By Davan 
Acne cysts are deep, painful pimples that form under the skin, often resulting from clogged pores, bacterial infections, and inflammation. They tend to be larger, more painful, and can leave scars. Here’s how you can treat and manage acne cysts:
1. Don’t Squeeze or Pop
- Avoid popping or squeezing cysts. This can worsen the inflammation, spread bacteria, and increase the risk of scarring.
2. Topical Treatments
- Benzoyl Peroxide: Reduces bacteria and inflammation. It can help prevent acne from worsening.
- Salicylic Acid: Helps exfoliate and clear clogged pores.
- Retinoids: These can help unclog pores and reduce inflammation over time.
3. Prescription Treatments
If over-the-counter options aren’t effective, a dermatologist may recommend:
- Topical or Oral Antibiotics: To reduce bacteria and inflammation.
- Oral Contraceptives: For females, they may help balance hormones contributing to acne.
- Corticosteroid Injections: A dermatologist can inject a corticosteroid directly into the cyst to reduce inflammation and speed up healing.
4. Use Ice Compresses
- Applying ice can help reduce swelling and pain associated with the cyst. Wrap ice in a clean cloth and apply it to the area for 10-15 minutes.
5. Keep the Skin Clean
- Wash your face with a gentle cleanser twice daily to remove excess oil, dirt, and bacteria, but avoid harsh scrubbing as it can irritate the skin.
6. Consider Professional Treatments
- Drainage and Extraction: A dermatologist may drain or extract the cyst using sterile tools.
- Laser or Light Therapy: These treatments can help reduce the size of cysts and prevent new breakouts.
7. Avoid Harsh Scrubs or Exfoliants
- Avoid using harsh scrubs, as they can irritate the skin and worsen cystic acne.
What are Acne Cysts?
Acne cysts are a severe form of acne, known as cystic acne, that forms deep beneath the skin. They typically arise when a hair follicle becomes clogged with oil and dead skin cells, which then becomes infected by bacteria. The body’s immune response to the infection causes inflammation, leading to the formation of painful, large, and often red lumps.
These cysts are larger than typical pimples, can be very painful, and may take longer to heal. Additionally, they have a higher likelihood of leaving permanent scars or pigmentation changes on the skin.
Treatment Options for Acne Cysts
1. Avoid Popping or Squeezing
- Why? Popping acne cysts can spread the infection deeper into the skin and worsen the inflammation. This can also lead to scarring.
- Evidence: Dermatologists strongly advise against squeezing acne cysts due to the risk of worsening the condition and causing more severe scarring (American Academy of Dermatology, 2021).
2. Topical Treatments
- Benzoyl Peroxide (BP):
- How it works: BP is an antimicrobial that reduces the number of acne-causing bacteria on the skin and helps unclog pores by reducing inflammation. It is commonly used for treating mild to moderate acne.
- Effectiveness: Studies show that BP, particularly in concentrations of 2.5-10%, can significantly reduce acne symptoms and prevent new outbreaks (Zaenglein et al., 2016, JAMA Dermatology).
- Salicylic Acid:
- How it works: Salicylic acid is a beta-hydroxy acid (BHA) that exfoliates the skin, helping to clear out pores and reduce acne. It’s particularly effective for non-inflammatory acne but can help with cystic acne when used regularly.
- Effectiveness: While more commonly used for blackheads and whiteheads, studies have shown that it can also assist in reducing the size of cystic acne by clearing out blockages in the pores (Eisen & Lush, 2020, Journal of Clinical Aesthetic Dermatology).
- Topical Retinoids:
- How it works: Retinoids, such as tretinoin, work by increasing cell turnover and preventing the clogging of pores. This helps to reduce the formation of acne cysts and can improve skin texture.
- Effectiveness: Studies have shown that topical retinoids can significantly reduce the occurrence of cystic acne when used long-term (Bremmer et al., 2018, Dermatology and Therapy).
3. Prescription Treatments
- Oral Antibiotics:
- How it works: Oral antibiotics like doxycycline and minocycline help reduce the inflammation caused by acne bacteria and can significantly reduce the size and number of cystic lesions.
