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Bella Guide: Cystic Acne 101

If you're in your 20s or 30s, you've probably experienced stubborn breakouts on your chin. And no matter how much you exfoliate or get facials, a few stubborn lumps won't go away. Welcome to the wonderful world of cystic acne!

Cystic acne differs from your everyday, run-of-the-mill pimple farm. This kind of spot is buried under the skin, so it won't come to a head no matter the amount of poking and prodding you do. Worse yet, the cysts can be red, tender and sore. And lucky for us women, hormones make them more common for us than for men—which is why these devils pop up around that time of the month. To find out what you can do about cystic acne, just

Unfortunately, there's no magic treatment to clear up cystic acne. Don't even think about trying to squeeze the cysts, as you'll just wind up with a lot of pain and potential scarring. (Really, don't do it!) In a few weeks or even months, most of these zits clear up on their own. In more extreme cases, a few treatment options can improve the situation:

  • It won't eliminate cystic acne, but gently applying a warm-to-hot wet washcloth on the pimple seems to help it disappear a little more quickly. It could just be the placebo effect, but at the very least, it's soothing and calming.
  • Birth control pills regulate hormones, which minimizes the breakout factor; but, as is the case with any other medication, you might experience side effects. I use YAZ, a low-dose pill approved by the FDA to keep women minimally zitty (and minimally pregnant). I still break out a little bit each month, but nowhere near as badly as I used to.
  • Topical retinoids such as Retin-A Micro can help clear up cystic acne, but things might get worse before they get better—be prepared for peeling, redness and photosensitivity. I tried Retin-A Micro a few years ago and decided the side effects weren't for me, but your experience could be different.

  • Accutane is considered the last-resort option for severe, recurring cystic acne. While it's largely effective, most dermatologists I've talked to say they won't prescribe it unless it's the sole remaining option due to the side effects (which can include birth defects).


