Cystic Acne is very different compared to whiteheads or blackheads as they are superficial whereas cystic acne is deep down under the skin layers. Where acne is common, with over 80% of people between 11 and 30 suffer from acne, not everyone suffers the same. Some suffer from a mild outbreak, whereas others suffer from the large red swollen painful lumps of cystic acne the type that can scar your skin forever.
Cystic Acne is an inflammatory type of acne that causes deep under the skin tender red and painful bumps. Generally, they flare up in big groups and come and go at random intervals normally on the face but can be on the back, chest, arms, and shoulders. And it is due to the depth of the acne that cystic acne causes scars that last a lifetime.
Cystic Acne is caused by Bacteria being trapped deep in your pores causing inflammation, redness, swelling, and pain. The risk factors for getting cystic acne can be genetic, hormonal, or just random bad luck. It is more common in males due to cystic acne being linked to testosterone, especially men who use Anabolic Steroids for muscle growth, and for women during their menstrual cycles.
We can not yet blame the diet for cystic acne as it tends to be more hormonal based linked to testosterone; however, any sugary foods should be eaten in moderation however there is no evidence that a proper diet will cure acne.
For people that do not get Cystic Acne until they are in their 30’s or 40’s this is largely due to hormonal imbalances and your doctor might want you to work with a gynecologist or endocrinologist to test for hormonal imbalances. In women particularly not just around their menstrual cycles but hormonal changes that occur during pregnancy can trigger cystic acne later after the pregnancy and for the rest of the females adult life.
The treatment for Cystic Acne is not straightforward where some might respond to Over the counter benzoyl peroxide those people are few and far between. Most need stronger treatment such as antibiotics that will kill the bacteria and calm the inflammation. However, antibiotics have side effects such as diarrhea, nausea, and can result in antibiotic resistance so the antibiotics will no longer work. Plus sadly once you go off antibiotics some acne tends to come right back.
Since Cystic Acne is not usually a short term problem, many people resort to a topical antibiotic cream or a vitamin a cream such as Retin A that helps your body shed dead skin cells and prevent clogging of the pores. For females, your doctor might advise you to take birth control pills every month to help regulate your hormones or the doctor might suggest spironolactone which is a hormonal treatment that reduces testosterone levels which will reduce oil production.
However the most often used cystic acne treatment is Isotretinoin which is an oral form of Vitamin A. Isotretinoin targets all sources of cystic acne by killing the acne-causing bacteria, unclogging pores, and reduce the excess oil and inflammation. It is the only medicine that permanently stops cystic acne instead of just treating it. You’ll need to take it for four to six months but clears up 90% of the cases.
The most common side effect is dryness of the skin, peeling of lips and while it can cause birth defects you should go on birth control and use the second form of protection to avoid getting pregnant; however, it is very safe to procreate and get pregnant as soon as one month after coming off Accutane.
Many doctors suggest a daily routine of a gentle cleanser like Purposes or Cetaphil and lukewarm water morning and night to wash with. Plus use a moisturizer daily to refresh your skin.