Cystic Acne: Getting Clear Without Accutane
When Accutane debuted in 1982, it was hailed as a miracle drug. It provided complete remission of severe cystic acne for 85% of patients within five months. But years of controversy followed as the drug was linked to serious risks, including depression, psychosis, suicide, miscarriage, and birth defects. Those risks, coupled with unpleasant side effects like excessive peeling and extreme dryness of the nasal cavities and lips, made Accutane a drug of last resort.
So, are there effective alternatives to Accutane that don’t come with a laundry list of caveats? Read on for the best way to clear cystic acne without isotretinoin . First, a little context to help better understand your options.
What Causes A Blind Pimple
Blind pimples are typically triggered by a surge of hormones, which makes sense why they commonly occur around someone’s menstrual cycle. During this time, the skins oil glands become hypersensitive to the hormonal surge and react by overproducing sebum, which can cause the gland to become engorged, swollen, or hardened, Rouleau says.
There are lots of different causes of acne, but as Dr. Yadav puts it, blind pimples form just like any other pimple: Bacteria + sebum + a congested pore = inflammation beneath the skin. What sets blind pimples apart from other breakouts is that theyre not at the skins surface, but deeper in the skin at the subcutaneous level, Dr. Yadav notes. And that, my friends, is why theyre impossible to pop, slow to heal, and quite painful to deal with.
Ii Do Not Use Harsh Products
Us the correct ratios when making pastes and masks to apply on the skin. Some products like vinegar may irritate if not used well. Alcohol-based products are not recommended for use on the skin because there is a chance they might irritate. Use purified water each time you are mixing the masks to encourage clearer skin and reduce further breakouts.
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Use A Gentle Cleanser
A good quality cleanser will help to remove excess sebum, dead skin cells, cosmetics and other substances that can clog your pores and cause acne breakouts.
Its best to use a cleanser at least once a day. Choose a gentle cleanser thats formulated to clean and hydrate your skin without stripping away excess moisture, such as our Deep Sea Cleanser for Acne.
When you wash your face, use your fingertips to gently apply cleanser to your skin. Its best not to use a washcloth, sponge or cleansing brush, as these could irritate your skin and make your acne breakouts worse.
What Is Severe Acne

Severe acne causes breakouts that often extend deep into the skin. Called cysts and nodules, these breakouts tend to be painful. When severe acne clears, acne scars often appear.
You may also see many blackheads, whiteheads, or both when acne is severe.
Anyone who has severe acne knows how stubborn it can be. You cannot clear it with acne treatment that you buy at the store. To see clearing, you either have to wait it out or see a dermatologist. Waiting out severe acne can take years.
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Easy Steps To Treat A Red Painful Cystic Pimple
Most of us know how to deal with the odd spot, but those deep, often painful cystic pimples that emerge under the surface of the skin need to be approached with caution. Acne can appear in several shapes, sizes and formsfactors such as poor hygiene, hormone imbalances, diet and genetics can exacerbate them. Sporadic surface spots such as blackheads and whiteheads can be easily removed with exfoliation, deep cleansing and extractions, explains Dr Howard Murad, a board-certified dermatologist based in Los Angeles.
If the skin does not heal normally, the follicle wall may rupture, and the skin surface becomes red and swollen. Pustules are the next stage of the process when a severe inflammatory reaction can result in large, tender pus-filled lesions in the deeper layers of the skin, which are called cysts, he adds. Dermatologists class these spots as the most severe and difficult to treat, but there is plenty you can do to tackle and tame the occasional cystic spot at home.
Causes Of Nodular Acne And How To Treat It
Nodular acne is a severe form of acne that causes large, inflamed, and painful breakouts called acne nodules. Acne nodules are larger and more serious than a typical pimple and affect deeper layers of the skin. Nodular acne can appear on the face, back, and the body.
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What Are Cystic Pimples
Cystic pimples are a severe form of acne.
These pimples occur when cysts develop deep in the skin. They are often painful, and present as hard bumps on the skin. Typically, cystic pimples are red in color, and there can be swelling in the skin around the actual bump.
Beyond the pain, perhaps the most frustrating aspect of cystic acne is the time it takes for the pimples to clear up. It can take 1 to 4 weeks for a cystic pimple to clear sometimes even longer.
Ask Your Doctor About Prescription Meds
If you have regularly occurring blind cysts or regular cysts, internal prescription treatment is the best treatment option, although its more of a long-term solution than a quick fix. There are four categories of internal treatments: antibiotics, birth control pills, Accutane, and spironolactone, Dr. Schultz says. The root cause is excess oil stimulated by hormones, and all of these treatments in some way reduce the production of oil or the effect bacteria has on that oil.
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What Are Whiteheads Nose Chin Face
Whiteheads are small, raised bumps on the surface of the skin, and they are another form of clogged pore that can be a precursor to pimples. Similar to blackheads, whiteheads form when the hair follicle fills with sebum. Unlike blackheads, whiteheads havenât pushed all the way through to the skinâs surface, so they are considered closed off from air that turns the sebum dark or black.
Whiteheads are sometimes called closed comedones. They often appear on the face, especially the chin and nose.
