Imagine an ordinary pimple. You’re probably picturing a fairly small, red spot, topped with a gooey-looking white spot. All of the elements of a pimple are easily visible, exactly because the acne inflammation still hasn’t affected the deeper layers of skin. While these ‘ordinary’ acne inflammations are already bad enough with their annoying pimples and scars, they’re still limited to the surface areas of the skin.
Sadly, not everyone is so lucky. In some cases, acne inflammation can deepen and intensify, which leads to damage in the deeper layers of skin tissue. When this happens, we’re usually dealing with cystic acne - and they’re especially tricky to deal with when they appear on a sensitive area such as the face or the neck.
Known as one of the most severe types of acne inflammation, cystic acne form when the pores become completely and irreversibly clogged. Clogged pores form so-called blackheads or whiteheads, which is the first stage of acne formation. As opposed to the common pimple, the build-up of material in cystic acne has no way of release, resulting in the swelling moving downwards under the skin. Hence, the typical cystic acne looks like a small hill made of skin, usually colored reddish or blue and soft to the touch. Cystic acne spreads the infected material (puss) between the inner layers of skin causing damage as it goes, which also makes it painful to the touch. This acne appears mainly on the face or the neck, but appearances on the chest, back or upper arms are also common.
Perhaps the worst aspects of cystic acne have to do with its long-term consequences. The damage these acne cause to the medium and deep layers of skin tissue often leave scars that can’t heal for years and decades, unlike pimple scars which are easier to treat. Besides discoloration of various hues, cystic acne also leave atrophic (hollow) and hypertrophic (protruded) scars, which take a long time and need serious treatment.
The aftermath of cystic acne may exact psychological trauma to the affected person, negatively impacting their social life and self-image. This is especially true when the cystic acne has left its marks on the face or the neck. However, these consequences are treatable as we will see further down in the text.
Everyone can - but your chances are astronomically better if you’re over 30 years of age. Research has shown that cystic acne occurs mostly in people between 11 and 30 years old, and out of those, 80% of people experience at least one appearance of ‘ordinary’ acne. For better or worse, cystic acne is a relatively rare occurrence, but it’s one of the most severe types of acne prone to leaving long-term scarring. If present on your chin, cheeks, face or neck, best avoid popping them.
The common misconceptions surrounding the causes of cystic acne are popular, but false. No, cystic acne isn’t caused by eating fast food, masturbation (or the lack of), too much chocolate or poor hygiene. In most cases, cystic acne appears during adolescence and are the direct result of hormonal changes. This is why cystic acne are often referred to as hormonal acne. However, that’s not the only reason since grown-ups can get cystic acne too. The causes in those cases seem to be genetic, or in women, connected to the hormonal changes during menopause.
No matter what you do, it’s important not to squeeze or try to pop a cystic pimple regardless of where it is located. Despite the temporary release, the effects will be painful and counterproductive. Popping cystic acne can spread the infectious material around, clogging other pores and making more and more cystic acne. Even worse, exerting additional pressure on your skin will only cause further damage, thus increasing the likelihood of lifelong scarring.
Since cystic acne represents a very severe, deep acne inflammation, applying surface treatments will only lead to partial success. However, over-the-counter solutions can make the whole ordeal a lot easier by increasing hygiene and preventing scarring. For definitive treatment, though, it’s necessary to visit a dermatologist and follow a treatment plan along with prescribed medication as therapy.
On the off-chance that you have no time for any of that, but need to deal with a huge cyst, you can try draining it with a needle on your own. Be sure to follow the instructions and take all necessary measures to do it cleanly and properly.
These usually consist of lotions, gels, various creams, and skin care solutions. Whichever product you choose, though, be sure that it has at least one or more of the following ingredients:
Everyone’s skin is different, so if any product gives you increased redness, burning, rashes or other allergic reactions, be sure to stop applying them immediately. Washing your face with lukewarm water works very well too. But if you wish to avoid such a scenario in the future, it is always wise to perform a patch test first.
Cystic acne is rarely responsive to surface treatments because their roots are usually systemic, hormonal, or at the very least, involve a bacterial infection under the skin. That’s why your doctor or dermatologist can opt for prescriptive therapy, and suggest oral medication in the form of pills or other types of therapy. For example, some women find birth control pills beneficial, as they can balance their progestin and estrogen hormone levels. Here is a list of what a dermatologist will likely suggest for cystic acne:
If you have cystic acne, you also have some form of bacterial infection and the intense inflammation to go with it. This is why your doctor might try giving you antibiotics or other strong medications to lessen the infection and kill the bacteria. Due to the bacteria being protected by layers of healthy and damaged skin, however, keep in mind that the acne might not respond to antibiotic treatment, or respond much later. Still, it’s worth giving antibiotics a shot.
As previously stated, these can help some women restore hormonal balance and treat acne.
These are lotions, gels, creams and other solutions packing more punch than your usual over-the-counter products. Having the status of prescriptive medication, these solutions usually contain ingredients such as retinoid, which is a form of Vitamin A. Retinoids help unclog your pores and facilitate contact between antibiotics and the infected areas.
Once known as Accutane, Isotretinoin is now available in medications carrying different brand names such as Sotret, Myorisan, Claravis, Absorica, Amnesteem, and others. Isotretinoin is effective at addressing nearly all causes of acne, from systemic to superficial, but the therapy lasts for months. In most cases, the patient is supposed to take a pill containing Isotretinoin at least once to twice a day for five or six months. Due to the systemic and long-term effect of Isotretinoin, it is not recommended for pregnant women, but exactly because it offers systemic changes, Isotretinoin is usually very effective. Most people end up with clear skin, completely and permanently. This solution has a slew of potential adverse effects though, from chapped lips to joint pains, so it’s definitely not for everyone, and won’t work for everyone.
Usually, a medication intended to send you frequently to the bathroom as a way to get rid of excess water, spironolactone has also been shown to have positive effects in treating cystic acne in women.
Stress and fatigue are very connected to our level and composition of hormones, and this is especially important when it comes to cystic acne. Try to avoid stressful situations and keep a healthy lifestyle, with less coffee, plenty of sleep and moderate exercise.
Cystic acne is not your usual run-of-the-mill acne inflammation - they’re one of the most serious types of acne prone to leaving the most severe scars. The causes, as we have seen, are often deep and physiological. Ranging from hormonal imbalances to bacterial infection and good old genetics, there is no ‘one size fits all’ easy treatment for cystic acne. A combination of treatments will eventually help, however, and following the treatment plan outlined by your doctor or dermatologist is your fastest way to healing.
Additionally, keeping a healthy, balanced, and relaxed lifestyle helps too. Such homeostasis will help you keep your hormones balanced, and will reduce, or even prevent cystic acne breakouts. Finally, remember that cystic acne can leave long-term or even lifelong scarring. Whatever you do - don’t pop them.