Cystic Acne

Cystic acne is the most severe type of acne, causing large pus-filled lumps that look similar to boils. This type of acne is harder to treat and is also more likely to lead to permanent acne scars. 

It’s common to develop acne at any age, although it tends to affect teenagers when they are going through the hormonal changes of puberty. Although acne is very common, cystic acne is relatively rare.Cystic acne is more likely to develop when you’re in your teens or early 20s, although it has been observed in children as young as eight and adults aged 50. It affects the same areas of your body as non-cystic acne, usually the face, chest, back, the tops of the arms and the shoulders.It’s more common in men, although women can also develop it. Women with cystic acne will often have cysts on the lower half of their face.

The symptoms are quite visible due to the fact that the cysts and pustules can be large and swollen. It can affect the way you feel about yourself in severe cases, because of the way the acne affects the look of your face. Some of the cysts can feel very tender and even painful to touch.

If cystic acne isn’t treated, there’s a chance that it may lead to scarring in the form of:

• 'Ice pick' scars (small but deep pits in the skin)
• Shallow depressions
• Larger pits
• Hypertrophic scarring (raised, red scars)

If you have cystic acne, see your doctor for advice and to find an effective form of treatment. Meanwhile, don’t be tempted to pick the spots or try to burst cysts as this can worsen the infection and make it spread.It might be difficult, but try not to worry about it. Stress can make acne worse because it can cause your body to release even more of the hormones that are causing the problem.There are also a few lifestyle changes you can make, such as eating a healthy diet and getting plenty of exercise and sleep. There’s some research that suggests that a low-glycemic diet (one which limits sugar) can sometimes help acne symptoms.

The exact cause of acne isn’t known but it’s through that hormones called androgens are an important factor. These hormones increase as you reach your teens and causes changes in your skin that can result in acne. Hormonal changes in women, such as the menstrual cycle, pregnancy, and menopause can also trigger acne, as can a condition called polycystic ovary syndrome.

Some women find that using a progesterone only pill can cause or worsen acne and other medications can also trigger and/or aggravate the condition.

This includes medicines that contain the following ingredients:

• corticosteroids
• androgens
• lithium

Some studies have shown that diet can be a factor in making acne worse. The main culprits are thought to be dairy products and foods which are rich in carbohydrate like bread and chips. Chocolate might also be a trigger. A recent study of 14 men with acne found that eating chocolate increased their acne. This was only a small study however, and more research is needed to find out why this could happen, and also whether people with acne should change their diets.

At the moment there’s no cure for acne but there are several treatments for acne available which can be very effective in improving symptoms.

If you know you are prone to cystic acne, treating your skin with care is one way to minimise the breakouts.

• Try not to wash your skin too often as this can make acne worse. You only need to wash twice a day at most.
• Always use lukewarm water rather than very hot or cold as extremes of temperature can aggravate acne. Use a mild soap or cleanser.
• Don’t use harsh or abrasive soaps, cleansing granules, astringents, or exfoliating scrubs.
• Try to avoid using too much makeup, and wherever you can opt for water-based, non-comedogenic formulations.
• Make sure that you always take your make-up off before you go to bed.

If you have cystic acne, you’ll probably find that over-the-counter products for acne won’t have much effect. Make an appointment to see your doctor or use our convenient online acne treatment service.

You may be able to benefit from one of the following treatments:

• Oral antibiotics - these can help to control the bacteria causing the skin infection, and reduce the inflammation.
• Creams, lotions, or gels which contain a form of vitamin A called a retinoid can help to unclog your pores and support any antibiotics you’re prescribed.
• Isotretinoin - a tablet form of retinoid that you’ll need to take every day for several months. The pros of this type of medicine are that they are very effective and can clear the condition completely. They are a powerful drug, however and not suitable for pregnant women.
• Spironolactone this is often prescribed for water retention but it works as a hormone blocker.
• The contraceptive pill can also help some women.

It’s worth noting that any acne treatment can take up to three months to work. If you don’t see any improvement at all after six to eight weeks, speak to your doctor.