Cover Your Blind Pimple With A Zit Sticker
If youve used a warm compress to draw the pimple up and out of your skin, try topping the area afterward with a hydrocolloid pimple patch, which Dr. Yadav explains, will help accelerate your skins recovery after the pimple has been eradicated. Or you can always slap on some pimple patches to keep bacteria out and stop yourself from picking your cystic acne while you wait for it to heal on its own.
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How To Shrink A Cystic Pimple
Jake Agneweditorial policyhow we make moneyIn this articleThe Bottom Line
Cystic pimples are some of the most frustrating forms of acne. They are often painful, and can linger for weeks.
If you are looking into how to shrink a cystic pimple, read on for at-home and professional treatment options, as well as preventative steps.
How To Get Rid Of Redness From Acne Fast: Treatments And Home Remedies

- Inflamed acne lesions cause redness on the skin
- When inflammation is reduced this color will fade
- Over-the-counter and prescription medications can help ease the redness and inflammation by treating acne
- Some home remedies can temporarily remove the redness of acne blemishes within hours of application
While it is difficult to completely eliminate acne blemishes quickly, there are many treatments that can effectively treat acne and reduce the associated redness in the long term through the use of over-the-counter or prescription medications. To temporarily get rid of redness from acne blemishes within a few hours of application, you can turn to some effective home remedies.
Contents
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What Are Other Cystic Acne Treatments
Other treatments for cystic acne include:
- Corticosteroid injections: Used to quickly shrink large, painful acne cysts.
- Incision and draining: Helps to open up an acne cyst and drain the pus.
- Birth control pill or spironolactone: Used by women to lower hormone levels that cause cystic acne.
- Isotretinoin: An oral retinoid .
How To Treat Acne Scarring
Ideally, the best way to treat acne scars is to be proactive and prevent them from forming in the first place. You can accomplish this by seeking treatment for your acne early. Avoid picking or popping your acne cysts, which increases the risk of infection and scarring. Try to wash your face each evening, and after sweating, with a gentle cleansernever scrub your face. You should also wear sunscreen anytime you are in the sun.
Despite all of these measures, some people still end up with acne scars. Fortunately, several treatments can help but may require more than one session to achieve optimal results.
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Cocktail A Spot Treatment
K, dont get too excitedno topical product will get rid of your cystic zit at home, aside from time . BUT, a cocktail of benzoyl peroxide and 1 percent hydrocortisone cream can help flatten the zit faster, says Dr. Gohara. Both are anti-inflammatories that will help calm the bump, and the less inflammation you have now, the less hyperpigmentation and scarring youll have when the zit heals, she says. So once a day for one week, dab benzoyl peroxide on the cyst, let it dry, and then tap on a thin layer of hydrocortisone cream.
Experiment With Acne Lasers
There are a few different types of in-office lasers your dermatologist can use to target and destroy bacteria within your skin, the most popular of which is Aerolase. Aerolase penetrates the skin, kills bacteria thats involved with acne, and also delivers whats called a heat shock that shrinks the oil glands and helps cut down on oil production, says Dr. Howe.
Its not overly painful, and it can be effective on some types of acnebut only to a certain degree, and not on everyone. I always warn patients that its expensive, around $300 to $400 per session, and results will depend on their acne, says Dr. Howe, who uses Aerolase in conjunction with a tried-and-true hormonal acne treatments, like a topical prescription and/or an oral prescription. Just know that lasers are not a long-term fix: Almost all patients will need a monthly maintenance treatment, he says.
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Which Products Help Treat Cystic Acne
Start with an oil-free cleanser
“Think of your cleanser not as a true wash, but rather as a short-contact therapy,” Dr. Zeichner suggests. For this reason, he typically recommends that patients with cystic acne use cleansers that contain high concentrations of salicylic acid, a beta hydroxy acid that helps shrink cystic pimples by removing excess oil, sloughing off dead skin cells, and drying them out.
Typically, salicylic acid concentrations range between 0.5 to two percent, and if you’re prone to cystic acne, Dr. Zeichner recommends looking for a cleanser that leans toward a higher concentration. A couple of great 1.5 to 2 percent salicylic acid-based cleansers include La Roche-Posay Effaclar Medicated Acne Face Wash and Murad Clarifying Cleanser.
Dr. Zeichner says to apply the cleanser and let it sit while you sing the alphabet before rinsing it off. “The cleanser needs enough contact time with the skin for the active ingredients to exert their effects.”
Follow up with an oil-free moisturizer
Even if you’re prone to cystic acne, you should still use a facial moisturizer regularly in order to maintain a healthy skin barrier. “Patients who are prone to cystic breakouts should use oil-free, noncomedogenic moisturizers to hydrate their skin,” says Maryland-based board-certified dermatologist Ife Rodney, M.D.
What Not To Do
While a cystic pimple heals, it is important to be gentle with the skin.
Do not try to pop, pick, or squeeze a cystic pimple. It may be tempting, but popping a pimple can introduce more bacteria to the pore, slow healing, drive the infection deeper into the skin, and increase the chance of scarring.
