How to Get Rid of Cystic Acne, According to a Top Dermatologist

Getting a pimple or two sucks, but cystic acne is an entirely different situation.

It's painful and much harder to cover with makeup because it creates bumps in the skin which are next to impossible to hide. Not to mention, cystic acne tends to linger for a long time. If you or someone you know is struggling with cystic acne, listen up. We tapped Board Certified Dermatologist Dr. Jennifer Herrmann for all her tips on how to reduce and get rid of these painful blemishes.


(Photo courtesy Dr. Jennifer Herrmann)

Sweety High: What are the main causes of cystic acne?

Dr. Herrmann: Three main factors contribute to all forms of acne: bacteria, skin cells that are too "sticky" and block pores, and hormones that accelerate oil production from our oil glands. Cystic acne occurs when pores become severely blocked and skin cell decree and bacteria accumulate beneath the skin. This causes a large inflammatory reaction resulting in redness, pain, and cysts.


SH: What are some things you should do if you have cystic acne?

Dr. Hermann: It depends on the type of cystic acne. In classic adolescent acne, we often use a combination of medication that can help kill bacteria, promote exfoliation and sometimes shut down oil gland production. In adult women, hormones tend to be more of a contributing factor, so we also often try to help regulate hormones, using medications like birth control pills or spironolactone, a medicine that can lessen testosterone, which is often implicated in excess oil production.

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SH: What are some things you shouldn't do if you have cystic acne?

Dr. Hermann: You know this, but… Please don't pick, scratch or try to drain cysts. This can often worsen inflammation and lead to scarring, which is very challenging to treat.


SH: What remedies do you suggest to treat cystic acne?

Dr. Hermann: Because this type of acne can lead to scarring, it's important to see a board certified dermatologist to help you develop a treatment plan specific to your skin type. For some, diets high in dairy or refined sugars (high glycemic index) worsen or fuel acne, so minimizing these foods or additives may be helpful.


SH: Are there any lifestyle changes that can help with cystic acne?

Dr. Hermann: Yes, stress reduction is important. Stress can increase the hormone cortisol, which can lead to more oil production fueling the inflammatory process and worsening cystic acne. (diet modifications see above)


SH: Is cystic acne hormonal at all?

Dr. Hermann: Yes, it can be, especially in adult women, where acne is mostly on the lower face, jawline, neck, chest and back.


SH: If I have cystic acne in my teens, will I have it for life?

Dr. Hermann: Not necessarily. With appropriate treatment and natural changes in hormones as you progress through puberty, acne often improves and resolves.

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SH: What are the biggest mistakes you see teens making with cystic acne?

Dr. Hermann: Manipulating lesions (picking and squeezing) and not sticking to treatment plans. Acne medications take time to work, typically 2-3 months to really start making a difference, so persistence and patience are key!


SH: Help, now I have scars from my cystic acne—what should I do?

Dr. Hermann: It's best to see a board-certified dermatologist. Treatment depends on the type of scars you have and typically involves a multi-pronged approach with in-office treatments, such as laser resurfacing and topical creams.


SH: Any other general notes on how to get rid or clear up cystic acne?

Dr. Hermann: For individual, very painful bumps, using an ice pack for a few minutes or a bit of over-the-counter hydrocortisone directly on the spot can help improve pain and help resolve the bump faster.


Speaking of acne, HERE are some other easy lifestyle changes that can help.