Effectively Treating Cystic Acne.

Cystic Acne vs Hormonal Acne

When you’re a teenager it’s not unusual for you to have bumps, blisters, and pimples. It’s all part of the process of growing up, but if those skin irritations caused by hormones become large, red, and extremely painful, then you could have cystic acne. This type of acne can cause long term damage and create unsightly scars that last past adolescence. The key is to treat these breakouts quickly, don’t wait them out otherwise the cysts can last for long periods of time and affect large areas of the body.

What is Cystic Acne?

You get a pimple when a pore in your skin gets clogged, usually with dead skin cells. Sometimes bacteria get trapped inside the pore, too, causing the area to become red and swollen.

Cystic acne happens when this infection goes deep into your skin, creating a red, tender bump that’s full of pus. It may hurt or itch. If a cyst bursts, the infection can spread, causing more breakouts.

Who Gets It?

Usually it appears during puberty and can last into your 20s if not treated. It is also seen in older ages if present with oily skin or can sometimes present in pregnant women. Hormonal imbalances can also trigger acne to form cysts which can cause this condition to present later in life. Overall, over 85% of cases present in puberty and last until the early 20s.

How is it treated?

Although it’s worth testing OTC treatments like benzoyl peroxide or salicylic acid at home, if you have severe acne you’re better off seeing our dermatologist to minimize breakouts and scarring. The treatment Dr. Vitaly Blatnoy will pick depends on the cause behind your breakouts, the severity, whether there’s scarring and if you’ve been on other treatments that failed in past.

Some common treatments may include:

Antibiotic + medicine you apply to the acne: This is often the first treatment recommended for severe acne. Taking an antibiotic can reduce the redness and swelling of acne. The medicine you apply to your skin works on reducing bacteria and clogged pores.

If this treatment fails to clear your skin, your dermatologist may switch your antibiotic or talk with you about isotretinoin (eye-so-tret-eh-no-in).

Isotretinoin: This is a potent medicine that attacks all four causes of acne — bacteria, clogged pores, excess oil, and inflammation (redness and swelling). About 85% of patients see permanent clearing after one course of isotretinoin.

Due to possible side effects, you will need to carefully consider whether you want to take this medicine. If you decide to take isotretinoin, you must enroll in a monitoring program.

Birth control pill (females only): A birth control pill can be an effective part of an acne treatment plan. When treating severe acne, a birth control pill may be used along with an antibiotic or a medicine called spironolactone (spy-ren-no-lac-tone) to get the acne under control.

Give your acne treatment time to work. It can take 2 to 3 months to see results.


If the pill may be an option for you, it’s important to tell your dermatologist about all of your medical conditions, including heart disease. Your dermatologist must weigh the risks of using a birth control pill to treat acne against the benefits.

Spironolactone (females only): This medication can also effectively treat severe acne in women. It reduces excess oil.

If this may be an option for you, be sure to tell your dermatologist about all of your medical conditions.

Acne removal: Your dermatologist can use a few different techniques to remove a large cyst or nodule.

One way your dermatologist can get rid of a painful cyst or nodule is to inject it with a corticosteroid. This helps to quickly reduce the size and pain.

Another procedure is called “incision and drainage.” It’s used to drain a large, painful acne cyst or nodule that medicine cannot clear. You should not try to drain a cyst or nodule at home. The risk of infection is great when done outside of a medical office.

Dermatologists use a procedure called acne extraction to remove whiteheads and blackheads that fail to clear with acne treatment.

Low-dose prednisone: This is a super potent corticosteroid. Dermatologists prescribe it to treat a very serious type of severe acne called acne fulminans. It’s also used to treat pityrosporum folliculitis, an itchy, acne-like rash.