Cystic Acne: Key Features, Top 5 Causes & 5 Prevention Steps

Acne is a major enemy of the skin, and many women have likely experienced it at some point. Acne can cause redness, swelling, and inflammation, which not only feels uncomfortable but also impacts one’s appearance. Among the various types of acne, the most severe and troublesome is cystic acne—a form that causes intense pain, takes months to heal, and often leaves behind scars.

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What is Cystic Acne?

Cystic acne, like common acne, is triggered by Cutibacterium acnes (formerly known as Propionibacterium acnes). However, it differs in that the inflammation occurs deep in the skin’s lowest layers, making it hard to detect at first. By the time a cyst becomes visible, the deep layers of the skin are already seriously inflamed, leading to raised, swollen, red nodules without a visible pus head. These bumps can protrude like a small hill on the skin and are nearly impossible to conceal with makeup.

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What are the Characteristics of Cystic Acne?

Cystic acne is the most severe type of acne and typically occurs when sebaceous glands overreact to androgens (male hormones), resulting in excessive sebum production. The excess oil leads to congestion in the dermis, causing swelling and hardening. Since the oil cannot reach the skin’s surface, it accumulates and ruptures internally, forming large nodules or cysts.

Distinct features of cystic acne include:

1. Raised, red, and swollen bumps
2. Painful and firm to the touch
3. No visible opening or whitehead
4. Usually does not form surface pus

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Top 5 Causes of Cystic Acne

While hormonal imbalance is the main trigger (especially during puberty, menstruation, pregnancy, or menopause), other contributing factors include:

1. Excess Sebum Production

Some women naturally have more active sebaceous glands, making their skin oilier. Lifestyle habits like late nights, stress, and sleep deprivation can worsen this. Overactive sebum increases the risk of clogged pores, leading to cystic acne.

2. Abnormal Keratinization

The skin's stratum corneum helps retain moisture and shield against environmental stress. When dead skin cells aren’t shed properly, they clog pores and trap sebum, leading to deep inflammation and cyst formation.

3. Inflammation Around Hair Follicles

Blocked oil and keratin buildup can compress the hair follicles and trigger inflammation—redness, swelling, and pain. If this worsens, it may evolve into cystic acne.

4. Bacterial Infection (Cutibacterium acnes)

When pores remain clogged and oily, they create an ideal breeding ground for bacteria. Any added skin irritation can further provoke cystic acne.

5. Polycystic Ovary Syndrome (PCOS)

PCOS is a common condition where androgens are elevated. Hormonal imbalance and high insulin levels disrupt ovulation and may increase acne flare-ups, particularly cystic acne.

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Emergency Relief for Cystic Acne: 4 Common Methods

Cystic acne flare-ups are painful and form noticeable hard lumps. Try these remedies to alleviate symptoms:

1. Use Salicylic Acid Exfoliants

Acid-based skincare boosts cell turnover and clears clogged pores. Regular use of small-molecule acids like salicylic or azelaic acid helps reduce redness, control bacteria, and improve inflammation.

2. Acne Creams

Topical creams can sterilize, reduce inflammation, and regulate sebum. Look for ingredients like sulfur, azelaic acid, salicylic acid, or benzoyl peroxide.

3. Acne Patches

These hydrocolloid patches protect acne from bacteria and dirt while supporting healing and reducing the temptation to pick at blemishes.

4. Cortisone Injections

For rapid results, dermatologists may inject diluted corticosteroids directly into cystic acne. These “acne shots” help calm inflammation quickly. However, they are not suitable for infected cysts or those with cellulitis, and may cause dents in those prone to scarring—so professional evaluation is a must.

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5 Key Steps to Prevent Cystic Acne

Prevention is always better than cure. Follow these daily practices:

1. Apply Sunscreen

Avoiding sunscreen may worsen oil-water imbalance and speed up skin aging. Choose lightweight, non-greasy sunscreens or use hats and masks for protection.

2. Regular Exfoliation

Built-up dead skin can block pores. Weekly exfoliation clears these layers, enhances cell turnover, and helps prevent breakouts.

3. Avoid High-Sugar, Dairy & High-GI Foods

Foods like cookies, cake, and dairy can spike insulin and promote oil production, increasing acne risk. Cut back to help control flare-ups.

4. Gentle Cleansing and Moisturizing

Use mild, water-soluble cleansers twice daily with lukewarm water. Avoid over-washing, which can disrupt skin balance.

5. Don’t Over-Control Oil

Washing your face 3–4 times daily can backfire. Cystic acne stems from deep dermal inflammation, not surface oil. Over-washing worsens dryness and oil imbalance.

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Western Medical Treatments for Cystic Acne

If cystic acne has already broken out, prompt treatment is crucial. Western medicine typically offers the following:

1. Oral Antibiotics

Commonly prescribed to reduce bacteria and inflammation. Tetracyclines and macrolides are popular choices. Side effects may include dizziness, headaches, or diarrhea, and acne may return after stopping.

2. Hormone Therapy

Since excess androgens often trigger cystic acne, hormone blockers may be prescribed—but only after thorough consultation due to possible side effects.

3. Isotretinoin (Vitamin A Derivative)

This retinoid shrinks sebaceous glands and prevents bacterial growth. It's highly effective but may cause skin irritation, redness, and is strictly contraindicated during pregnancy due to risk of birth defects.

4. Low-Level Laser Therapy

LED light treatments (red and blue) can reduce oil production and bacterial activity. However, multiple sessions are required for visible improvement.

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Traditional Chinese Medicine’s (TCM) Approach to Cystic Acne

TCM takes a holistic view, treating both the root and symptoms. Based on individual constitution and acne type, practitioners may use herbs or acupuncture.

From a TCM perspective, cystic acne stems from internal heat toxins that disturb qi and blood flow, leading to stagnation, nodules, and pain.

Treatment focuses on clearing heat toxins and softening nodules. Common herbs include Viola, Forsythia, Salvia, Red Peony Root, Pinellia, and Poria.

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Say Goodbye to Cystic Acne! Try Perfect Medical’s Acne Treatment

Cystic acne is often large and deeply inflamed. DIY remedies can worsen the condition and delay healing. Instead of waiting months for natural recovery, why not seek professional help?

Perfect Medical’s Acne Treatment is an excellent solution for cystic acne removal. It clears pores from deep within the skin, balances oil production, and reduces breakouts from recurring.

The treatment uses a patented vacuum microdermabrasion technique to gently exfoliate dead skin without pain. Combined with a deep-purifying serum infusion, it dissolves blackheads and unclogs pores, while restoring a healthy oil balance.

With advanced technology and vacuum pressure, the treatment delivers active ingredients deep into the skin and stimulates collagen repair. It rejuvenates damaged tissue and boosts collagen production, helping skin recover its smooth, refined texture.

Perfect Medical’s Acne Treatment targets not only cystic acne, but also hormonal acne, clogged pores, blackheads, and stress-induced breakouts.

Still battling breakouts? If over-the-counter creams aren’t working, let the professionals take over. Perfect Medical is now offering free trial treatments—click the link below to sign up and experience premium acne care for yourself!