Cystic acne is a severe type of acne in which the pores in the skin gets clogged, usually with dead skin cells leading to infection and inflammation. This infection penetrates the skin creating red, tender bumps that may hurt or itch. Sometimes bacteria gets trapped inside the pore and spreads, causing more breakouts in case of a rapture. These acne spots are rooted deep within the epidermis, and unlike pimples and pustules, they do not surface on the skin. Rather, they are painful and can either be open or closed, referred to as blackheads and whiteheads.

This skin condition mainly affects the face, upper trunk and upper arms. Acne most often affects people with oily skin, adolescents, young adults and older adults with hormonal imbalances.

Cystic acne appears to be larger and deeper within the skin.

It produces cysts and nodules alongside inflammatory papules and pustules.

Acne can also cause visible scarring.

Cystic acne often looks like a boil.

It is usually a large pus-filled cyst

Has large white bumps

Generally reddish and painful.

Acne cysts are perhaps most noticeable on the face. They can also appear on the chest, neck, back, shoulders, behind ears and arms.

The pores of the skin have sebaceous glands that secrete an oily substance known as sebum.

Normal sebum secretions protect the hair follicles and skin, but overproduction of sebum and overgrowth of skin cells can cause the pores to become clogged. This can create the perfect conditions for the overgrowth of cystic acne

Acne is caused when pores become clogged with excess sebum, dead skin cells, bacteria and infection which surface as a sore. This inflammation can lead to papules, pustules, nodules, and cysts. A cystic acne is a severe form of acne. If not properly treated, deep lesions developing under the skin, which can result in permanent scars. In a case where acne is as a result of hormonal changes in adolescence, cystic acne can improve with age. However, there are persistent and painful bumps won’t go away without medication.
Several reasons are responsible for this skin condition such as the following:

Hormonal Changes
This is more common amongst teenagers and often develops during the onset of puberty. Hormonal changes in teenagers can cause the increase of the hormone called androgens. When significantly larger amounts of androgens are produced, the skin’s oil glands react by producing an excess of sebum. This excess of sebum can cause skin cell proliferation. This can lead to changes in the skin that can result in clogged pores and acne. In women, hormonal changes can be triggered by menstrual cycles, pregnancy, menopause, or a condition called polycystic ovary syndrome.

High Levels Of Stress
Stress is a major culprit of sudden hormonal changes. Between working full time, being a parent and engaging in other activities can results in high levels of stress. Chronic stress triggers the production of the stress hormone cortisol. Unfortunately, a tiny bit of testosterone flows out with it. In a woman, this male hormone can cause the oil glands to produce more oil, which is the root cause of breakouts.

Air Pollution
The face is exposed to micro-organisms due to air pollution that layers on the face. At the end of the day, it is advisable to wipe face with a face wiper and deep cleanser to deeply clean pores that soap fails to reach. High levels of humidity and sweating also increase the risks of cystic acne. Avoid being over-exposed to the sun, as it can affect skin health and appearance.

Using Wrong Chemical-Based Products
Greasy cosmetics, cleansers, lotions on particularly oily or combination skin can cause breakouts. Oil-free, non-comedogenic, or water-based are a recommended option as they do not clog pores. Avoid applying heavy makeup, and make sure to take off makeup before bed.

Certain types of medication can worsen the presence of acne, including birth control, particularly brands that contain only progesterone, lithium, phenytoin, and other drugs. It’s important to talk to a specialist about any skin issues that may arise after starting a new medication.

Frequent Intense Cleaning
Frequent and overly washing the face can worsen the effects of acne. Cleansing more than twice a day is too much and can just dry out skin, which can trigger the sebaceous glands to produce excess oil to compensate the loss of oil. Washing twice a day is enough. Do not scrub aggressively when washing and avoid abrasive soaps, cleansing granules, astringents, or exfoliating agents.
Leave pimples alone, picking and squeezing would likely worsen the acne.

