Cystic Acne: What You Should Know
Cystic acne is a severe form of inflammatory acne that develops deep inside the skin. It can cause large, painful lumps and has a higher risk of permanent scarring.
🔥 What causes it?
Cystic acne develops when several acne processes combine:
- Excess oil — Hormones can stimulate the sebaceous glands to produce more sebum.
- Clogged pores — Oil mixes with dead skin cells and blocks the follicle.
- Inflammation — The body’s immune response causes swelling and redness.
- Deep follicle damage — When inflammation extends deep into the skin, large painful lesions can form.
👀 What does cystic acne look like?
It often appears as:
- Large, deep bumps
- Red or swollen skin
- Tender or painful lumps
- Lesions that don’t have an obvious “head”
- Acne that persists for weeks
What people call a “cyst” isn’t always technically a true cyst; dermatologists may classify many of these lesions as nodules or nodulocystic acne.
⚠️ Why it matters
Deep inflammatory acne can damage surrounding tissue and is more likely to leave scars than mild blackheads or whiteheads.
That’s why repeatedly squeezing or picking these lesions is a bad idea—it can increase inflammation and scarring.
💊 How is it treated?
Treatment depends on severity. Dermatologists may use combinations of:
- Prescription retinoids to prevent clogged follicles
- Benzoyl peroxide to reduce C. acnes and inflammation
- Oral antibiotics for short-term control of inflammatory acne
- Hormonal treatments for appropriate patients
- Isotretinoin for severe or persistent acne
- Corticosteroid injections into individual large, painful lesions in some cases
Over-the-counter products often aren’t enough for significant deep acne.
🩺 When should you see a dermatologist?
Consider professional treatment if you have deep, painful acne, frequent breakouts, acne scars, or acne that isn’t improving with appropriate over-the-counter treatment.
Bottom line: Cystic acne isn’t simply a surface problem. Because inflammation occurs deep in the skin and can cause scarring, early, effective treatment is important.
