Cystic Acne: Identification, Causes, Symptoms, And Treatment

Medically Reviewed By Dr. Aanand Geria, MD
Written by Pooja Karkala

Cystic acne is a severe form of acne. It is painful and usually requires medical attention. If not treated properly, it may cause permanent scarring. It is always best to consult a doctor for proper treatment. However, you can also manage and soothe the irritation and inflammation with home remedies. In this article, we have discussed everything you need to know about cystic acne, home remedies to calm it, and treatment options. Take a look!

How To Identify Cystic Acne

Cystic acne is a severe form of acne (1). It is formed deeper within the skin and is larger than any other form of acne. The cysts have a smooth surface and appear a bit shinier due to the tightness of the skin. Cystic acne usually appear on the face, neck,

back, chest, arms, and behind the ears. It occurs as painful large pus-filled white bumps. Redness and inflammation are other identifying characteristics of this condition. Cystic acne usually leaves permanent deep pits (ice pick scars) or shallow depressions on the skin.

From hormonal changes in puberty to using certain skin care products, several reasons can trigger cystic acne. Scroll down to know more about it!

Causes Of Cystic Acne

Acne is caused when dirt, impurities, sebum, and bacteria get trapped in the skin pores, leading to inflammation. When the infection is deep, and the inflammation is severe, cysts or nodules are formed.

The hormonal changes in adolescence are a major factor behind cystic acne. High androgen levels may increase sebum production and clog the pores, trapping dirt and bacteria. Other factors that may trigger cystic acne include:

  • Hormonal fluctuation during pregnancy, menstrual cycle, and menopause
  • Certain medications like corticosteroids, birth control pills, and hormonal therapies
  • Certain chemicals in skin care products
  • Genetics and conditions like polycystic ovary syndrome (PCOS)

Cystic acne is problematic and needs immediate attention and care. Find some of the best natural ways to soothe painful cystic acne below.

Home Remedies For Cystic Acne

Note: These remedies will not treat cystic acne. They may only help in soothing the inflammation.

1. Baking Soda

You Will Need

  • 1-2 tablespoons of baking soda
  • 1 tablespoon of water

What You Need To Do

  1. Mix the ingredients to form a paste.
  2. Apply it to the affected areas and leave it on for a minute.
  3. Wash it off with lukewarm water and pat dry.
  4. Follow up with a moisturizer.

How Often?

Once or twice a week.

Why This Works

Baking soda fights acne-causing bacteria and dries up excess sebum to reduce the inflammation (2). Apply the paste to the affected area in slow, circular motions.

2. Apple Cider Vinegar

You Will Need

  • 1 tablespoon of raw apple cider vinegar
  • Cotton buds
  • 1 tablespoon of water

What You Need To Do

  1. Dilute the ACV with water.
  2. Apply the mixture with the cotton bud as a spot treatment.

How Often?

Do this twice a day.

Why This Works

Apple cider vinegar is said to balance the skin pH, helping maintain its acid mantle and soothing the inflammation.

3. Epsom Salt

You Will Need

  • 2 tablespoons of Epsom salt
  • 1 ½ tablespoons of baking soda
  • Warm water

What You Need To Do

  1. Mix the ingredients to form a paste.
  2. Apply it as a spot treatment to the affected areas and let it dry for a few minutes.
  3. Wash it off with warm water.

How Often?

Do this every alternate day.

Why This Works

Epsom salt has pain-relieving properties and is often used in traditional remedies. It may help reduce swelling and pain and provide relief. This remedy works best for oily to combination skin types.

Caution: The paste can dry the skin. Seek medical help if you experience irritation.

4. Neem Oil

You Will Need

  • 2-3 drops of pure neem oil
  • Cotton pads

What You Need To Do

  1. Clean your face and apply neem oil with a cotton pad to the cystic acne.
  2. Leave it on overnight and wash it off in the morning.

How Often?

Do this two to three times a day.

Why This Works

Neem oil is used as an alternative remedy for acne (3). It may help reduce inflammation and redness associated with cystic acne.

5. Witch Hazel

You Will Need

  • 1 teaspoon of witch hazel
  • Cotton ball

What You Need To Do

  1. Dab the cotton ball soaked in witch hazel on the cleansed affected areas.
  2. Leave it on.

How Often?

Use it twice or thrice every day as a toner after you wash your face.

Why This Works

The antiseptic and astringent properties of witch hazel can soothe acne and reduce inflammation (4).

Home remedies may only help manage the redness and inflammation. You need proper treatment for cystic acne. Check out the over-the-counter treatment methods available for cystic acne below.