Excess Intake Of Sugary Foods
Excess intake of sugar can cause an increase in insulin level which can potentially endanger the skin health. There’s some evidence to show that insulin may boost oil-triggering male hormones. Choose low-glycemic foods that have complex carbs like whole grains, which break down slower in the body and cause less of an insulin spike.

Some people are naturally more susceptible to acne based on inherited traits.

The Treatments For Cystic Acne

Exfoliate Regularly
Exfoliation involves the removal of the oldest dead skin cells on your skin’s outermost surface. Proper exfoliation may be able to reduce cystic acne and prevent the formation of new lesions. However, you must choose a right type of exfoliator. Using a wrong product may only worsen the effects of cystic acne and cause scarring.
Avoid using body scrubs on your face as body scrubs are typically stronger than facial scrubs and should not be used on the face. Generally, most exfoliating scrubs contain chemical or physical exfoliating agents or a combination of the two. However, exfoliating scrubs containing chemical exfoliators, preferably products labelled ‘non-comedogenic’ may be suitable for cystic acne. Avoid harsh physical exfoliating agents such as sea salt as they are not suitable, could irritate and damage the skin. Products containing very fine, gentle physical exfoliators, such as microbeads, are suitable.

Quick Tip: Wash your face with lukewarm water. Put a pea-sized amount of scrub on your fingertips and rub the product in your hands to distribute the exfoliator. Then, gently rub the product over your skin without applying pressure, going from top to bottom. Wash off the scrub’s residue with lukewarm water. Do not use a washcloth, sponge or other abrasive materials while scrubbing or washing. We recommend you use a scrub once or twice a week and be patient as It can take up to six to eight weeks to notice a significant improvement.

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Over The Counter Ingredients

Salicylic acid also called a beta-hydroxyl acid. Salicylic works by gently unclogging pores. It can be found in most of the cleansers and spot treatments. It also breaks up comedones such as whiteheads and blackheads.

Benzoyl peroxide is by works by killing the acne bacteria, while exfoliating the pores at the same time. It can be a little harsh and dry out the skin, you should use benzoyl peroxide moderately. It is much better to stick to spot-treating with this one. Water-based and alcohol-based formulations of benzoyl peroxide are available. Benzoyl peroxide is available in a number of formulations that may be applied to the skin. Its products include cleansing liquids and bars, lotions, creams, and gels, are used once or twice a day. The most common side-effect is skin irritation.

Sulfur is a great spot treatment and it works by drawing oil out of the skin and has a drying effect. Commonly found as the active ingredient in some face masks.

Glycolic Acid is an alpha-hydroxy acid and an exfoliating ingredient that targets both acne and wrinkles at the same time. It works by removing dead cells on a surface. It helps improve skin’s texture and reduce fine lines and wrinkles while also clearing up breakouts.

Retinol is a vitamin A derivative. The skin absorbs retinol and converts it to retinoic acid. Retin-A is the prescription form and is one of the most effective treatments for acne, which is equally effective for anti-ageing.

Birth-control pills help some women by regulating their hormones.

Drug Treatment

Isotretinoin formally known as Accutane attacks all causes of acne. The recommended dosage for most of this medication is 1 milligram (mg) for every kilogram of body weight once daily for 16 to 20 weeks. For most people, this clears the skin completely and permanently. Pregnant women should avoid this drug as it has significant side effects and is dangerous to an unborn child. Other potential adverse effects of Isotretinoin are eye and genital dryness, chapped lips, joint pains, depression, liver damage and elevated lipid levels.

Spironolactone is a medication that works by getting rid of excess water and can be highly effective for cystic acne in women.

Steroid injections such as injecting a corticosteroid medication called triamcinolone directly into a cyst can help prevent inflammation and prevent scarring. This treatment should be carried out by a dermatologist.

Instant Remedies

Avoid touching cysts as that can deepen and worsen acne.
Make healthier lifestyle choices: get more sleep and exercise regularly, limit sugar intake and consume more fruits, vegetables and whole grains.
Try to relax as stress can cause your body to release more hormones that trigger acne.

In the cases of severe cystic acne, chances are you may need to see a dermatologist.

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