By Michelle Rostamian
Dealing with any type of acne can be frustrating, but cystic acne is particularly troublesome. Besides being painful, cystic acne is stubborn to treat, prone to scarring, and easier to spot thanks to the large, inflamed, deep nodules and boils it’s characterized by.
According to Dr. Anar Mikailov, board-certified dermatologist and founder of KP Away, the current consensus with dermatologists globally is that the first line of treatment against cystic acne is oral isotretinoin.
Rather not take prescription medicine? While topical treatments alone are not as effective, there are things you can do to minimize cystic acne’s appearance. No matter which route you choose—oral, topical, or a combination of both— Mikailov says that treatment needs to start as early as possible to prevent severe scarring.
Keep reading for five ways to fight cystic acne.
If you’re struggling with cystic acne, you’re likely struggling with the painful side effects that come with it. Thankfully, Mikailov says that icing can provide some relief.
“Icing the skin helps constrict blood vessels, which can help decrease inflammation and relieve the pain and itchiness associated with cystic acne,” he says.
Just make sure to always wrap the ice in a paper towel (to avoid getting an ice burn). To properly ice, Mikailov says to hold the paper towel-wrapped ice cubes against the cystic acne for 30 to 60 seconds on, 30 to 60 seconds off, for no more than 10 minutes at a time.
Benzoyl peroxide is a tried-and-true acne-fighter that works against acne-causing, pore-clogging bacteria that live deep within the skin. It also helps to reduce inflammation and comes in various strengths that help treat mild to severe types of breakouts. For cystic acne, apply the spot treatment onto cleansed skin and wash off after a few hours. If your skin skews sensitive, Mikailov recommends applying the topical treatment after moisturizing to mitigate any potential irritation.
“Any type of over-aggressive exfoliation, of both the chemical and physical variety, can irritate the skin and cause more inflammation that can aggravate cystic acne,” warns Mikailov. “It may also cause the pus to erupt under the skin, leading to infection and more scarring.”
When it comes to treating cystic acne, the key is being gentle in your approach and the products you use. Opt for a chemical exfoliant (versus an abrasive scrub) that contains salicylic acid, which can help unclog pores and are helpful as part of maintenance therapy, says Mikailov. “When using a salicylic acid treatment, stick to a very gentle, non-drying, and non-irritating formula, as it’s important not to irritate the skin,” he says.
Mikailov says that cystic acne is the most common cause of permanent scars. To avoid this, SPF is necessary. The problem? Many SPF-containing products are known to be irritating. Stick to physical sunscreens—they contain mineral oxides and are less likely to aggravate your cystic acne—versus chemical sunscreens, which can potentially cause more inflammation.
Popping or extracting your acne can lead to permanent scarring, and scars from cystic acne are very difficult to treat, says Mikailov. Not to mention, popping can introduce more bacteria into the breakout, which can lead to infection and delay the natural healing process. “It can be hard dealing with cystic acne, but the sooner you are able to get help from a dermatologist, the faster you can clear the skin and prevent scars,” he says.