Although millions of people struggle with acne, those who have cystic acne are aware of how challenging it is to treat in comparison to regular pimples. According to Dr. Emma Weiss, an assistant professor of dermatology at the University of Colorado, Anschutz Medical Campus and a board-certified dermatologist, cystic acne is a severe form of acne that causes large, pus-filled cysts beneath the skin’s surface. Depending on the severity, these cysts can cause scarring. However, it is feasible to treat cystic acne, and in order to prevent irreversible scarring, specialists advise beginning therapy right away.
I talked to board-certified dermatologists about the best over-the-counter and prescription therapies to look for in order to assist you decide how to reduce the appearance of cysts or get rid of them completely. Below is a list of their recommended goods to utilize in conjunction with more severe treatments.
GO Ahead and SkipWhat causes cystic acne, what are the best therapies for it, what active components can assist, and why should I trust NBC Select?
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Best overallDifferin Adapalene Gel 0.1% Acne Treatment
$12.79$15.99Amazon
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Best face washCeraVe Acne Foaming Cream Face Cleanser
$13.59$17.99Amazon
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Best body washPanoxyl Acne Foaming Wash
$undefined$9.77Amazon
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Best spot treatmentNeutrogena Rapid Clear Stubborn Acne Spot Gel
$9.98$13.39Amazon
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How to treat cystic acne
You may be familiar with over-the-counter acne remedies that can cure common, everyday pimples, such as benzoyl peroxide, salicylic acid, and retinol (a vitamin A derivative). But according to our experts, these acne-fighting chemicals aren’t powerful enough to treat cystic acne on their own.
According to specialists, treating cystic acne necessitates seeing a dermatologist and probably involving some kind of medical intervention. In order to address the underlying causes of the cysts, some of the most successful therapies include oral prescription drugs such as spironolactone, isotretinoin (often marketed under the name Accutane), and in-office cortisone injections. According to Weiss, the most crucial lesson learned is that early management is necessary for cystic acne in order to avoid severe scarring.
Cystic acne is very difficult to treat topically. Over-the-counter medications might be able to reduce and lessen the irritation. However, it’s far more difficult to make it go away, and using [OTC medicines] by itself won’t work, according to board-certified dermatologist Dr. Mona Gohara of Dermatology Physicians of Connecticut.
Nonetheless, some over-the-counter acne remedies work better when combined with stronger prescription medications. Dr. Tracy Evans, a board-certified dermatologist and medical director of Pacific Skin and Cosmetic Dermatology, advises using an oil-free moisturizer that is kind to the skin and cleansing your skin at least a few times a week with a wash that contains salicylic acid or oralpha hydroxy acids (AHAs) like lactic acid. Weiss advises people with acne-prone skin to avoid clogging their pores by using noncomedogenic lotions, cosmetics, and other face treatments.
How I picked the best cystic acne treatments
According to dermatologists, over-the-counter products can aid you, even though they can’t treat cystic acne. Take into account the following elements when looking for treatments for cystic acne:
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Ingredients:
Look foracne-fighting active ingredients
like salicylic acid, benzoyl peroxide and adapalene. Since people with moderate to severe cystic acne tend to have
sensitive
and inflamed skin, you should also consider a gentle formula that s free of alcohol, fragrance or abrasive scrubs to prevent irritation.
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Formulation:
All of the products I recommend are noncomedogenic, meaning they re less likely to clog pores and help prevent new breakouts from forming. -
Product type:
Consider what type of OTC product fits into yourskin care routine
, especially when pairing them with prescription medications. Types of products that can help treat cystic acne include
face cleansers
,
gentle moisturizers
and gel spot treatments.
Best cystic acne treatments
When combined with oral drugs and in-office treatments, the over-the-counter remedies listed below can help treat cystic acne, according to experts.
Best face washes for cystic acne
CeraVe Acne Foaming Cream Face Cleanser
CeraVe Acne Foaming Cream Face Cleanser
- Hydrating ingredients
- Removes makeup
- Anti-inflammatory
- Not for very dry skin
According to Weiss, if you have cystic acne on your face and other parts of your body, this foamy cleanser with 4% benzoyl peroxide is a fantastic choice. Because of its moisturizing and anti-inflammatory properties, it contains other components like niacinamide and hyaluronic acid that may be beneficial for those with acne, she explains. CeraVe claims that this wash helps stop the formation of fresh acne by gently removing makeup, oil, and debris. For people with sensitive skin, the noncomedogenic wash is also fragrance-free.
