It’s a squishy, swollen knot on the hinge of your jaw. It’s a smattering of tender bumps across your back. It’s that deep blemish that you can never quite pop.
It is...cystic acne.
Cystic acne is considered among the most severe forms of acne, appearing as large, sore lumps beneath the skin. These cysts are actually swollen cavities that form deep within the skin and may be filled with pus, sebum, blood, or keratin.
They can be super painful, super embarrassing, and super stubborn! Seriously, these breakouts can linger on your face, shoulders, and back for weeks or even months.
But why? And more importantly, WHAT CAN YOU DO ABOUT THEM?
Girl, we’ve got you. Find the answers you’re looking for in this definitive guide to cystic acne!
Cystic Acne Causes
Faced with the painful reality of cystic acne, you may assume that it’s the symptom of a serious health problem. After all, it feels and looks like a big deal!
It may surprise you to know that cystic acne is caused by the same factors as a mild or moderate acne breakout. Most often, we’re looking at the big three: excess oil, trapped skin cells, and bacteria.
First off, oil is not the enemy. Your skin produces sebum, its natural skin oil, to keep itself healthy and moisturized.
However, people with acne-prone complexions often suffer from too much of a good thing. You know the look — you’ve passed dewy ten miles ago, and are now well on your way to straight-up greasy. (Story of my LIFE.)
The goal here is balance! You want enough oil to keep your skin hydrated and protected, but not so much that you are a shiny, breakout-prone mess.
Trapped Skin Cells
The second major cause of cystic acne is an overabundance of skin cells, specifically the dead cells that your body usually sheds. Emphasis on usually.
Acne sufferers may produce up to four or five times the average amount of skin cells, and simply can’t shed them fast enough. Many of the extra cells never make it out of your pores at all, encountering skin oil while awaiting their turn to shed.
And once the oil gets involved, it starts gluing your excess skin cells together, creating blockages in your pores.
Enter the final player: bacteria.
Now that your pores are all stopped up, bacteria like P. acnes swoop in to join the party, feeding on that tasty buffet of oil and skin cells.
As they eat and multiply, these bacteria trigger swelling and irritation, bursting through your pore’s cell wall and spreading infection into the surrounding skin.
When this happens near the surface, you’ll probably end up with a regular pimple. But if blockage and inflammation occur deep within the layers of your skin, your body may react by trying to contain the infection.
Contain how? By enclosing it within a cyst.
Congratulations! You’ve unlocked cystic acne.
Hormonal Cystic Acne
We’ve covered the direct causes of your cystic breakouts. But what about indirect contributors, like hormones? Hormones play a significant role in the formation of cystic acne, especially among women.
Hormonal Shifts and Imbalances
Cystic acne is commonly triggered by hormonal shifts like menstruation, pregnancy, or puberty (which is why so many of us were acne-covered messes in high school).
But these are, for the most part, natural shifts. Cystic acne can also be a result of an actual hormonal imbalance.
Our hormones operate in a delicate, easily disturbed equilibrium. The root of a hormonal imbalance could be anything from diet or birth control to conditions like PCOS or endometriosis.
When it comes to hormonal imbalance, cystic breakouts are often thanks to an uptick in androgen hormones like testosterone. Androgens increase two of our acne triggers — oil production and skin cell turnover — priming your skin to form deep breakouts.
Ever heard of a stress breakout? That’s right, hormonal cystic acne can also be set off by your anxiety. Prolonged stress causes the release of acne-triggering hormones called cortisol and CRH.
Like testosterone, cortisol increases your oil production. Meanwhile, CRH activates inflammation, encouraging your clogged pores and blemishes to get extra red and swollen.
End result? Breakout central.
Been missing out on some zzz’s lately? Your body is going to feel the impact of your restless nights as physical stress. And you know what that means: the release of acne-triggering hormones cortisol and CRH, here to taunt your already tired skin with excess oil and inflammation.
(Struggling with insomnia? Try these tips and tricks for better sleep!)
Cystic acne is bad enough, but it doesn’t even stop there. Some people end up dealing with cystic acne’s mean big brother: nodulocystic acne.
Nodulocystic acne is just the worst. Not only does it appear with acne cysts, which are already difficult to treat, but they are accompanied by hardened lumps called nodules.
Like cystic acne, nodulocystic breakouts tend to linger, painful and tough to beat.
It’s unclear why some of us end up with severe cystic or nodulocystic acne instead of a milder condition. But it looks like genetics may play a role.
Thanks a bunch, ancestors.
Cystic Back Acne
60% of acne sufferers experience bacne at some point. And whether you’re dealing with acne that’s cystic or nodulocystic, there’s a good chance that your back is one of the battlegrounds.
Just consider these factors:
The skin on your back is about 100 times thicker than the skin on your face, making it tough to keep those pores unclogged.
This thick skin also makes cysts extra challenging to treat. Topical treatments struggle to penetrate, unable to reach the deep level of your cysts.
Your best bet here is a gentle but effective exfoliant, to help prevent pore blockages. Products like our Rejuvenating Essence Body Polish work to remove dead skin cells and other contaminants without stripping or damaging your skin.
Tight sports garments are a common culprit for recurring bacne, trapping moisture and encouraging the growth of unwelcome bacteria. (We see you, boob-squashing sports bra.)
Be sure to cleanse skin ASAP after a workout, and wash sportswear between Every. Single. Use.
