What are the treatment options for cystic acne?

Cystic acne forms deeper in the skin than surface spots and can be tender, swollen and slow to settle. Picking, squeezing or repeatedly changing products can increase irritation and the risk of post-inflammatory colour change or scarring. The right treatment depends on lesion depth, how widely acne is distributed, previous treatments, medical history and pregnancy potential. A dermatologist may combine a longer-term medicine with a short-term measure for a particularly inflamed nodule.

A corticosteroid injection can reduce inflammation in a selected painful lesion; read about Steroid Injection Into The Skin. Oral antibiotics may be used for inflammatory acne as part of a supervised plan; see Oral Antibiotics For Acne. Isotretinoin can be discussed when acne is severe, persistent or at risk of scarring; see Isotretinoin Treatment. Use a gentle cleanser, avoid scrubbing and do not squeeze lesions. Tell the prescriber about all medicines, supplements and any possibility of pregnancy before treatment.

Book a dermatology appointment when deep or painful lesions keep returning, leave marks or interfere with sleep or confidence. Seek urgent help for facial swelling with breathing difficulty or a severe reaction after medicine. During treatment, report significant mood changes, severe headache with visual symptoms, persistent abdominal symptoms or a widespread rash promptly.

Ask which option fits the severity and distribution of your acne, when improvement should be assessed, how scarring will be prevented and what monitoring is needed. If isotretinoin is discussed, ask about pregnancy prevention, testing and side effects relevant to you.