Treatments Options For Cystic Acne

1. Retinoids And Isotretinoin

Retinoids and isotretinoin are vitamin A derivatives and potent prescription medications for cystic acne (5), (6). These are usually available in the forms of creams, lotions, and ointments.

Doctors often prescribe oral Accutane for treating severe cystic acne. However, avoid taking this if you are pregnant, as it may cause birth defects. Other potential side effects include mood disorders, liver problems, dry eyes, blood in urine, increased skin sensitivity to the sun, and muscle or joint pains (7). Hence, talk about all possible side effects with your doctor before starting the medication.

2. Oral Antibiotics

Oral antibiotics can treat severe inflammatory acne. These are often combined with topical retinoids and benzoyl peroxide to reduce inflammatory and comedonal lesions.

Antibiotics like tetracyclines (doxycycline and minocycline) and macrolides (azithromycin and erythromycin) have antibacterial effects and reduce the proliferation of acne-causing bacteria (8). Oral antibiotics also cause some side effects, including sun sensitivity, vomiting, abdominal pain, diarrhea, and nausea. Consult your doctor before using them.

3. Spironolactone And Corticosteroids

Spironolactone is a steroid used for treating severe acne. Studies found that a dose of 50 to 100 mg per day could reduce excess sebum production and reduce inflammation (9).

Spironolactone and corticosteroids can regulate excess androgen levels and reduce acne inflammation. This treatment is often prescribed for treating hormonal acne. However, it may cause breast enlargement in men (10). Also, if you are pregnant, consult a doctor before taking steroids and spironolactone.

4. Oral Contraceptives

Oral contraceptives are a viable option for controlling hormonal fluctuation and acne. Birth control pills balance estrogen levels, decrease androgen levels, and reduce sebum production to reduce acne (11). However, these are not suitable for everyone.

Avoid oral contraceptives if you smoke, have blood clot issues, or trying to get pregnant. Women may experience side effects like breast tenderness, increased vaginal discharge, abdominal cramping, nausea, and headaches (12). It may rarely cause adverse effects like blood clots and heart attacks, especially in women over 35 years.

5. Benzoyl Peroxide

Benzoyl peroxide is available as cleansing liquids and bars, lotions, creams, and gels. It is a bactericidal, keratolytic (breaks down outer layers of skin), and comedolytic (prevents comedone formation) agent. It also has anti-inflammatory properties that reduce acne-causing bacteria and prevent new lesions (13), (14).

Alcohol-based formulations of benzoyl peroxide have a drying effect, making them suitable for oily skin. However, excessive use of benzoyl peroxide may cause skin irritation.

Apart from systemic treatments and home remedies, the following tips can help you prevent or reduce the risk of worsening your acne.

How To Prevent Cystic Acne

  • Cleanse your face twice a day. Avoid using rough scrubs, strong cleansers, and soaps. Use a gentle cleanser in the morning and before sleeping. Rinse your face with lukewarm water.
  • Wear sunscreen to prevent sunburns and tanning.
  • Avoid touching, scratching, and rubbing the acne lesions.
  • If you have an oily scalp, shampoo your hair regularly.
  • Use non-comedogenic and oil-free skin care products.

Summing It Up

Cystic acne is a severe type of acne and is different from regular pimples. It needs special treatment to avoid permanent scars. From hormonal changes and pregnancy to menopause, anything can trigger cystic acne. Consult your doctor to treat the underlying conditions to reduce acne inflammation and try the home remedies discussed in the article to calm and soothe the lesions.


Articles on StyleCraze are backed by verified information from peer-reviewed and academic research papers, reputed organizations, research institutions, and medical associations to ensure accuracy and relevance. Read our editorial policy to learn more.

  1. Acne: more than skin deep
  3. A review of diagnosis and treatment of acne in adult female patients
  4. Antioxidant and potential anti-inflammatory activity of extracts and formulations of white tea rose and witch hazel on primary human dermal fibroblast cells
  5. Management of severe acne
  6. Why Topical Retinoids Are Mainstay of Therapy for Acne
  7. Acne
  8. Oral Antibiotic Therapy for Acne Vulgaris
  9. Oral Spironolactone in Post-teenage Female Patients with Acne Vulgaris
  11. Oral contraceptives in the treatment of acne
  12. Oral Contraceptive Pills
  13. Management of acne

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Dr. Aanand Geria

Dr. Aanand Geria is a board-certified dermatologist and founder of Geria Dermatology in Rutherford, New Jersey. He is an expert in ethnic skin, minimally invasive cosmetic injectables, body contouring, and lasers. He earned his medical degree from Rutgers New Jersey Medical School, graduating with Alpha Omega Alpha honors. Dr. Geria is a fellow of the American Academy of Dermatology and... more