Cystic Acne Treatment

Before we can discuss the many cystic acne treatment options, we must first define cystic acne. This is because proper treatment requires definitive diagnosis, which your dermatologist is best trained for. Still, it is possible to know what cystic acne looks like so that you are better equipped to deal with it in a psychological and physical manner.

Cystic acne is diagnosed through two characteristics. First, the acne is characterized by nodules filled with yellowish pus. Second, these nodules must be 5mm or more in diameter before a cystic acne diagnosis is made. Unfortunately, cystic acne can be painful even when there are no touch triggers being applied to the pimples.

Men and teenage boys are more prone to cystic acne although women have also been known to suffer from it. The causes behind cystic acne are usually attributed to overactive oil glands, excess dead skin cells and a proliferation of the Propionibacteria acnes bacteria, which are nobody’s deliberate fault so you can quit being too hard on yourself for having acne.

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Oral Antibiotics

The first line of defense in cystic acne treatment regimen is oral antibiotics. Topical antibiotics are often ineffective in cystic acne because the bacterial infection runs deeper than the skin’s surface. Keep in mind too, that cystic acne is difficult to control from the outside such that systemic medications are an absolute necessity.

Both topical and oral antibiotics, however, work in two ways. First, these medications kill the bacteria that cause acne, which are the abovementioned Propionibacteria acne. Second, antibiotics also decrease the degree of inflammation together with cortisone shots.

Your doctor will start on a high dosage and then move progressively to lower dosage as your acne clears up. This is to prevent antibiotic resistance with consistently high doses. You will be prescribed one of the most common antibiotics in cystic acne treatment such as erythromycin, tetracycline, minocycline and doxycycline.

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We have to emphasize that oral antibiotics are not to be taken without the medical advice of a doctor. Again, the primary reason is to avoid antibiotic resistance borne from the abuse of the substance.

Oral Contraceptives

Birth control pills are only effective in women for the treatment of cystic acne. In men, undesirable hormonal changes can result from oral contraceptive use, which will only worsen the situation.

But not all oral contraceptives are good for cystic acne treatment. Your doctor will usually prescribe birth control pills containing a combination of progestin and estrogen, both of which work by lessening the oil gland secretions and, in the process, suppressing the acne-causing androgen hormones.

Your doctor will also prescribe topical medications to control the bacterial infection and inflammation. The more popular birth control pills include Ortho Tri-Cyclen, Estrostep and Yaz although other brands will also have similar effects.


Formerly known as Accutane, Isotretinoin is a derivative of Vitamin A. Its main effect is in shrinking the sebaceous glands, which lessens the amount of oil on the skin’s surface and then lessens the amount of comedones produced.

We have to emphasize that like surgical drainage and excision, isotretinoin is a last resort for severe acne. The side effects with isotretinoin include skin allergies, nausea and vomiting.

Indeed, you have many cystic acne treatment options to get you out of your misery. The most important thing is to work with your dermatologist.