Cystic acne is a particularly troublesome form of acne that leads to deep, painful pimples. The pimples themselves often have trouble coming to the surface and fester deep under the surface of your skin, frequently traveling to and connecting with adjacent pores.
It’s rare to meet anyone who hasn’t experienced one of these epic types of pimples. Unfortunately, there are many people that suffer with constant breakouts of cysts. We call it cystic acne, and sadly, it can go on and on for years. The biggest problem with this type of acne is that it can lead to devastating scarring. As a dermatologist, I am dedicated to preventing this from happening. Aggressive acne often requires aggressive measures, and it is my commitment to my patients to effectively address it and prevent it in the future.
In this blog post, I will briefly touch on some of the cystic acne treatment options we have at Advanced Skin Care and Dermatology Physicians. I am not afraid to use any of these tools when appropriate and needed – for me, cystic acne is a war with a sense of urgency in order to prevent devastating scarring.
In mild cases where people only get the occasional outbreak of deep pimples, topical acne products may be sufficient to control acne breakouts. We often attack acne at multiple angles. In my practice, everyone who has acne is on some sort of retinoid. This topical, prescription medication works to keep your pores unclogged. Retinoids can be prescription strength, or they can come in a milder form called retinol.
The second best medicine to add to your skin care for cystic acne is benzoyl peroxide because it works to kill bacteria and also helps unclog pores. Understand that a clogged pore is the first step in a cascade of events that leads to a pimple. Bacteria then flourish in clogged pores. A great benzoyl peroxide cleanser for people with acne is our Foaming Benzoyl Peroxide Acne Treatment Cleanser. It’s an easy product that cleans skin and medicates to fight acne all in one. However, we recommend using the benzoyl peroxide in the morning and waiting until your evening routine to use a non-benzoyl peroxide cleanser at night with the Retinol Cream. This is because benzoyl peroxide and retinol work best when they are not directly combined.
Benzoyl peroxide can also be applied as a lotion and paired with other medicated ingredients in cleansers. This is the basis of our Acne Treatment Kits. Here, salicylic acid and glycolic acid are used in cleansers and treatment pads and followed with benzoyl peroxide applied as a lotion. We recommend using the Foaming Acne Cleanser, followed by the Treatment Pads and Benzoyl Peroxide during the day. At night, we advise using the cleanser then the treatment pads and the Retinol Cream. This combination is as strong and intense as acne treatment gets without a prescription.
Antibiotics work to kill bacteria involved in acne (called Propionibacterium acnes). Antibiotics can also work to decrease the inflammation in the skin that make acne worse. The problem, however, with antibiotics is that they may stop working after a while. Some people may not even see any improvement on antibiotics.
It’s important to realize that not every antibiotic will work for acne, and that antibiotics alter the good probiotic germs in your body. The best way to approach antibiotics is to see a dermatologist to help you choose the best medicine you can get on and off of as fast as possible with precision results.
This medication works particularly well for women with “hormonal acne.” Hormonal acne has a classic appearance in that it’s more pronounced around the jawline and chin and tends to flare with menstrual cycles. This type of acne is more common in women who have something called polycystic ovarian syndrome (PCOS), a condition in which women have enlarged ovaries, abnormal menstrual cycles, excess hair growth and a body metabolism prone to obesity.
Hormonal acne can happen in any female, however, and just because they have this type of acne does not mean they have PCOS. The medication spironolactone is also used in conditions like heart failure and liver failure to help get rid of excess fluid. It also has anti-testosterone effects so can be helpful in treating hormonal acne. Testosterone drives the production of sebum and makes acne worse. But, when used in the right way, this medication can be a safe and effective treatment of acne.
This medicine is the pill form of a retinoid. It is the most effective treatment of cystic acne that we, as dermatologists have. It’s the only medication that can “cure” acne. It attacks acne at all levels, most importantly by shrinking the oil glands.
It is such a powerful medication that it can cause birth defects if a pregnant woman is exposed to it. This is why isotretinoin is so tightly regulated. However, it’s an extremely effective treatment of acne. One course of treatment is often enough, but sometimes people have to go through treatment more than once to get rid of their acne for good.
Whatever your acne troubles may be, we have the tools to treat it! Don’t let your acne get to the point of developing scars – come in as soon as possible since we have so many options to help you. Ask us how we can help!
Dr. Hayes – Board Certified Dermatologist
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