Cystic acne is probably the most challenging type of acne to treat. It’s deep under the skin and can be red and painful to touch. And, sometimes, it can even be itchy. And usually, the only way of getting rid of them is by visiting a dermatologist. But is there anything you can do at home to reduce them? Let’s have a look.
Cause of cystic acne
We all know that we have pores on our skin. And in those pores, there are glands that produce oil (sebum) which protects our skin and moisturises it. Those glands (sebaceous glands) can sometimes work extra hard and produce too much sebum. And when there is too much sebum, it can clog our pores and cause breakouts.
But excess sebum also provides a prosperous ground for the bacteria P. acnes. And this bacteria, when it mixes with sebum and dirt, can block our pores and cause big, swollen and painful bumps called cystic acne.
Hormones are usually the ones that regulate our sebum production. And in the teenage years, our hormones can go a bit crazy and overstimulate our glands to produce excess sebum. And that’s why you can get cystic acne during puberty.
However, women have their hormones fluctuating throughout the month. And those hormone fluctuations can cause cystic acne before the period. The same can happen when using hormonal therapy, birth control or during pregnancy.
Also, periods of stress can mess up our hormones and cause cystic acne.
Sometimes, unfortunately, acne is caused by genetics, and there is no way of stopping them.
Usually, acne is caused by the trapped dirt and oil which clog the pores, but with cystic acne, there are some bacteria added to the mix. Bacteria cause this type of acne to become red, inflamed and swollen.
How to recognise cystic acne
Cystic acne is the most severe type of acne. It is characterized by big, swollen, red bumps (cysts). They are bigger than your usual breakouts, and they last longer.
These bumps are under the skin, and they don’t always have a head. And if you try to press on them, you will see that they are very sore to touch. Sometimes, there might be some puss oozing out of the cyst.
How to treat cystic acne with skincare
Unfortunately, cystic acne can be very tricky to treat. But it’s important to treat it, as ignoring it can leave scars. Sometimes, it can go away on its own after a while, but that’s not guaranteed and not the best option. The best thing to do would be to visit your doctor and get a referral to your dermatologist.
I understand that it can be hard to get an appointment with a dermatologist because they have massive waiting lists or are very expensive.
So let’s have a look at some of the skincare tips to help you get rid of cystic acne.
1. Use a Salicylic acid cleanser
Salicylic acid is an acid from the BHA group. Its primary role is to exfoliate. By exfoliating, we remove the top layer of dead skin cells and help whatever is trapped under them to come out. Usually, that’s the sebum mixed with dirt. Salicylic acid is specific because it can get into the blocked pore, dissolve that dirt and sebum and get it out. If your skin is normal, combination or oily, you can use a cleanser with 2% salicylic acid. And if your skin is sensitive, go for a lower concentration of 0.5% or 1%.
With 2% salicylic acid, this cleanser is at the upper limit of salicylic acid allowed in an OTC product. That makes it a fantastic product for combating breakouts. And with added niacinamide, it can, over time, help with sebum production in the skin and can help reduce redness and inflammation.
It’s a perfect option for those with normal, combination or oily skin.
This Murad cleanser has two types of salicylic acid – a free form and an encapsulated salicylic acid. Free-form salicylic acid starts working straight away, and encapsulated form is slowly released and treated over time. This product contains 1.5% salicylic acid and has green tea extract that can help soothe the skin and calm irritations.
Murad Clarifying Cleanser is suitable for oily skin.
Vichy Normaderm Cleanser contains 0.5% salicylic acid and is more suitable for sensitive acne-prone skin. Alongside salicylic acid, there is also glycolic acid from the alpha hydroxy acid group. Glycolic acid also has exfoliating properties, but it can balance the production of sebum too.
If your skin is extremely sensitive, use this product every few days, as it contains SLS that might be harsh on your skin.
2. Use an oil-free moisturiser
Even though your skin might be oily, it still needs hydration and moisturisation. If you are unsure what the difference is, you can read it here: Moisturising vs hydrating – what’s the difference? The best would be to use a hydrating serum and an oil-free moisturiser. Those products will ensure you don’t overdry your skin with all the exfoliators (acids). And they will protect your skin barrier and could reduce redness and inflammation.
Choose products with hyaluronic acid, ceramides, and niacinamide. You could maybe use a hyaluronic acid serum and a face cream with ceramides and niacinamide. Or you could just find a cream that suits your skin and doesn’t break you out. You don’t have to use both products but have at least a moisturiser. Otherwise, your skin will get dehydrated and produce extra sebum, which could block your pores again.
When looking for a face cream, avoid ingredients that can block your pores (comedogenic ingredients). Those can be different for everyone, but the most common ones are beeswax, shea butter, coconut oil, cocoa butter, mineral oil and most other oils and butters. Your best bet would be to go for a cream that says non-comedogenic on it (or oil-free).
This toner is my absolute must-have product for acne-prone skin. Niacinamide works to balance oil production in the skin, and it can reduce the appearance of breakouts. It also has anti-inflammatory properties and can make pores appear smaller. It is a fantastic product, and I would recommend it to everyone. I even have a review written here: Q+A Niacinamide Daily Toner review.
