Cystic acne is caused by overactive oil glands and bacteria, which create blockages that become inflamed and filled with pus. This is the most severe type of acne, with infections deep under the skin and difficult to eradicate. Several treatments are available from dermatologists and other physicians to provide some relief and prevent scarring.
Topical solutions for acne may be a first step in treatment, usually combined with oral medications. Topical medication alone is not very effective at treating cystic acne, particularly in severe cases.
Isotretinoin is commonly prescribed, available under brand names such as Accutane, Claravis and Sotret. This medication reduces the size of oil glands so that less oil is produced and bacterial growth is inhibited.
Oral antibiotics may be prescribed to reduce the bacteria. Commonly prescribed antibiotics for cystic acne treatments include tetracycline and doxycycline.
Some oral contraceptives can decrease production of sebum by the oil glands, which is a cause of acne.
The dermatologist may decide it is necessary to perform a surgical excision on some cysts to drain them. It is vital that patients not try doing this on their own.
Physicians also may inject a mild steroid into the cyst, which reduces the acne and prevents scarring.