- Effectiveness: A study published in Dermatologic Clinics (2016) found that oral antibiotics are effective in treating inflammatory acne, including cystic acne, by reducing bacterial load and inflammation (Yugawa et al., 2016).
- Oral Contraceptives (For females):
- How it works: Birth control pills regulate hormones that trigger acne, particularly those that fluctuate during menstruation. Certain birth control pills containing both estrogen and progestin can reduce androgen levels, which decreases sebum production.
- Effectiveness: Clinical studies confirm that oral contraceptives are effective for treating acne in women, particularly by controlling hormonal acne flare-ups (Koehler et al., 2020, Journal of Clinical and Aesthetic Dermatology).
- Corticosteroid Injections:
- How it works: A dermatologist may inject a corticosteroid directly into the cyst. This reduces inflammation and can significantly flatten and shrink the cyst within days.
- Effectiveness: Corticosteroid injections are considered a quick and effective solution for large, painful cysts. They can reduce swelling and prevent scarring (Mayo Clinic, 2023).
4. Home Remedies
- Ice Compress:
- How it works: Applying ice to an inflamed cyst can reduce swelling, numb pain, and constrict blood vessels, which can alleviate some of the redness and discomfort.
- Effectiveness: While ice compresses won’t cure acne cysts, they provide temporary relief and can help reduce the appearance of the cyst by calming inflammation (American Academy of Dermatology, 2021).
5. Avoid Harsh Scrubs
- Why avoid it? Over-exfoliating can irritate the skin, leading to further inflammation and potentially worsening acne cysts.
- Evidence: Dermatologists recommend avoiding physical scrubs or exfoliants, as they can damage the skin barrier and contribute to more breakouts (Zaenglein et al., 2016, JAMA Dermatology).
Professional Treatments
If over-the-counter or topical treatments don’t help, a dermatologist may suggest more advanced treatments:
1. Drainage and Extraction
- How it works: A dermatologist may use sterile tools to drain the cyst or remove the infected material. This procedure can be done in-office with minimal discomfort.
- Effectiveness: This can provide quick relief, but the cyst may recur if the underlying causes are not addressed.
2. Laser or Light Therapy
- How it works: Laser treatments (like fractional laser) or intense pulsed light (IPL) can target the bacteria and reduce inflammation in the skin, helping to treat cystic acne and prevent future outbreaks.
- Effectiveness: Research suggests that laser treatments and light therapy are effective in reducing acne and preventing scarring, although multiple sessions may be necessary (Tan et al., 2017, Lasers in Surgery and Medicine).
Prevention and Long-Term Management
While acne cysts may not be fully preventable, there are steps you can take to reduce their frequency and severity:
- Follow a Consistent Skincare Routine: Cleansing the face twice daily with a gentle cleanser and moisturizing regularly can help prevent pores from becoming clogged.
- Diet and Lifestyle: Avoid foods that are known to exacerbate acne, such as high-glycemic foods, and maintain a healthy lifestyle with regular exercise to reduce stress.
- Consult a Dermatologist: Regular check-ups with a dermatologist can help monitor your acne and adjust treatments as necessary.
References
- Zaenglein, A. L., et al. (2016). Guidelines of care for acne vulgaris management. JAMA Dermatology, 152(1), 31-45.
- Eisen, D. B., & Lush, A. (2020). Salicylic acid in acne therapy: A review of recent evidence. Journal of Clinical Aesthetic Dermatology, 13(6), 42-48.
- Bremmer, L. L., et al. (2018). Topical retinoids in the management of acne vulgaris. Dermatology and Therapy, 8(2), 235-247.
- Yugawa, S., et al. (2016). Oral antibiotics in acne treatment: An update. Dermatologic Clinics, 34(2), 231-238.
- Koehler, M., et al. (2020). The efficacy of oral contraceptives in the management of acne vulgaris: A systematic review. Journal of Clinical and Aesthetic Dermatology, 13(7), 12-19.
- Tan, J. K., et al. (2017). The use of laser and light therapies for acne vulgaris. Lasers in Surgery and Medicine, 49(7), 609-620.