What is cystic acne?

Cystic acne is another term for severe acne that causes large, pus-filled, painful spots to develop on the skin. These spots are known as cysts, and they’re prone to bursting and causing permanent scarring. 

If you’re worried that you might have cystic acne, read on for a guide to symptoms and treatments.

How do I know if I have cystic acne?

You’ll know that you have cystic acne if you develop cysts on your skin. Nearly everybody with acne has spots on their face, but you might also have cysts on your back and chest. 

Cysts are described by the NHS as “the most severe type of spot caused by acne”. They’re large and usually very painful and tender. They look similar to boils and when they burst they can leave open wounds that damage the skin cause scarring.

Cysts caused by acne are not just occasional big spots that crop up on otherwise clear skin. If you have this type of acne you’ll have other types of acne spots, like papules, pustules and nodules. Papules are small red bumps. Pustules are similar to papules, but with a white, pus-filled tip. Nodules are large hard lumps under the surface of the skin. 

In addition to spots, you’ll probably also have oily skin that is tender, red and sometimes hot to the touch. You might also have some scarring on your skin, caused by cysts that have burst. 

What causes cystic acne?

Acne occurs when the hair follicles in the skin become blocked with sebum and dead skin cells. If a blocked follicle becomes infected from bacteria on the skin (which is normally harmless), it can develop into a spot.

We don’t fully understand why some people are more likely to have acne than others, or why for some people it’s severe enough to cause cysts. What we do know is that people with acne produce too much sebum from their sebaceous glands. This substance is designed to lubricate the skin, but in people with acne, the body makes too much.

It’s thought that hormones play a big role in acne, which is why it’s common for teenagers to first get spots when they go through puberty. Women with polycystic ovary syndrome (PCOS) – a condition where women have high levels of “male” hormones – are also prone to acne for the same reason.

Another risk factor for acne is a family history of the condition. If your parents or siblings have it, you’re more likely to have it too.

Acne triggers

People who are prone to acne might find that certain things set off their symptoms and cause particularly bad flare-ups. If you have cystic acne, you might notice that you develop cysts after: 

• Hormonal changes e.g. having your period or going through pregnancy 
• Taking medication like steroids or lithium 
• Smoking 
• Putting pressure on the skin e.g. by wearing a headband or backpack

It’s not always easy to avoid triggers. If you can, make changes like quitting smoking and avoiding pressure on affected areas of skin. If you think medication might be causing your acne flare-ups, talk to your prescribing doctor to see if there’s an alternative. 

How to treat cystic acne

There’s a common misconception that acne can be treated by keeping your face clean, but this isn’t the case. Having a good skincare routine can help, but it won’t solve the underlying problem, which is that your skin produces too much sebum. 

In the case of cystic acne, treatment can be tricky because the symptoms are so severe. 

However, there are some prescription treatments that can help. If you’re experiencing cystic acne, you should visit your GP. 

Prescription treatments

When you visit your doctor about your cystic acne, it’s likely that they’ll prescribe antibiotic tablets, as well as retinoids and other topical treatments (i.e. treatments applied directly to the skin).

The antibiotics help prevent your blocked follicles from getting infected with bacteria. The topical retinoids help to exfoliate the skin by removing dead skin cells. This prevents dead skin building up in the follicles. Other topical treatments include benzoyl peroxide and azelaic acid.

Another prescription treatment is isotretinoin, which is branded as Roaccutane and Rizuderm. This type of treatment can be really effective in treating cystic acne, but it’s associated with some serious side effects, so it won’t be right for everyone. Isotretinoin works by reducing the amount of sebum your body produces, preventing the follicles from getting blocked and infected, and reducing redness and swelling.

If you’re a woman, your GP might prescribe a combined contraceptive pill, or a hormonal treatment like co-cyprindiol. 

Treatment for cystic acne from LloydsPharmacy Online Doctor

If you aren’t able to see your GP, or you simply prefer the convenience of ordering online, visit our Acne clinic. We supply a range of treatments for severe acne that can be safely prescribed through our secure online system.

Simply fill out a short, confidential consultation for one of our doctors to check and they’ll recommend you treatment. If they think the treatment isn’t right for you, or if there’s a better treatment for your symptoms, they’ll let you know. Approved treatments can be sent to your nearest LloydsPharmacy for collection or delivered to your home address.

Treatment for cystic acne scars

Cystic acne can cause scarring on the face and body if the cysts burst and damage the skin. Scarring can also occur if you scratch, pick or squeeze your spots. You might notice small, deep holes (ice pick scars) or craters (box car scars), or that your skin has an uneven and bumpy appearance (rolling scars).

Treatment is available for these kinds of acne scars, but it involves cosmetic surgery techniques like dermabrasion, laser treatment, and excision. These treatments are usually not available for free on the NHS. 

Find out more by reading this article: Acne scars. 

References

https://www.nhs.uk/conditions/acne/
https://www.nhs.uk/conditions/acne/causes/
https://www.nhs.uk/conditions/acne/treatment/
https://www.nhs.uk/conditions/acne/complications/