artiksun artiksun 8 years
another method to help clear up large cysts is to get cortisone injections administered by a dermatologist. this can get pricey because (at least where i live) derms can't give more than 1 shot per office visit like they used to, so i only do this for very large, very painful cysts in bad spots (like along my lips, near my eye, behind my ear, or along my jawline). the doctor will use a very small needle and inject the medicine right under the cyst. it burns a little, but doesn't hurt tremendously. most times the cyst is half the size when i wake up the next morning.
ilovebedes ilovebedes 9 years
hmmm. i think i get these every so often but they leave scars even though i don't touch them. but they also take a long time to go away
kcwebgirl kcwebgirl 9 years
cystic acne is the only kind of acne i get and it sucks! i've always wondered what my wedding pics would look like since my skin never seems to "clear" up. i use differin though and it helps control them breakouts. like is much better on differin than off, and the side effects are minimal.
padmipani padmipani 9 years
also, neosporen. a topical antibiotic.
padmipani padmipani 9 years
i have gotten these for years. it got to the point that i was taking antibiotics every month and they didn't work any more. i have found a few natural ways to reduce them. hope they help others too. - reflexology. worked wonders and stopped them for coming. i haven't had one since. reflexology clears out the lymph system where the toxin causes are held. - oregano oil. it is a natural antibiotic that is VERY strong oragano but totally worth not getting them. a small bottle will cost about $40 but you only need a few drops at a time and is much better for you than the pills. - tea tree oil and calenjula. essential oil and homeopathic. at the FIRST sign start taking. Also the homeopathic for acne worked well too. again taken at FIRST signs eliminate the swelling often accompanied with them. - herbal hormone regulators. i haven't tried but if they ever start again i am doing that as i don't do the birth control thing. hope this helps someone!
elme1009 elme1009 9 years
I have had this particular problem for years and it usually pops up (pardon the pun) when I've got some hormonal change going on - and it takes months to go away. They are the meanest, most long lasting zits. It doesn't help to only get them around period time because they last for weeks. I've now learned that that only thing that really knocks it out is antibiotics. The cysts are caused by the presence of bacteria in the skin. My dermatologist has got me on Solodyn. You have to be on it for about 6 weeks. After that, any time you get a flare up, you can take it for just a few days and it will do the job. It is insanely expensive, so insurance is a must. I'm also using Benzaclyn. For EMERGENCY TREATMENT: tell your dermatologist you have a upcoming event and that you need an immediate fix. They should give you an injection of prednisone or some steroid, which will take away the swelling and inflammation. That should help take care of the problem for a few days. The injection will wear off after a few days, but by then, hopefully you're on some good antibiotics. I am definitely going to try Zeno, since so many people have said positive things about it helping with cysts. And laser treatment sounds like something worthwhile to explore to get rid of scars. I also read recently that the Oil of Olay Regenerist foaming moisturizer contains some ingredient that will help get rid of scarring, and after one night of using it, I noticed a difference. Good luck to you all out there suffering along with me! Take heart! There is relief available!
lovelie lovelie 9 years
I have been plagued with annoying breakouts since middle school, I am 21 and I finally have gotten my skin under control...for the most part. I still get a cystic pimple once in a while. However, one of the big obstacles was getting rid of the damage that the acne did to my skin. For about 7 months, I went through 8-9 rounds of micro-dermabrasion and chemical peels. These were a miracle, not only did they clear up all the damage and minimize scarring (which was almost as bad as the acne itself) and gave me a whole new skin regime. I would suggest to anyone AVON Anew microdermabraison. It is online, and it works like a charm!
Candyhunnie Candyhunnie 9 years
My acne started waaaay back when I was 10-11. It finally stopped when I was 13 and I've had pretty alright skin aside from skin discolouring that a dermatoligist is treating. My back medicine has recently made me break out though. Yuck! I'm getting a different one prescribed I just wished i could have known sooner! I don't just get little pimples I get half a cetemeter big sebum filled painful spots! Oooh dear. Guess I've just got to grin and bear it huh? (:
byzybee byzybee 9 years
I was one of those who had this pretty badly, each one took about 3 months to go away, and my dermatologist gave up and prescribed Accutane. But before I could begin the (incredibly expensive) program, my face magically cleared up, and has since stayed clear! What I changed: I stopped using my massive amounts of prescriptions and creams, and just washed my face with regular old handsoap from Bath and Body works :O Strange, but true. Haven't had a single one in 5 months.
jessikatastic jessikatastic 10 years
Something that also works really well is a product called Sunbreeze. I prefer the oil. You can purchase it here:
meganekko meganekko 10 years
I've used alcohol-dipped pins to pop these monsters and I absolutely hate them! From now on I'm going to try to warm-hot washcloth application!
baybridget baybridget 10 years