This serum might be the perfect one-stop-shop product for those with cystic acne. It has a few nourishing and soothing ingredients like hyaluronic acid, three essential ceramides and vitamin B5, which has a soothing effect. This product has patented MVE technology that slowly releases ceramides over time and ensures constant hydration.
This CeraVe Moisturising lotion is a fantastic budget-friendly option for a moisturiser. It has three superstar ingredients – hyaluronic acid, niacinamide and ceramides. Those all support the health of your skin barrier. CeraVe Moisturising Lotion has a lightweight formula that provides deep hydration.
It is a fragrance-free and non-comedogenic formula, so it can be a perfect option for acne-prone skin that is dehydrated from acne-fighting ingredients.
3. Use retinoids at night
Retinol is the number one anti-ageing ingredient. But it’s not just going to help you look younger forever – it can also help with acne. And that is because retinol speeds up skin cell turnover. And if your cells are shedding at a faster speed than before, there are lower chances of getting blocked pores and acne.
If you have never used retinol, start with low concentration and use it only a few times a week. You can increase the frequency after a few weeks until you get to use it every night. Retinyl palmitate is the weakest form of retinoids, then there is retinol, and after is retinaldehyde. If you are only starting to use one of those three forms of retinoids in the beginning until your skin gets used to it.
And always wear SPF if you are using retinoids. Because they speed up your cell turnover, your top layer of the skin will always be young. There won’t be those dead skin cells to protect you from the sun. So put on your SPF 50 every morning.
Retinol from La Roche-Posay is, in my opinion, the best retinol for beginners or those with sensitive skin. It’s formulated with 0.3% retinol and has lipo hydroxy acid for an extra exfoliating effect. I’ve used this product as my first retinol, and it helped reduce my breakouts immensely. If you want to read my review, click here: La Roche Posay Redermic R Retinol Review.
Medik8’s Crystal Retinal 3 is the next step up from the previous product. It contains 0.03% retinol which might seem lower than 0.3% retinol, but it’s, in fact, stronger. Retinal requires one less conversion in our skin than retinol, and that’s why it works better and faster in exfoliating our skin.
This product is also full of nourishing ingredients such as hyaluronic acid, glycerin, and vitamin E that hydrate and soothe the skin.
I wouldn’t recommend this Retinal to someone that has never used retinol products before, as it might be too strong. But if you can work your way up to it, it could benefit your skin.
4. Use spot treatments
On the nights when you don’t use retinoids, you can use spot treatments. That can be salicylic acid spot treatment or zinc spot treatment. I prefer the zinc one as it’s not as harsh as salicylic acid, but you can use either one. When you use a spot treatment, make sure that you put it only directly onto the spot and don’t spread it around it. Those treatments are concentrated and stronger than your other products and can dry the surrounding area too much.
This spot treatment is zinc-based. It works by speeding up the maturation of the spot and drying it up. So it pulls the spot out faster and drys it up as it comes out.
It also contains green clay that absorbs the oil and schist oil extract that purifies the skin.
The addition of Uriage thermal water calms the skin as well.
Apply it directly onto the spot every night until the spot is gone.
EradiKate is similar to the previous spot treatment, but it has a little bit more ingredients in it. Alongside zinc and clay, there are also salicylic acid and the highest allowed concentration of sulphur at 10%. Sulphur works similarly to salicylic acid and benzoyl peroxide, but it’s gentler on the skin. This product works very well on those deep underskin bumps, pulling them out and drying them out.
5. Always wear SPF
As I said, under using retinoids, you must use SPF every day. With all this product (and most acne products in general), your skin will be shedding dead skin cells faster than usual. And that can leave your skin photosensitive. That means that your skin will be more sensitive to the sunlight and can burn easier. And we don’t want that.
We have to give our skin the best possible chance to recover, and that includes protecting it. Protecting your skin and preventing sunburn also protects your skin barrier. And a healthy skin barrier means fewer breakouts. Also, protecting your skin from the sun means that you will look younger for longer. I think that’s a win-win situation right here.
This new sunscreen from La Roche Posay is a terrific product for those with oily skin. Not only does it protect from the sun with its high SPF 50, but it also has ingredients which regulate sebum protection and prevent new breakouts. Those star ingredients are salicylic acid and niacinamide. So while applying this product to protect your skin from the sun, this product provides tremendous benefits in reducing breakouts and the size of your pores. Win-win!
Vichy Ideal Soleil SPF50 has a lightweight, non-greasy, mattifying formula that is suitable for those with oily skin. It doesn’t leave any white cast or greasy feeling and absorbs quickly into the skin.
6. Use mineral makeup instead of the regular one
Mineral makeup is made exclusively from minerals from fine earth. Those minerals are micronized, or ground and milled, into tiny particles to create makeup. It does not contain any chemicals, dyes, preservatives, silicons, alcohol, or perfumes found in conventional cosmetics.
When I say mineral makeup, I don’t mean those ‘mineral enriched’ liquid foundations and similar products. What I’m referring to is actual mineral powder makeup.
