Cystic acne is not just a surface issue; it’s a deeper, more severe form of acne that can cause long-term damage to your skin. Understanding what causes cystic acne, as well as how to prevent and treat it, is essential for those suffering from this painful skin condition. In this article, we’ll cover the root causes of cystic acne, discuss prevention methods, and explore the available treatment options for managing this challenging condition.
Cystic acne is often caused by similar factors that trigger other types of acne but is exacerbated by more intense inflammation, hormonal fluctuations and other internal processes. To understand what causes cystic acne, we need to first look at the general causes of acne.
Acne, in general, occurs when hair follicles become clogged with dead skin cells, sebum (the oil produced by sebaceous glands), and bacteria. This results in inflammation, which leads to the formation of pimples. However, cystic acne goes much deeper. The main difference lies in the level of inflammation and the location of the breakout. While regular acne typically forms on the surface of the skin, cystic acne occurs deeper within the skin’s layers, causing painful, swollen bumps that often feel like they’re under the skin. They are often described as the type of acne with “no head”.
But what causes acne to turn cystic? One of the primary factors is hormones. Fluctuations in sex hormones—particularly androgen hormones like testosterone—cause the sebaceous glands to produce excessive oil. This extra oil can quickly clog pores, leading to more severe forms of acne. Hormonal fluctuations during puberty, menstruation, pregnancy, and conditions like polycystic ovarian syndrome (PCOS) are some of the major contributors. These changes in hormone levels lead to the overproduction of oil, making cystic acne particularly common among teenagers and women in their reproductive years.
Another critical factor is skin type. People with naturally oily skin tend to experience more severe forms of acne, including cystic acne. This is because the excess oil, when combined with dead skin cells, easily clogs pores. Additionally, stress can worsen acne by causing the body to produce more hormones like cortisol, which can trigger oil production. Other triggers include certain skincare products that clog pores, some medications, and a diet that is high in dairy and high-glycemic index foods (e.g bubble tea, chocolate, ice cream). These foods contain dairy and can spike insulin levels, leading to hormonal imbalances that may make acne worse.
While hormones play a large role in cystic acne, several other factors can increase the likelihood of developing this condition.
While you might not be able to change factors like your genetics or hormonal cycles, there are several effective strategies to prevent cystic acne from occurring or worsening. Prevention often involves adjusting your skincare routine and lifestyle choices to reduce triggers.
Cleansing your skin regularly with a cleanser that is effectiv yet gentle is essential to removing excess oil and preventing clogged pores. Avoid scrubbing your skin harshly, as this can make acne worse by irritating the skin. You can combine cleansers by using a gentle cleanser in the morning, and a gentle exfoliating cleanser at night. Gentle exfoliation is particularly important after physical activity or excess perspiration.
Choose skincare and makeup products labelled as non-comedogenic, meaning they won’t clog your pores. Mineral, powder-based makeup is often less likely to clog pores. People with acne-prone skin should avoid using heavy, oily creams and opt for lighter, oil-free moisturisers.
Since stress can trigger hormonal changes that lead to acne breakouts, incorporating stress-reducing activities like yoga, meditation, or regular exercise can help improve skin health. Helping a routine sleep cycle is also effective in minimizing physical stress which can contribute to acne.
Three food types trigger acne- dairy, high glycaemic index foods and processed foods. Foods that are high in sugars and simple carbohydrates, such as white bread and sweets, can trigger acne breakouts. Opt for a diet rich in vegetables, whole grains, and lean proteins, which helps keep your hormone levels balanced. Studies have shown that a Mediterranean diet rich in antioxidants and anti-inflammatory properties can also help mitigate acne.
If you already suffer from cystic acne, prevention alone may not be enough. Cystic acne often requires medical treatment due to its severity. Fortunately, there are several treatment options available.
We have a range of topical retinoids available in Lumine, ranging from adapalene 0.3% to tretinoin 0.025%/0.05% to trifarotene 0.005%. Prescription grade azelaic acid 20% and clindamycin-benzoyl peroxide may also be useful in select individuals.
For more severe cases, oral medications like isotretinoin may be necessary. Isotretinoin, also known as Accutane, is extremely effective for cystic acne and has the potential to induce long term remission of acne. However, it comes with significant side effects and should only be used under close medical supervision.
Now that you know what causes cystic acne, it's essential to understand that results take time. While many over-the-counter products promise quick fixes, treating cystic acne requires a more strategic, long-term approach.
Cystic acne is complex, often requiring a combination of treatments to see substantial improvements. Some people may need to try multiple options, such as different topical medications, oral treatments, or even laser therapies, before finding the one that works best for them. A dermatologist can guide you through these choices and make necessary adjustments as your skin responds to treatments. They can also monitor any side effects, particularly for powerful medications like isotretinoin, which can have severe side effects if not carefully managed.
Moreover, it’s vital to have realistic expectations. Treatment for cystic acne, especially severe forms, won’t provide overnight results. Improvements might take weeks or even months, depending on the treatment plan and your skin’s condition. It’s essential to stick to the prescribed regimen and not lose patience when results don’t appear immediately.
Another critical aspect is avoiding the temptation to pop or squeeze cysts, no matter how frustrating they may be. Cystic acne is rooted deep within the skin, and attempting to “drain” it on your own can cause more harm than good. Popping cysts can lead to further inflammation, infection, and significant scarring, which may take even longer to heal. Instead, trusting a professional to handle severe acne and following their advice will help your skin heal more effectively and minimise long-term damage.
Cystic acne can be a frustrating and painful condition, resulting in significant impact on one’s self esteem and confidence, but understanding what causes acne and what triggers cystic acne can help you take control of your skin health. By making adjustments to your skincare routine, diet, and stress levels, you can reduce the frequency and severity of breakouts. In cases where prevention isn’t enough, there are several medical treatments available, ranging from topical retinoids to oral antibiotics and laser therapy.
If you’re struggling with cystic acne, don’t hesitate to seek professional help. With the right treatment plan, you can manage this severe form of acne and work toward achieving clearer, healthier skin.
