By Davan 
🔴 Cystic Acne
These are deep, painful, red lumps under the skin (not black or white on the surface).
✅ Best Treatments:
| Type | What to Use | Notes |
|---|---|---|
| Topical Retinoids | Adapalene (Differin) | Promotes skin turnover, prevents clogging. Use nightly. |
| Benzoyl Peroxide | 2.5–5% gel or wash | Kills acne-causing bacteria. Combine with retinoid. |
| Oral Antibiotics | Doxycycline, Minocycline | Prescription only. Use short-term (8–12 weeks). |
| Isotretinoin (Accutane) | For severe, resistant acne | Very effective but needs medical supervision. |
| Cortisone Injection | Dermatologist-only | Instantly flattens a large cyst. Good for urgent care. |
📌 Do NOT squeeze or pop cystic acne — it causes deeper inflammation and long-term scars.
⚫ Large Blackheads (Open Comedones)
These are clogged pores filled with oxidized oil and dead skin.
✅ Best Treatments:
| Method | What to Use | Notes |
|---|---|---|
| Salicylic Acid | 0.5–2% cleanser or serum | Exfoliates inside the pore. Daily use recommended. |
| Retinoids | Adapalene, Tretinoin | Keeps pores unclogged long-term. |
| Professional Extraction | By esthetician or dermatologist | Safe removal of big blackheads. Never pick at home. |
| Clay or Charcoal Masks | Weekly | Absorb excess oil and clean pores. |
| Pore Strips | Not recommended for deep blackheads | Only work on surface-level plugs and may irritate skin. |
⚠️ What to Avoid
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DIY popping or squeezing (causes scarring/infection)
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Toothpaste, lemon juice, or other harsh home remedies
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Skipping moisturizer — oily skin still needs hydration!
🧴 Sample Routine (for both types)
| Step | Product Type | Example |
|---|---|---|
| Cleanser | Gentle w/ Salicylic Acid | CeraVe SA Cleanser |
| Treatment | Adapalene gel (nightly) | Differin Gel |
| Moisturizer | Oil-free, non-comedogenic | Neutrogena Hydro Boost |
| Sunscreen | Broad spectrum SPF 30+ | La Roche-Posay Anthelios |
🔴 Managing Large Cystic Acne
Cystic acne presents as deep, painful nodules beneath the skin’s surface, often leading to scarring if not properly managed. Effective treatment strategies include:
1. Topical Retinoids
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Mechanism: Retinoids normalize skin cell turnover, preventing clogged pores.
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Examples: Adapalene (Differin), Tretinoin.
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Usage: Apply a pea-sized amount to affected areas nightly.
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Note: May cause initial irritation; start with a lower concentration and gradually increase.
2. Benzoyl Peroxide
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Mechanism: Reduces acne-causing bacteria and inflammation.
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Usage: Apply 2.5–5% gel or wash once or twice daily.
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Note: Can be drying; use a moisturizer to prevent excessive dryness.
3. Oral Antibiotics
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Examples: Doxycycline, Minocycline.
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Indication: For moderate to severe inflammatory acne.
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Duration: Typically used short-term (8–12 weeks).
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Note: Combine with topical treatments to reduce antibiotic resistance.
4. Isotretinoin (Accutane)
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Indication: For severe, recalcitrant acne or acne causing significant distress.
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Dosage: 0.25–0.5 mg/kg daily, aiming for a cumulative dose of 120–150 mg/kg.
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Monitoring: Requires regular liver function and lipid panel tests.
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Note: Strict pregnancy prevention is necessary due to teratogenicity.
5. Corticosteroid Injections
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Indication: Rapid reduction of large, painful cysts.
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Procedure: Administered by a dermatologist.
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Note: Provides quick relief and can prevent scarring.
⚫ Treating Large Blackheads (Open Comedones)
Blackheads are clogged pores filled with oxidized oil and dead skin cells. Treatment approaches include:
1. Salicylic Acid
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Mechanism: Penetrates pores to exfoliate and reduce oil buildup.
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Usage: Use a 0.5–2% cleanser or serum daily.
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Note: May take 6–8 weeks to show results.
2. Topical Retinoids
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Mechanism: Promotes skin cell turnover and prevents pore blockages.
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Usage: Apply a pea-sized amount to affected areas nightly.
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Note: Can be drying; use a moisturizer to prevent excessive dryness.
3. Clay or Charcoal Masks
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Mechanism: Absorb excess oil and impurities from the skin.
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Usage: Apply once or twice a week.
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Note: Avoid overuse to prevent skin dryness.
4. Professional Treatments
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Options: Comedone extraction, microdermabrasion, chemical peels, laser therapy.
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Indication: When home treatments are ineffective.
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Note: Performed by trained dermatologists or estheticians.
5. Avoid Squeezing
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Risk: Can worsen inflammation and cause scarring.
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Recommendation: Use appropriate treatments and consult a dermatologist if necessary.
🧼 General Skincare Tips
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Cleanser: Use a gentle, non-comedogenic cleanser twice daily.
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Moisturizer: Apply an oil-free, non-comedogenic moisturizer to maintain skin hydration.
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Sunscreen: Use a broad-spectrum SPF 30+ sunscreen daily to prevent hyperpigmentation.
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Avoid Touching Face: Minimize touching your face to reduce the transfer of oils and bacteria.