The benefit of this makeup is that it doesn’t clog pores, contains anti-inflammatory ingredients (zinc oxide) and can soothe the skin.
I have an in-depth post about mineral makeup here: What Is Mineral Makeup (Benefits And How To Apply).
And if you are afraid that mineral makeup won’t cover your acne, trust me, it will. I’ve been using mineral makeup for a few years now, and even when I had terrible breakouts, it would always cover them.
7. Double-cleanse your skin
I have probably mentioned double cleansing in every post I’ve written so far. But that’s because it is so important to have your skin thoroughly cleansed. If your skin is clean, anything else you put on will work much better and to its full potential. That’s because there is no residue of makeup or dirt stopping it.
As you can imagine, double cleansing means cleansing your skin twice. It means using an oil or balm product first to melt your makeup, SPF and sebum and then using a gel or foam to wash everything off. And no, it won’t make your oily skin more oily. If anything, it can make it less oily because that first cleansing product (oil or a balm) can dissolve the sebum from your pores, leaving your skin clean and fresh.
To learn more about double cleansing, click here: Double cleansing – why is it so important?.
And if you want to find out which products are best to clean acne-prone skin, I have a post about that too: The best guide to cleansing acne-prone skin.
Can I pop my cystic acne?
In short, the answer is no.
If you ever had cystic acne, you would know how painful they are to touch. Now imagine squeezing that. Ouch! (I know because I tried to do it – big mistake!)
Not only that it’s extremely painful to do that, but it also does you no good. Cystic acne is usually under the skin, and if you try to squeeze it out, you will only push it down further. And it will become more inflamed and sorer and will last longer. I guess you don’t want that?
If you want to do something about them, just use your spot treatment frequently enough. That should help dry them out and minimise them.
How can I prevent cystic acne?
Unfortunately, if your cystic acne is genetic, there isn’t much you can do to prevent them. But even if it happens, you can still follow these tips to reduce them and help get rid of them faster.
1. Use face tissues instead of towels
This tip is, by far, the one that made the most significant difference in my skin. Even though I was changing my face towels every single day, face tissues work so much better for me. Most people don’t even use a separate towel for their face from the towel they use for their hands. And some people, like me, use different towels they change every day. But those towels are washed with harsh washing powders and fabric conditioners that can irritate the skin. Fabric conditioners, in particular, are the ones that leave a coating on your towels to make them smell good and feel soft, but that residue can really mess with your skin.
And I know it’s wasteful using tissues for your face, but we can cut our wastefulness somewhere else. If that bothers you, or you don’t want to keep buying face tissues, you can try washing your face towels in a mild washing powder and without using fabric conditioner. See if that makes any difference.
2. Change your pillowcases every second day
This tip correlates to the previous one. We don’t really think about these things, but they make a massive difference to our skin. Just think about how you sleep (hopefully) eight hours every night, and you are turning and drooling on your pillow, and your hair is everywhere, leaving all the hair products on the pillowcase. And you repeat that day after day until you eventually change your bedding. Even if you change your bedding weekly, that’s still too long to be sleeping on all that grime.
So just change your pillowcase every second day, and turn your pillow around in between changing pillowcases. This way, you will be sleeping on a fresh pillowcase (or a fresh side of the pillowcase) every night. There is no better feeling than that.
And when you wash your pillowcases, keep them separate from the rest of your laundry, wash them with a mild washing powder and don’t use a fabric conditioner. Your skin will thank you.
3. Change your diet
Don’t worry – you don’t have to change your diet drastically. But there are small changes that could help you with your cystic acne. For starters, keep track of how what you eat affects your skin. Maybe one day, you eat a delicious burger and then the following day, you wake up with a large cyst or maybe a small pimple. Then think about what you had in that burger, and next time, swap the sauces – maybe instead of mayo, this time you put ketchup. The next day, again, see if there is a breakout.
Or you keep eating a small protein yoghurt every day, and your skin is getting worse and worse. And then you stop eating them for a few days, and your skin calms down. You realise there is a connection, and you stop eating those yoghurts because you want nice skin.
Those are some situations that I had where I realised that some food does cause my acne. And I stopped eating them. Now, I do eat those foods here and there, but nowhere near as often as I used to. And they don’t affect my skin as much as they used to.
Generally, foods that affect the skin the most are dairy and high-sugar foods. So try to avoid them.
Conclusion
Cystic acne is red, swollen, painful bumps under the skin’s surface. They can be hard to treat, but there are a few skincare and lifestyle changes you can do to help minimise their appearance.
Skincare changes you can do include:
- using a salicylic acid cleanser
- using an oil-free moisturiser
- using retinoids at night
- using spot treatment
- using SPF every day
- using mineral powder makeup instead of liquid foundations
- double cleansing at night
And lifestyle changes you can make are:
- using face tissue instead of face towels
- changing your pillowcases every second day
- avoiding dairy and high-sugar foods in your diet
These changes should reduce your cystic acne, but they are not a guaranteed treatment. If, after three months of implementing these changes, your cystic acne is still there, you should visit a dermatologist. If cystic acne is left untreated, it can leave scars.
Hope this post helps you. Let me know if you try any of these tips and if they help you.