Neutrogena Oil-Free Salicylic Acid Acne Wash
Neutrogena Oil-Free Salicylic Acid Acne Wash
- Oil-free
- Removes dead skin
- Unclogs pores
- Can irritate sensitive skin
Board-certified dermatologist Dr. Eileen Deignan, chief of dermatology at Emerson Hospital, recommends this foamy cleanser because it helps clear clogged pores and soothe acne-related discomfort. According to Weiss, the face wash’s 2% salicylic acid helps unclog pores and eliminate dead skin cells. The manufacturer claims that because it is free of oils, perfumes, and parabens, it is appropriate for the majority of skin types.
Panoxyl Acne Foaming Wash
Panoxyl Acne Foaming Wash
- Can use on body
- High level of benzoyl peroxide
- Reduces dark spots
- Not for very sensitive skin
- Can bleach towels
- Strong scent
You can use Panoxyl’s foamy wash to treat cystic acne on your face and body if you have oily or non-sensitive skin. The greatest concentration of the acne-fighting ingredient on this list, 10% benzoyl peroxide, is present in its recipe. Weiss advises incorporating the product gradually into your skin care regimen because some people, particularly those with sensitive skin, may find the high quantity of benzoyl peroxide uncomfortable.
Best exfoliants and spot treatments for cystic acne
Paula s Choice Skin Perfecting 2% BHA Liquid Exfoliant
Paula s Choice Skin Perfecting 2% BHA Liquid Exfoliant
- Gently exfoliates
- Unclogs pores
- Oil control
- Not for very sensitive skin
A favorite among our NBC Select employees, this liquid leave-on exfoliator contains 2% salicylic acid to help clear clogged pores, eliminate dead skin, and combat acne. According to the firm, green tea is also used in its formulation to assist reduce inflammation. As long as your skin can handle it, you can use this exfoliator up to twice a day.
Neutrogena Rapid Clear Stubborn Acne Spot Gel
Neutrogena Rapid Clear Stubborn Acne Spot Gel
- Prevents future breakouts
- Can use daily
- Can bleach fabrics
According to Gohara, who frequently suggests this product to her patients with cystic acne, you can apply this spot therapy gel immediately on top of acne to lessen its size and redness as well as actively prevent new breakouts. It contains 10% benzoyl peroxide. One to three times a day, Neutrogena advises using a thin layer of the acne gel.
Best OTC retinoids for cystic acne
Differin Adapalene Gel 0.1% Acne Treatment
Differin Adapalene Gel 0.1% Acne Treatment
- Prevents new pimples
- Pump packaging
- Cures inflammation
- Takes some time to work
- Not for very sensitive skin
According to Weiss, products containing adapalene, the sole over-the-counter topical retinoid, can be beneficial when combined with other prescription medications. They can reduce inflammation, deeply cleanse pores, and stop new pimples from appearing. Following cleansing and prior to moisturizing, the manufacturer advises applying a thin layer of Differin Gel to the skin’s afflicted regions.
La Roche-Posay Effaclar Adapalene Gel
La Roche-Posay Effaclar Adapalene Gel
- Oil-free
- Prevents new pimples
- Not for sensitive skin
La Roche-Posay’s Effaclar Adapalene Gel, which includes 0.1% adapalene to help unclog pores and combat acne, is another adapalene product that Weiss suggests. The gel is noncomedogenic and free of oil and smell.
Best moisturizers for cystic acne
CeraVe Daily Moisturizing Lotion
CeraVe Daily Moisturizing Lotion
- Good for sensitive skin
- Thick yet lightweight
- Gentle formula
- Nothing to note at this time
To maintain the integrity of their skin barrier, I advise my acne-prone patients to use a mild, noncomedogenic moisturizer, adds Weiss. Expert-favorite CeraVe’s daily moisturizing lotion is suitable for sensitive skin because it is fragrance-free and approved by the National Eczema Association. According to CeraVe, the lotion contains hyaluronic acid and ceramides to help the skin retain its natural moisture for up to 24 hours.
La Roche-Posay Toleriane Double Repair Face Moisturizer
La Roche-Posay Toleriane Double Repair Face Moisturizer
- Reduces redness
- Good for sensitive skin
- Lightweight
- Thinner consistency
According to the brand, this La Roche-Posay moisturizer is one of our top expert-recommended face moisturizers for rosacea and acne-prone skin. It is mild enough for sensitive skin and contains ceramides and niacinamide to keep it hydrated. Because it helps reduce my persistent redness and irritation, I use this moisturizer day and night on my sensitive skin, which is prone to acne and rosacea. According to La Roche-Posay, the moisturizer provides 48-hour moisture and is suitable for use on the hands, face, and neck.
What causes cystic acne?
Because of the buildup of oil, germs, and dead skin cells, cystic acne, a form of inflammatory acne, results in deep, excruciating lesions beneath the surface. According to Weiss, cysts can range in severity from minor (you may have one or two cysts on your chin around your menstrual cycle, for instance) to severe (affecting the entire face, including the chest and upper back).
