Question:
What causes cystic acne? What’s the best way to treat it
using OTC treatments?
Answer:
Let’s start by clarifying what a cyst is, since that’s
the basis for the term ‘cystic acne’.
A
cyst is basically a sack that typically contains a fluid or other
material. So, when the term ‘cystic acne’ is used,
it’s referring to acne that involves the formation of cysts.
Here’s
how that happens. All acne forms in the pore (or follicle), a
cavity in the skin that also contains a hair shaft and an attached
sebaceous gland that produces oils bound for the skin’s
surface.
Because
of a blockage of the pore, oil becomes trapped behind the plug.
As the sebaceous gland continues to produce more oil, it backs
up within the follicle. This collection of oil gradually causes
the follicle to swell, essentially creating a sack of oil within
the skin – or a cyst.
There
are bacteria that are normally found within the follicle and live
there in relatively small numbers. They feed on the oil in the
follicle, but since it is normally just a fine film around the
hair shaft, gradually seeping toward the surface, their food supply
is limited.
Now,
with the backed up pool of oil within the cyst, the bacteria find
they’re living in a banquet hall! As a result they multiply
dramatically. So, now the cyst is filled with oil and bacteria.
But,
the bacteria have a nasty habit. They produce molecules that are
very irritating and cause an inflammatory reaction. And with lots
of them in the cyst, things start to get out of control.
White
blood cells come to the area to attack the bacteria and find their
way into the cyst where the battle rages – and the swelling
of the cyst continues. Increased blood flow to the area causes
it to turn red and the surrounding tissue swells and hurts.
If
this all continues without being brought under control, the cyst
can swell so far that it finally ruptures. Now all the toxic stuff
that was held within the cyst is released out into the tissue
– causing dramatic inflammation and damage. The ultimate
result is that scar tissue forms in the process of repairing the
damage.
That’s what cystic acne is.
Now,
what can you do about it?
Cystic
acne is still basically acne. So, treatment for cystic acne is
much the same as for acne in general. If it is out of control,
it’s a good idea to see a dermatologist in order to minimize
the risk of scarring. Once scarring occurs, it’s generally
with you for life – so it’s best to prevent it in
the first place.
In
addition to prescription medication, your dermatologist can also
treat the cysts individually by opening them and draining the
stuff in them or by injecting medication right into the cyst.
If
you aren’t quite ready to see a dermatologist and feel that
you have time to try to control the problem with over-the-counter
(OTC) medications, there are a few things you should keep in mind.
You
should consider including benzoyl peroxide as a part of your treatment
plan. It penetrates deeply into the pore and is quite good at
killing the bacteria there.
In general, the higher the concentration of benzoyl peroxide used,
the more effective it will be in decreasing the bacterial presence.
However, people differ as to how well their skin tolerates the
medication, so there is no one strength that will be ideal for
everyone.
AcneRecovery’s
Treatment Lotion uses benzoyl peroxide and enables the user to
adjust the strength from a low of 2.0% to as high as 7.0%, if
needed. This enables users to find the right balance for their
acne needs and tolerance of benzoyl peroxide.
Other
suggestions:
•
Zip Popping - Don’t do it! Remember the cyst full of stuff?
If you put all that pressure on the zit, you may cause it to rupture
– exactly the thing you didn’t want to happen! If
they’re bad, see the dermatologist.
•
Open The Pore - If you can also get the plug to dissolve and open
the channel to the surface, you’ll be better off. Salicylic
acid medications are helpful for this. Like AcneRecovery’s
Face Wash and Repair Lotion.
•
Oil Control - Using oil wipes or clay mask treatments to help
reduce the oiliness of the skin can help.
•
Gentle Cleansing - Don’t be overly aggressive in cleansing
the skin, but many find the gentle scrubbing beads found in some
cleansers (like AcneRecovery Face Wash) to be helpful.
If
you have a question that you haven't been able to find an answer
to on this site, please send your question about acne to Dr.
Wilkinson.