In addition to not popping a pimple, the AAD advise that people avoid:
- touching the face unnecessarily
- using harsh skin care products, particularly those that contain alcohol
- tanning, either outside or on tanning beds
- applying toothpaste or other home remedies found online
Many home remedies for acne are not based on strong evidence. Some may be ineffective, while others may do more harm than good. As a result, it is best to follow advice from trusted sources or a board-certified dermatologist.
Cystic acne is a severe type of acne. Doctors sometimes call it nodulocystic acne. It occurs when large acne cysts or nodules form, penetrating deep into the skin.
The symptoms of cystic acne include:
- large, painful pimples
- lumps under the skin that may not come to a head, or that may take weeks to come to a head
- inflammation and swelling on the skin
This type of acne can take longer to heal than other types. It is also more likely to cause scars than less severe types.
There are a that can contribute to this, including:
Some people also find that certain foods aggravate acne, such as foods with a high glycemic index and dairy products.
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Bacteria & Oil Buildup
Cystic acne is the result of a buildup of bacteria and sebum, but this does not occur because someone doesnt wash their face enough. Instead, cystic acne can be triggered by other environmental factors, including the products we use on our skin.
Wearing makeup or tight clothing for long periods of time can exacerbate cystic acne by trapping moisture, sweat, and oil.
Acne Bacteria And Acne Inflammation

Acne bacteria usually get the blame for acne inflammation, but they do not really injure the skin. Instead, they secrete chemicals that make surrounding skin cells sensitive to inflammation generated by the immune system itself. Destruction of the skin gives them an escape route to travel to a new home. In fact, small numbers of acne bacteria are actually beneficial to the skin.
The skin makes sebum to keep itself flexible and to keep itself from drying out. Many of the things people do to dry out their acne actually increase the production of sebum. Swabbing the skin with rubbing alcohol, for instance, does just this. When the skin is stressed or stretched or inflamed, sebaceous glands near pores produce more sebum to protect the skin. When the body as a whole is stressed, the brain releases corticotropin stimulating hormone, which also triggers production of excessive sebum.
Acne bacteria feed on sebum to keep it from accumulating faster than pores can transport it to the surface, where it can be washed away. As long as the pore is filled with fresh, liquid sebum, the bacteria can feed and multiply. As sebum ages, however, it releases essential fatty acids. These are beneficial to the skin, but toxic to bacteria. The skin regulates the number of bacteria in pores, keeping the population of bacteria the right size to be helpfuluntil pores get clogged.
The bacteria secrete chemicals that make the skin more sensitive to a substance called interleukin-8.
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Iii Do Not Use Very Hot Water
Some methods, like hot pressing, involve the use of hot water. However, you should not use water that will cause burns to your skin. Hot water can cause severe burns if enough care is not taken. The best thing to do is let the towel or the teabag cool off a bit before applying them to your skin. Tea bags have a thin layer that will transfer all the heat from the tea leaves. The objective is to get nicotine transferred and not burns.
Hot water causes dry skin. Therefore, after using hot water when cleansing, apply moisturizer on your skin to prevent dryness and flaking. Dry skin will encourage more acne on your skin by leading to the production of dead skin, which ends up clogging the pores.
Foods That Cool Inflammation And Improve Acne
Alright, time for some antidotes. Heres a list of the most potent foods you can eat to stop inflammation in its tracks:
- Fish for the anti-inflammatory omega-3 fats
- Oysters (zinc, selenium, and DHA all join to reduce inflammation
- Ginger
- White tea
- Free-range eggs
This is just a small sampling of all the great healthy and anti-inflammatory foods out there. By focusing on foods like these, and avoiding the worst inflammatory foods from above, you practically guarantee clear skin.
Thats not an exaggeration.
Thats how powerful of an effect food has on acne.
Not only do the inflammatory foods above cause inflammation , they also block your pores and cause your skin to produce excess oil , so youre really attacking acne from three sides by removing these foods. Together, these diet modifications are the single most effective way to get rid of acne that Ive ever seen. Better than Proactiv, longer-lasting than laser treatments better than everything.
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Home Remedies For Cystic Acne
- Try topical creams like Retinoid A . A dermatologist can also prescribe higher strength retinoids.
- Use warm compresses to soothe inflammation. Make sure to use a clean washcloth and dont use water thats too hot. This can help encourage pus to come to the surfacebut dont pop the pimple once it has.
- Remove makeup every single night before going to bed. It may also help to choose products that are labeled non-comedogenic or oil-free to combat build-up under the skin.
- Use a gentle facial cleanser. Harsh scrubs can further irritate and dry out your skin, which can lead to excess oil production as your skin works to make up what was lost. You should wash your face at least once per day in the evening before bed with a gentle cleanser.
- Avoid picking at your skin to lessen irritation and prevent infection from spreading. If you find yourself unconsciously touching irritated areas, try covering cysts with an adhesive bandage and keeping your nails short.
- Consider your diet.There is evidence that a low-glycemic diet can help alleviate acne. It may help to cut back on sugar and other high-glycemic foods like white bread, potatoes, and pasta.
Dont use homemade remedies like toothpaste, baking soda, honey, or sugar on your skin. These substances can irritate and clog your pores, and do not work at combating cystic acne.