Acne seems to have a way of occurring at the worst possible moment, like the night before prom or six minutes before your wedding, giving you one more thing to stress over prior to your big moment. Cystic acne, however, takes distress to the next level and often causes significant discomfort and scarring. The experts at the National Institute of Arthritis and Musculoskeletal and Skin Diseases note it usually responds well to therapy but likely needs aggressive treatment managed by a dermatologist. (Reference 1/Subheading Treatment for Severe Nodular or Cystic Acne)
Definition
The whiteheads, blackheads and small red bumps commonly seen in mild to moderate acne outbreaks originate close to the surface of your skin. Cystic acne develops deeper in the skin and typically shows up as large, red, painful bumps on your skin surface. Acne cysts filled with pus can eventually develop channels or tracts that link several lesions together, forming hard, red ridges on the skin surface. Health care professionals at the University of Maryland Medical Center report cystic acne can cause significant scarring, and severe outbreaks often have a profound psychological impact. (Ref 2 for attribution and Ref 1 for general information)
Treatment
Dermatologists generally use a combination of treatments for cystic acne, possibly trying several regimens before finding one that works best for you. Your doctor might begin with topical creams or washes and give you a prescription for oral antibiotics. If cystic acne does not clear with these therapies, your physician might suggest isotretinoin or Accutane. This medication reduces the size of oil glands, thus decreasing oil production and subsequent bacterial growth, according to NIAMS. Dermatologists sometimes inject corticosteroids into large cystic or nodular lesions, which reduces inflammation and swelling and can help prevent scarring. (Ref 1/Subheading Treatment for Severe Nodular or Cystic Acne and Other Acne Treatments)
Home Remedies
While cystic acne generally requires medical care, dermatologists at Mayo Clinic suggest you can take steps to lessen skin irritation by using gentle cleansers and avoid using facial scrubs, masks or astringents. Other suggestions include keeping your hair off your face, shampooing oily hair frequently and limiting cosmetics to water-based products that do not clog pores. The health care professionals at Mayo Clinic also advise you to avoid squeezing or picking at your cystic acne since this only worsens the inflammation and potential for scarring. (Ref 3)
Considerations
Most patients treated with isotretinoin or Accutane experience complete or nearly complete resolution of their acne after 15 to 20 weeks of treatment, according to NIAMS. However, the potential side effects of this medication include severe birth defects in developing fetuses, changes in liver function, increased cholesterol and high triglyceride levels. NIAMS also reports a number of people taking isotretinoin have committed or attempted suicide. The actual connection between isotretinoin and suicide or depression is concerning but not clear; however, they recommend you consult your doctor if you feel unusually sad, experience loss of appetite, loss of interest in activities, trouble concentrating or other symptoms of depression while taking isotretinoin. (Ref 1)
Expert Insight
Science continues to work on developing better understanding of how acne develops and methods to improve treatment outcomes. For instance, NIAMS reports that one of its research groups is studying ways to regulate the skin's natural oil production with medications that do not include the serious side effects of isotretinoin. Another group hopes to discover ways to use the body's immune system to combat acne while other researchers are trying to develop laser therapy that does less damage to the outer surface of the skin as it controls acne. (Ref 1)
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