Most people struggle with acne at some point in their lives, but cystic acne is to regular acne as a broken bone is to a bruise. Cystic acne affects deeper levels of tissue, and is characterized by fluid-filled, painful cysts under the skin. Sufferers are at a high risk for scarring, and need to be treated by a dermatologist who knows how to get rid of cystic acne. Fortunately, there are more treatment options than ever before.
While antibiotics are becoming somewhat less effective because the bacteria that cause cystic acne have built up resistance, tetracyclines and erythromycins can still help get rid of cystic acne, either alone or in conjunction with other treatments. Like most medications, these antibiotics can have side effects, including photosensitivity, stomach pain, oral discomfort, liver damage and pregnancy complications.
Topical retinoids open clogged pores to allow other medications to reach the bacteria that are causing the cystic acne. Examples include adapalene, tazarotene and tretinoin. They may seem to make things worse initially, causing increased redness and peeling, but cystic acne usually improves within several weeks. Side effects include photosensitivity, dryness, redness and peeling. Women who are pregnant or breastfeeding should not use tazarotene.
Oral (Systemic) Retinoids
Oral retinoids like isotretinoin (Accutane) are very effective in getting rid of cystic acne. They’re usually taken for six months to a year, and sometimes result in long-term remission. However, there can be severe side effects, including depression, miscarriage, birth defects, deafness and bowel disease. Because of that, many doctors won’t prescribe oral retinoids until other options have been exhausted.
Once used only to repair scars, laser therapy is now used as a means of getting rid of cystic acne. Lasers burn away the follicle sac and sebaceous glands, and sometimes even kill the bacteria that are causing the acne. This treatment can also result in overall improvement in the skin’s appearance. Side effects and risks are lower than with other forms of treatment, but some patients have been burned because a laser’s cooling system malfunctioned.
While you should never try to “pop” or drain cystic acne yourself (the inflammation is too deep, and you’ll just increase the risk of scarring), professional surgical excision can be a very effective treatment. Doctors make a small incision, remove the infected tissue and drain any fluid. Skin is numbed for the procedure, and pain medications can help when the numbing agent wears off.
Intralesional Corticosteroid Injections
Steroids reduce inflammation but, when used systemically (absorbed throughout the body), can have quite a few side effects. Injections allow a doctor to administer steroids directly to a lesion, thereby avoiding systemic absorption. When a doctor injects a steroid solution directly into a cyst, it softens, flattens and, within about a week, heals. Steroid injections also reduce the risk of scarring. Side effects can include pitting of the skin that is usually temporary.
Photodynamic, or “light” therapy, is an emerging treatment that shows a lot of promise in how to get rid of cystic acne. It shrinks the skin’s oil glands, and may even kill some of the bacteria that causes acne in the first place. In some cases, patients even see improvement in older acne scars. Photodynamic therapy involves several treatments over a period of weeks, and patients need to avoid any sun exposure for 48 hours after a treatment. Side effects can include redness, peeling and crusting.
For women wondering how to get rid of cystic acne, hormones can be both the culprit and the cure. Women can take oral contraceptives that block or reduce the effects of the acne-causing hormones. The FDA has approved 3 oral contraceptives for use in treating cystic acne: Ortho Tri-Cyclen, Estrostep and YAZ. Each is a combination pill, which means they contain both estrogen and progesterone. Progesterone-only pills can actually make cystic acne worse. As with all oral contraceptives, side effects can be serious, including blood clots, high blood pressure and stroke.
There are a number of effective options for people wondering how to get rid of cystic acne. Don’t keep suffering; contact a dermatologist today. Before beginning any course of treatment to get rid of cystic acne, thoroughly discuss the risks and benefits, especially if you’re pregnant, breastfeeding or likely to become pregnant. Your dermatologist will help you choose the treatment that’s right for you.