I am going to do a post every single time this issue comes up because I don't want anyone to have to go through what I went through! I suffer from cystic acne but have found an amazing system that got me from having 20 cysts on my face at a time to one every 5 months. It's called Lumiplexion, they just recently changed their name from Acne Treatment Clinic, and I've been using their products for about 11 years. You can buy their products online but they also do facials/extractions that are painful but really help. I tried everything but Accutane and this is the only thing that has worked for an extended period of time. Here are some tips that I've learned: Ice your face/cysts with an ice cube, it helps with the pain and swelling, have extractions done, keep your hands off your face, use glycolic or salicylic acid and be consistent with your regime!
lovekailua lovekailua 10 years
I just realized that i am terrible about keeping my makeup brushes clean (as in i rarely lean them) and I use BE minerals swirl tap buff. I wonder if that contributes to my cystic acne! :::runes to buy cleaner:::
dmblauren dmblauren 10 years
honestly, i find the only thing that helps me is proactive. i used to use proactive in high school then went off of it when i ws abroad. about 2 years ago my face was horrible. the worst ever. i started to get 10 or so of those huge monsters. and i was getting married that year so i was freaking out. i didn't want to leave the house - coverup can't hide mountains. i decided to go back on proactive and, no lie, within 6 weeks my face was much, much clearer. i'm still on it now, my skin is pretty good, although i still do get a couple on my jawline around that time of the month.
Schaianne Schaianne 10 years
Thanks for the article ... I was wondering what on earth was going on ... I had such a clear complexion when I was a kid!!
MissE MissE 10 years
This post struck me.... When I was a kid I had the usual acne problems, but it didn't get severe until I was about 20 years old. At that time I started to develop horrible cystic acne and would breakout all over my face. The cysts would slowly rise to the surface and eventually leave a mark on my face that looked like I had accidently burned myself with a curling iron. It was awful. Luckily I had a wonderful mother who recognized the situation and took me to the dermatologist. Since I used some Retin-A as a kid for minor zits (and it didn't work at all) they put me on Accutane immediately. All I can say is thank god they did. While the Accutane was inconvenient and made everything on my body dry out (lips, hair, skin) it was well worth it. Now, people actually say how WONDERFUL my skin is. I have zero acne scars and super soft / young looking skin. Now days one believes me when I tell how bad my skin was during college. As someone else above said, Accutane isn't for everyone. However I truly think people shouldn't be as scared of it as they are.
shannee shannee 10 years
Ugh I get these horrible things too and no amount of acne peroxides or acids will kill them for me. I just started using Tea tree oil and that seems to really bring down the swelling and speed up the healing, with out leaving behind that nasty dry skin that is harder to cover up than the pimple
nikkipez nikkipez 10 years
omg...i agree these posts are always RIGHT on...are you watching me bellasugar!! :) i had perfect skin and it seems like now that im 21 i have been getting cystic acne on my chin..they are hard to spot i usually feel them when washing my face...then i pick...and then you can see them from a mile away and they dont go away :( im going to see about getting you how minocyclin works with it?
Fiend Fiend 10 years
Thanks1 i just got 4!! under my chin. i usually get 1 or 2 around pms and they go away after 1 week but this time i got 4 and 2 havent gone away yet :sad: its been 2 weeks
tizinu tizinu 10 years
nbgal: I totally agree with you about dairy. I try to only have organic milk and avoid most dairy products. It helps with a lot things, in particular, it makes my cycle a lot less painful and it's an effective diet for reducing fat. On another note, a really great way to prevent the zit from swelling and scaring is Neosporin. Before a cystic zit rears its ugly head, you can feel it underneath your skin. The overnight addition of a triple antibiotic directly on that area (be sure to clean it thoroughly with non-comogenic soap!) helps me with the acne-- and reduces the swelling and progress of the zit. (I really should patent this huh?) I would encourage non-petroleum based topical antibiotics if you have any, but I always have Neosporin around and it works for the occasian cystic zit. You just have to catch it in time. This is not something you should use all the time: you don't want to kill the natural biotic flora on your skin. Doing that can make you more prone to acne-- it's really just for the occasional zit.
nbgal nbgal 10 years
I used to get these all the time both on the pill and off the pill. I realized that the main trigger for me was hormones in food. The highest hormone concentration can be found in dairy products from non-organic farms. As soon as I cut out processed dairy my face cleared up and I have had no issues with cystic acne since.
ethiopian_princess ethiopian_princess 10 years
I think this is what I get when I react to my SPF face cream
sioux5ita sioux5ita 10 years
Zeno helps when I get those huge cystic pimples because it makes the healing process faster and less tender. At least, this has been my experience. I know Zeno is expensive but I love it. Consider having friends/family pitch in to buy Zeno as a special gift which is how I got my lovely pale blue Zeno.
lovekailua lovekailua 10 years
i get these on my cheeks sometimes! and before I knew anything about them i picked and picked (im a picker :( ) and now i have is awful, i always had clear skin and just started getting these on my cheeks in the past few years (i'm 27). my bareescentuals covers them pretty well but i still hate them. ive given up hope of clearing the scars (they are still red some of them) because i cant afford dermatology. i just exfloate and no longer pick! one time i had a massive breakout (about 2 weeks after a very very very stressful event) and i got a prescription from my doctor to clear them up, i wish i had health insurance now. anyway, it sure is nice to see others talking about these darn things.
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