According to Weiss, cystic acne can be brought on by hormonal shifts or triggers associated with puberty, menopause, and pregnancy, as well as underlying medical problems including polycystic ovarian syndrome (PCOS), stress, and heredity. According to her, teens going through puberty and those with a family history of the condition may also be more susceptible to getting cystic acne.
What active ingredients can help treat cystic acne?
Salicylic acid, benzoyl peroxide, and adapalene are the three major active components found in over-the-counter medications that can help reduce inflammation brought on by cystic acne. These active compounds can be beneficial if used in conjunction with prescription drugs and in-office treatments, even if they probably won’t be able to fully treat cystic acne on their own. However, keep in mind that all of these chemicals have the potential to irritate skin, so delicate skin may not benefit from using them. Instead, you should incorporate them into your skin care regimen gradually.
Salicylic acid
Salicylic acid is a chemical exfoliant and beta hydroxy acid (BHA) that helps fight acne by targeting excess oil production, unclogging pores and removing dead skin cells, says Weiss. Typically, lotions, washes, and creams include 2% salicylic acid.
Benzoyl peroxide
According to Weiss, benzoyl peroxide specifically combats germs that cause acne to help lessen inflammation and the visibility of acne lesions. Products with extremely high benzoyl peroxide concentrations (about 10%) are common, however there isn’t much proof that stronger concentrations are better for treating acne.
According to Gohara, some research really indicates that the effectiveness of 2.5% and 10% benzoyl peroxide in treating acne differs very little. People with cystic acne that experience sensitivity or dryness may be able to tolerate the lower strength ingredients better, says Weiss.
Adapalene
Retinoids are more potent acne medications that have the potential to lower inflammation. Topical retinoids help increase skin cell turnover and clear out clogged pores, which may be contributing to the initial cause of cystic acne, says Weiss. While prescription retinoid gels and creams are the most effective at treating cystic acne, adapalene a topical OTC retinoid treatment works well to regulate the turnover of cells lining the pores to reduce clogging.
Keep in mind that adapalene can be very drying, so you should introduce this ingredient gradually into your skin care routine, using a small amount and moisturizing afterward, according to Gohara. Your skin is already irritated with the cystic acne, the last thing you want to do is stoke the fire, she says.
Frequently asked questions
One of the biggest concerns with cystic acne is the potential for severe and even permanent scarring, which is why you ll want to get on a treatment that will take care of cystic acne sooner rather than later, says Evans. People who have very severe cystic acne can scar very quickly, she says.
Scarring is always hard to treat, andcystic acne scarsmay require more intensive treatments like laser resurfacing of the skin, microneedling, hydrafacials and injectables that can break up the scar tissue using small needles, says Evans.
Here s some advice from our experts on what to keep in mind and some common misconceptions to avoid when crafting your cystic acne skin care routine.
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Simplify your routine
. Don t go overboard with the number of active ingredients you re introducing into your routine. If you re experiencing irritation or dryness, consider only using one or two active ingredients at a time or using the lowest percentage of salicylic acid or benzoyl peroxide so that it s not too irritating, says Weiss. -
Gradually introduce products
. I always recommend to my patients that they should be using products in a really slow and incremental way, says Gohara. When using more irritating ingredients like benzoyl peroxide and adapalene, start with a pea-sized amount once or twice a week, and then gradually increase it to three times a week while monitoring any irritation, says Gohara. -
Avoid harsh scrubs.
There s a common misconception that you should dry out acne, so people often use too many strong, irritating products, says Evans. This is a condition that needs to be treated from the inside out, so you have to be more gentle with your skin care, she says. Because cystic acne can cause very sensitive, inflamed skin, you should avoid using irritating products that contain alcohol or abrasive scrubs with small beads, which can cause microtears on the skin and lead to a damagedskin barrier
, experts say.
Meet our experts
At NBC Select, we work with experts who have specialized knowledge and authority based on relevant training and/or experience. We also take steps to ensure that all expert advice and recommendations are made independently and with no undisclosed financial conflicts of interest.
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Dr. Emma Weiss
is a board-certified dermatologist and assistant professor of dermatology at the University of Colorado Anschutz Medical Campus.
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Dr. Tracy Evans
is a board-certified dermatologist and medical director of Pacific Skin and Cosmetic Dermatology.
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Dr. Mona Gohara
is board-certified dermatologist at Dermatology Physicians of Connecticut.
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Dr. Eileen Deignan
is a board-certified dermatologist and chief of dermatology at Emerson Hospital.
Why trust NBC Select?
I’m anupdates editorat NBC Select who has covered a wide range of skin care topics, includingface sunscreens,rosaceaandkeratosis pilaris treatments. For this article, I spoke to four dermatologists about how to treat cystic acne and highlighted their recommendations for the best over-the-counter products to consider.
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