Expert Insights on Medical Aesthetics

5 Tips to Deal with Severe Cystic Acne from an Aesthetic Doctor

cystic acne

We all know that sinking feeling when you feel that big, tender bump on your face in the morning. You know what’s coming, yet there isn’t much you can do about it. If this sounds familiar, you probably have had cystic acne before.

This is an especially relevant topic as I have seen an increase in the number of patients seeking treatment for cystic acne since the COVID-19 pandemic started. This could be related to the increase in stress levels, or mandatory mask wearing.

Cystic acne is the most severe form of acne. Such breakouts are highly traumatic as big, red bumps form deep under your skin. They are painful and tend to scar. As a result, they shouldn’t be taken lightly at all. 

How Does Cystic Acne Look Like?

cystic acne

Apart from being the most serious form of acne, they also tend to be the largest. They arise from deeper layers of our skin compared to other milder forms of acne. You often do not see a “head” showing on the surface, although it may be present occasionally.

Other characteristics include: it feels boggy (feels like there’s fluid inside), redness and very tender. They most commonly appear on faces but can affect any part of our skin. 

What Causes Cystic Acne?

The medical cause of cystic acne isn’t fully known.

However, we know that it tends to form in people with oily skin type. It is also more common among teenagers, women and those with hormonal imbalance. You’re also at a higher risk of developing cystic acne if your parents had it before.

Cystic acne forms when dead skin cells and sebum block hair follicles. A plug of sebum called comedone forms, and becomes food for P acnes bacteria. This bacteria  breaks down sebum nto by-products which irritate and inflame our skin. This whole ball of swelling and inflammation then becomes an inflamed cystic acne. 

The most important thing to note about cystic acne is their high chance of scarring. 

How Can I Improve My Cystic Acne?

  • Keep your skincare simple! 
    • Use an effective, water-soluble cleanser twice a day. If you use makeup, wash it away with a makeup remover first before cleansing. Do not wash your face more than twice a day as it may dry your skin and stimulate it to produce more sebum. 
    • For stubborn or severe acne, use salicylic acid (see below) regularly
    • Avoid using harsh ingredients such as alcohol, menthol or products such as stiff bristle brushes.
    • Use an oil-free moisturizer as well-moisturized skin will tend to produce less sebum. This will reduce congestion and formation of blackheads and whiteheads.
    • Use a lightweight sunscreen daily as it 
  • Do Medical Facials with a Light Chemical Peel
    • When you suffer from cystic acne, you likely have other associated issues such as oily skin, blackheads and whiteheads. Regular medical facials will deep cleanse your pores and remove time bombs from your skin before they erupt into cystic acne. Your trained aesthetician will be able to assess which pimple should be popped and which should be left alone. If you’re unsure, it’s best to leave it to the pros. 
  • Use salicylic acid
    • Salicylic acid is great for acne prone skin as it helps our skin shed off dead skin cells more effectively. Also, it reduces inflammation in our skin and regulates oil production. You may use salicylic acid in the form of a cleanser or leave-on exfoliant. You may also apply it on the cystic acne itself. 
  • Do not pop your pimples!
    • Cystic acne tends to be very deep, compared to comedonal acne at the surface. While it may be tempting to, we should never try to squeeze a cystic acne. Squeezing cysts will very likely make them worse as you push inflammation deeper into the skin. 
  • Know when to see a Doctor
    • If you’re still having new cystic acne despite an optimal skincare routine, you should book an appointment with a doctor who specializes in acne. There are many effective medications available which may help you solve your problem. Also, delaying medical treatment is potentially harmful as permanent scars may form. 

We hope you’ll never have to deal with cystic acne. They are physically and emotionally painful to deal with, but we hope you’ll have a better idea after reading this post. If in doubt, seek professional help as soon as possible to reduce the risk of scarring. 

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