Cystic acne: Causes, symptoms and treatment

Cystic acne is the most serious type of acne, mainly affecting the face. While acne is very common in teenagers especially, cystic acne is quite uncommon and can be caused by hormonal changes during puberty.

The home doctor experts at House Call Doctor have all the information you need to know.


Cystic acne develops when cysts form deep underneath the skin, as a result of a combination of bacteria, oil and dry skin cells trapped in your pores. It’s more common to develop it in your teens or early 20’s, but there are rare cases in it occurring in people outside of this age bracket. Severe cystic acne occurs more commonly in men, but women do experience it too.

No one knows the exact cause of cystic acne, but it is more commonly linked to hormonal changes. A family history of cystic acne can also be a cause.


All other types of acne rest on top of the skin’s surface, whereas cystic acne tends to be larger in size and is deeper within the skin. Characteristics include:

  • Large pus-filled cyst
  • Large white bumps
  • Redness
  • Tender or painful to touch
  • May also develop on the chest, neck, back and arms.


Over the counter acne treatments are not strong enough to treat this more severe type of acne. The most effective treatment method is Isotretinoin (Accutane) which is a powerful prescription medication. Other treatment methods include:

  • Oral antibiotics work by decreasing bacteria and inflammation that could be contributing to the formation of cystic acne
  • Corticosteroid medication can be injected directly into a cyst to reduce inflammation and prevent scarring
  • Women can use oral contraceptives to help control and regulate overall hormone levels to reduce the acne.