The Shampoo Problem
Many shampoos contain oil and chemicals to make your hair glossy, but these ingredients are NOT great for acne-prone skin. The residue left behind after rinsing can contribute to breakouts on your shoulders and back, including cystic breakouts.
Our suggestion? Wash and rinse your hair toward the beginning of your shower, then cleanse your skin thoroughly to ditch any residue!
Cystic Acne Treatment: 8 Tips
Okay, it’s great to know how and why these awful cystic breakouts keep appearing. But it’s time for the real question on everyone’s mind:
How do you TREAT them?
1: No Popping Cystic Acne
After 1000+ words describing how awful and insidious cystic acne can be, you’re probably feeling ready to take drastic measures. I know I am.
But do not, I repeat, DO NOT try to pop a cyst on your own!
Cystic acne forms far beneath the skin and is nearly impossible to pop, much less to pop safely. You’re much more likely to cause yourself permanent scarring or burst the cyst beneath the skin, spreading all that nasty gunk and infection into the surrounding tissue.
Some cysts don’t even contain liquid, so how are you planning to pop that? Literally unpoppable!
If you have a cyst that won’t heal on its own, don’t take matters into your own hands. Visit a dermatologist to have the cyst extracted surgically. This will also decrease the likelihood of this same cyst acting up again later!
2: Shrink Your Cystic Pimples
So if you aren’t allowed to pop it, what CAN you do to help diminish a cystic pimple?
Begin treatment ASAP: The longer you wait, the more entrenched your cyst will become.
Skip the OTCs: Don’t waste precious time on over-the-counter acne washes. Their active ingredients don’t sink deep enough to fight cystic acne. Find a cleanser that reaches to the root of your problems, like our Radiant Cleansing Nectar. It helps remove toxins and bacteria while its rinseless formula fully penetrates your skin with healing vitamins and antioxidants.
Cleanse gently: Once you’ve got an effective cleanser (hey again, Nectar), use it regularly. But don’t go crazy with the scrubbing! It won’t help open up your cyst. You’ll only cause more redness and irritation.
Encourage drainage: Apply a warm compress to help thin and drain the contents of your cyst.
Calm swelling: Apply a cold compress to reduce swelling. (But don’t place ice directly against your skin! Danger, Will Robinson!)
Detoxify and reduce oil: Use a sensitive-skin spot treatment to start treating the area around your cyst. We recommend the Clear Skin Elixir for deep purification, drawing out bacteria so that your skin can finally begin the healing process.
3: Moderate Your Sun Exposure
We hate to burst your bubble, but tanning will do nothing to diminish your cystic acne. In fact, it can make your breakouts even worse!
To protect your skin from damage and help prevent new breakouts, limit your exposure to UV rays. And don’t forget the sunscreen — preferably a water-based sunscreen that won’t plug up your pores!
4: Wash Your Bedding
If you want to keep your skin fresh, clean, and acne-free, you need to launder your sheets diligently.
As you sleep, your sheets and pillowcases accrue a build-up of sebum, skin cells, bacteria, dirt, and makeup. This residue can end up right back on your skin, contributing to breakouts.
So wash your bedding! And not just your pillowcases (though you should definitely clean those, too). We’re talking an entirely stripped bed, fitted sheet and all.
5: Avoid Over-exfoliating
Nix all those acidic or abrasive scrubs, washcloths, and loofahs. They can cause irritation and shred the outer layers of your skin, leaving it vulnerable to even more problems.
For mild, daily exfoliation that won’t damage your skin, try our Radiant Cleansing Nectar. Applied with a cotton round, it gently buffs away dirt and oil. Complement with our Illuminating Essence Exfoliating Mask a few times a week to remove dull skin while depositing nutrients that heal and nourish!
6: Eat Clean
It’s a hard pill to swallow, but some foods can interfere with our hormones and contribute to developing acne breakouts. Two of the biggest culprits? Refined sugar and dairy. (Oh no, two of my favorite food groups!)
But eating clean doesn’t have to be about depriving yourself. Instead, focus on all the amazing things you CAN eat guilt-free, and build a repertoire of delicious, satisfying meals! To help you out, we’ve even compiled a list of the 99 Best Foods for Clear Skin.
Clean eating, here we come!
7: Find the Right Skincare Regimen
Just say no to harsh, dehydrating cleansers. All those chemicals and astringents you’ve been using to fight your cystic acne may be stressing your skin and throwing oil production into overdrive!
For a better long-term solution, seek out skincare that can treat your acne without wrecking the rest of your complexion.
The right mix of products can make an incredible difference! But we know it can be tough to find the right dream team.
Our Luminous Clear Skin Kit takes the mystery out of building your regimen, with five products curated to work in glorious synergy.
These natural products are powered by botanicals to deliver your skin an illuminating boost of vitamins and antioxidants. Together, they help soothe irritation, heal imperfections, combat acne, and balance your oil to prevent new breakouts.
Just see how our skincare line has helped other customers overcome their cystic acne!
8: Stay Positive
We know that this may be the toughest ask on this entire list. But fighting cystic acne is a process, and you’ll only make it through if you keep hope alive!
Cultivate a positive attitude however you can — whether it’s jamming out to your favorite tunes, de-stressing with a bit of meditation, or just reciting a few affirmations to your gorgeous reflection.
As my mother always told me:
This too shall pass. xx