Cystic Acne On The Neck: Causes & Treatment

Cystic Acne On The Neck: Causes & Treatment

Cystic acne occurs when cysts form deep under your skin, usually on the face, neck, chest, and back. This is the most serious and painful type of acne breakout.

Like acne on the face, neck pimples occur due to pores becoming clogged by bacteria, dead skin cells, and an overproduction of sebum. Most of these cases are caused by unattended pores in the back of the neck. When bacteria infects clogged pores, it can become an inflammatory and cystic acne.

Although you can get acne at any age, adolescent acne is the most common. It starts off with closed comedones, which are more commonly known as "whiteheads," and then it develops into open comedones, also known as blackheads.

Imagine an ordinary pimple. You're probably picturing a fairly small red spot, topped with a gooey-looking white spot. All the elements of a pimple are easily visible because the acne inflammation still hasn't affected the deeper layers of the 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 the skin tissue. When this happens, we're usually dealing with cystic acne - and they're especially painful when they appear on a sensitive area such as the face or the neck.

There are many ways to treat cystic acne, from over-the-counter medications and medical intervention from a doctor to skin care products such as Misumi's Complete Clear 3-Step System.

We're here to run you through some of the treatments for neck acne, so you can achieve the smoother skin you've been looking for.

cystic acne on the neck causes and treatments

What is Cystic Acne?

Known as one of the most severe types of acne inflammation, cystic acne forms when the pores become completely and irreversibly clogged. This is due to the oil glands producing too much oil. The excess oil and dead skin cells then block pores.

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 reddish or blue in color and soft to the touch. This is because it's filled with pus.

Cystic acne spreads the infected material (pus) between the inner layers of the skin, causing damage as it goes, making 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.

If you have a family history of acne, then you're more likely to get it.

Cystic Acne Aftermath

Perhaps the worst things about cystic acne have to do with its long-term consequences. The damage this acne causes to the medium and deep layers of skin tissue often leaves scars that can't heal for years and decades, unlike pimple scars which are easier to treat. Besides discoloration of various hues, cystic acne can 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 cystic acne has left its mark on the face or the neck.

However, these consequences are treatable.

Can I Get Cystic Acne?

Everyone can, but research has shown that cystic acne occurs mostly in people between 11 and 30 years old. 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 acne types and is prone to leaving long-term scarring. If present on your chin, cheeks, face, or neck, it's best to avoid popping them.

What Causes Cystic Acne?

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 is the direct result of hormonal changes. This is why cystic acne is often referred to as hormonal acne.

However, that's not the only reason - 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.

shame acne

I Have Cystic Acne on My Face and Neck. What Should I Do?

No matter what you do, it’s important not to squeeze or try to pop a cystic pimple, regardless of where it's located. Despite the temporary release, the effects will be painful and counterproductive. Popping cystic acne can spread infectious acne-causing bacteria around, clogging other pores and making more and more cystic acne.

Even worse, exerting additional pressure on your skin will only cause further damage, increasing the likelihood of lifelong scarring.

There are a plethora of acne treatments available containing anti-inflammatory properties to help with acne vulgaris. If you have the most severe form of acne, speak to a board-certified dermatologist before trying any acne treatments.

Cystic Acne Treatment

Since cystic acne is a very severe, deep acne inflammation, applying surface treatments will only lead to partial success. However, over-the-counter solutions can make acne flares a lot easier by increasing hygiene and preventing acne scars. To treat neck acne (or any other acne), visit a dermatologist and follow a treatment plan along with prescribed medication as therapy. 

On the off-chance you don't have time for that but need to deal with a huge cyst, you can try draining it with a needle. Be sure to follow the instructions and take all necessary measures to do it cleanly and properly. The last thing you want is even more neck breakouts.

Topical, Over-the-Counter Treatments

These usually consist of lotions, gels, various creams, and skin care solutions that help treat and prevent cystic acne but reduce oil. They will also keep your skin hydrated. Whichever product you choose, be sure that it has at least one or more of the following ingredients:

  • Benzoyl peroxide: Rich in oxygen, benzoyl peroxide kills the harmful bacteria causing acne inflammation and lessens swelling.
  • Salicylic acid: Salicylic acid helps your skin dry and makes surface layers and dead skin cells easier to peel off.
  • Sulfur: This helps unclog the pores and reduce sebum (otherwise known as excess oil), resulting in less oily skin.

Everyone's skin is different, so if any product gives you increased redness, burning, rashes, or other allergic reactions, be sure to stop applying it immediately. Washing your face with lukewarm water works very well too.

If you wish to avoid such a scenario in the future, it is always wise to perform a patch test first. 

Our #1 Recommended Cystic Acne Kit

We recommend trying Misumi Complete Clear 3 Step System, a unique and powerful combination of naturally-derived and proven treatments, including a signature cleanser, toner, and day moisturizer.

If you're looking for a breakthrough and easy-to-manage acne kit to help calm angry cystic breakouts fast, the Complete Clear 3 Step System is the perfect routine for you.



Medical Treatments and Prescription Drugs

Cystic acne is rarely responsive to surface treatments because the root cause is usually systemic, hormonal, or at the very least, involves 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:

Oral Antibiotics

If you have cystic acne, you also have some form of bacterial infection and 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. However, due to the bacteria being protected by layers of healthy and damaged skin, keep in mind that the acne might not respond to antibiotic treatment or respond much later. Still, it's worth giving antibiotics a shot.

Birth-Control Pills

As previously stated, these can help some women restore hormonal balance and treat hormonal acne.

Prescription-Strength Skin Care Solutions

These are lotions, gels, creams, and other solutions that pack more punch than your usual over-the-counter skincare 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.

Isotretinoin Solutions

Isotretinoin (known in the oral form as Accutane) 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's not recommended for pregnant women, but because it offers systemic changes, Isotretinoin is usually very effective. Most people end up with clear skin, completely and permanently - even those who suffer from more severe acne. Isotretinoin oral medications have a slew of potential adverse effects though, from chapped lips to joint pains, so it's definitely not 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.

Lifestyle Changes

It's not all about over-the-counter products and medications. Stress and fatigue are connected to our level and composition of hormones, and this is especially important when it comes to cystic acne. To avoid hormonal fluctuations, keep away from stressful situations and keep a healthy lifestyle, with less coffee, plenty of sleep, and moderate exercise.

Avoid pore-clogging ingredients that might make your acne worse. Make sure you invest in a good skin care routine to clean pores and get rid of dead skin cells, and wash your hair regularly. These are all things that can help prevent cystic acne (or even regular acne!)


So, What’s the Verdict?

Cystic acne is not your usual run-of-the-mill acne inflammation - it's the most severe type 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' treatment for cystic acne.

However, a combination of treatments will eventually help, 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, future breakouts. Finally, remember that cystic acne can leave long-term or even lifelong scarring. So, whatever you do - don't pop them.


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This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances, and its goal is to offer a general view of the subject. In case you are suffering from a severe case of acne, you should consult with a dermatologist or a certified medical professional.

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