebum leads to oily skin which results in more breakouts.

There’s also a chance your diet may be one of the causes. Some foods can trigger inflammation on the skin and speed up the formation of a cyst. High-glycemic foods and dairy are amongst the culprit linked to causing acne. A study associated skim milk to triggering acne growth.

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It is that painful, hard cyst on your chin that won’t seem to come to a head, stay on your face and continue to bug you. The longer it stays, the higher the chance it will develop into a stubborn acne scar.

Pimples growing on the chin are usually related to hormones, especially in women. Hormonal imbalance and shifts can disrupt the body’s healthy functioning and cause acne flare-ups. Acne growth on the chin may fluctuate during monthly periods. Also, an increase in androgens and testosterone in women are the main reasons why they’re prone to pimples growing on the chin.

Hormones are what stimulate oil production. Too much sebum triggers the growth of bacteria which then gets trapped in the pores. Cystic acne breakouts typically happen underneath the skin and the bacteria in there.

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Creams and ointments containing benzoyl peroxide, retinoids or antibiotics