Treatment Options for Cystic Acne

Cystic acne breakouts, in which deep rooted lesions form under the skin are known as severe acne. Bacteria can cause infection and inflammation when pores become clogged.

January 17, 2018

Treatment Options for Cystic Acne

Cystic acne is the most serious type of acne which can result from a combination of bacteria, oil, and dry skin cells that get trapped in your pores. When pores become blocked by excess sebum, skin cells, and bacteria, an infection can rise up in the pore. Cystic acne is a result of the most severe types of pore blockages.
A large, inflamed acne lesions form deep within the skin and result in painful, large bumps visible from the surface.

Treatment Options for Cystic Acne:

Cystic acne breakouts, in which deep rooted lesions form under the skin are known as severe acne. Bacteria can cause infection and inflammation when pores become clogged.
Over-the-counter (OTC) treatments for acne are not strong enough if cystic acne is more severe. You may need to see a dermatologist for prescription medications. The following methods used to treat cystic acne:
Some cases require combination therapies.


Isotretinoin is a powerful prescription medication which is recommended to take in tablet form every day. It is derived from a powerful form of vitamin A and considered the most effective treatment measure for cystic acne.
Improvements will show within four to six months. There are some serious risks associated with isotretinoin which include:

  • bruising
  • skin inflammation
  • inflammatory bowel disease
  • persistent headaches or nosebleeds
  • new or worsening mood disorders
  • blood in your urine
  • muscle and joint pain

Topical Retinoids:

These are also derived from vitamin A, but are not as effective as isotretion. Topical retinoids work by unplugging hair follicles to remove and prevent severe acne. Retinoids are sometimes used in conjunction with topical antibiotics to make them more effective. Topical retinoids come in the form of creams, gels, and lotions and can be used on a daily basis.
Some of the prescription-strength formulas which are effective in reducing cystic acne include Avage, Avita, Differin, Retin-A, Tazorac. Topical retinoids can make your skin red and can also cause it to peel. These side effects are usually temporary as your skin gets used to the medication. Be sure to wear sunscreen as retinoids can make you more susceptible to sunburn.

Oral antibiotics:

If it covers a large area of your skin, oral antibiotics are recommended to treat. Bacteria and inflammation that could be contributing to cystic acne formation can be reduced by using these antibiotics. But these does not work on excess oil and dead skin cells. If taken for long term there is a possibility of developing bacterial resistance. Therefore these are recommended to be used in the short term. Isotretinoin is suggested if antibiotics are not effective.
Possible side effects of oral antibiotics may include:

  • abdominal pain
  • nausea
  • diarrhea
  • vomiting
  • sun sensitivity


Spironolactone is another possible prescription medication for cystic acne which is also used as a diuretic to help treat edema and high blood pressure. This medication can work by managing excess androgen levels that could be contributing to inflammatory acne. Women with acne on their jawline or lower face can be benificial from this medication. As spironolactone may cause birth defects, you should not take it if you are planning a pregnancy. People with kidney disease also should not use this medication.
This also help reducing the risk of side effects, such as:

  • breast tenderness
  • headaches
  • dizziness
  • fatigue
  • high blood potassium (hyperkalemia)
  • menstrual irregularities

Oral contraceptives:

Oral contraceptives are effective if develop acne cysts during hormone fluctuations related to your menstrual cycle. Birth control pills contain estrogen, which can help regulate overall hormone levels and possibly reduce acne. These medications are not recommended if you are trying to get pregnant. Also these are not appropriate for you if you smoke or have blood clots.