Cystic acne is a severe form of acne that typically requires medical treatment; effective options include a combination of topical and oral therapies prescribed by a dermatologist, with isotretinoin (formerly Accutane) considered the most potent treatment for stubborn cases[1][2][5].
Common strategies to manage and get rid of cystic acne include:
- Topical Treatments: Prescription creams or gels containing retinoids (such as tretinoin or adapalene) and topical antibiotics help unclog pores and reduce infection. Over-the-counter benzoyl peroxide may also reduce bacteria and shrink pimples, but is often insufficient for cystic acne[1][3][4].
- Oral Antibiotics: Medications like doxycycline or minocycline are frequently prescribed to decrease the bacteria and inflammation associated with deep cysts. Oral antibiotics are usually used for the short term to avoid antibiotic resistance[2][3][4][5].
- Hormonal Treatments: Spironolactone (for women only) reduces androgen levels involved in acne formation. Oral contraceptives may also be helpful for hormonal cystic acne in females[3][4][5].
- Isotretinoin (Accutane): For severe or treatment-resistant cases, isotretinoin is regarded as the most effective therapy. A typical course lasts several months, and 80–85% of patients experience permanent improvement. Due to serious potential side effects (including birth defects), isotretinoin is strictly regulated and requires enrollment in risk management programs[2][3][5].
- Intralesional Corticosteroid Injections: For large, painful cysts, a dermatologist may inject the lesion with corticosteroids to quickly reduce swelling and discomfort[1][6].
- Procedures for Scarring or Non-Responsive Acne: Chemical peels, laser resurfacing, dermabrasion, and photodynamic therapy may be used for scarring or acne unresponsive to conventional medications[1][4][6].
General care tips include adopting a gentle skin routine, using non-comedogenic products, wearing facial sunscreen daily, and avoiding picking or squeezing cysts. Some evidence also supports dietary modifications (reducing sugar and processed foods) and stress management[1][3].
Cystic acne almost always requires intervention from a healthcare professional. Delaying treatment can increase the risk of scarring and ongoing emotional distress. Consult a dermatologist to develop a personalized plan and discuss any medication risks.
References
- [1] Cystic Acne Symptoms & Treatment | Aurora Health Care
- [2] Cystic Acne Breakouts & Treatment – Schweiger Dermatology Group
- [3] How to shrink a cystic pimple in 3 steps – Medical News Today
- [4] Acne Symptoms & Treatment | Aurora Health Care
- [5] What can clear severe acne? – American Academy of Dermatology
- [6] Management of acne – PMC
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