Trust me, I’ve faced no bigger beauty dilemma than my long, drawn out fight with cystic acne. I was blessed with a clear complexion during my high school years and then suffered the occasional pimple or break out while in college, but it wasn’t until my mid to late 20’s that my skin declared war. Just when I had begun to really worry about wrinkles and eye creams, the acne appeared with a vengeance. And not just the standard, oily skin variety pimples, but the dreaded cystic acne.
How do you know if you suffer from cystic acne? It makes the standard, pop-able pimple feel like a walk in the park. For starters, they are big! While I only would get one or two at a time, the size made them impossible to cover up. Cystic acne looks and feels as if a pea has been shoved under your skin. To add to the problem, typically cystic pimples do not form a white head. There is no way for the skin to break, letting the pus out to relieve some of the pressure. That means that these little devils really hurt! The pimple will be inflamed and hot to the touch and almost pulses with pain. (When I have a good cystic pimple raging, and I work out, I can feel my heart beating through the pimple when I cool down – it’s insane). Cystic acne can also be very itchy (but whatever you do – do not scratch!) Oh, and did I mention the pimple and a good ½ diameter of skin around it will be visibly red as well? Not a pretty picture.
For some time, I tried to cure the problem with some of the common answers for acne. Regular washing and spot treatments with all sorts of harsh chemicals – from drugstore shelves, to high-end beauty lines, to the medicinal washes prescribed by my dermatologist – nothing made a difference. Actually, that’s not true, they made the pimple and skin around it even more irritated and inflamed, with flakey skin and dry patches as an added bonus. Most topical, acne fighters are not made for cystic acne sufferers and can not penetrate deeply enough into the skin to make a difference.
I spent a number of years trying out different types and levels of (expensive) antibiotics. Some people have great success with this method (or using certain birth control pills) but I was never able to find a pill that helped my skin. After three years of being on constant antibiotics, I decided it was an expense I could do without, considering I still would routinely get a cyst or two every month – often in the exact same place as an earlier cyst. This, sadly, is common with cysts and can lead to scars and uneven skin texture in areas that are continually affected.
I did find one almost instantaneous treatment in the form of cortisone shots which my dermatologist injected directly into the pimple. While painful, expensive (my shots ranged from $65 $85 per visit in Los Angeles) and impossible to hide (you’ll bleed a bit and the pimple will be even more noticeable the first few hours), these shots made a dramatic difference in the size and longevity of the cyst. I realize this solution is not right for everyone, but it can be a lifesaver when you really need that cyst gone pronto (a wedding, prom, or other big event might call for this solution).
Lately, I’ve noticed that my cystic acne has been tapering off. I can’t think of a reason why this is happening now, except that I’m getting older – um, hooray!? There really is no known cause for these suckers; genetics, hormones, stress and over active oil glands all play a part. Sadly, cystic acne does run in my family (both sides!) and I definitely notice that my cysts coincide with my menstrual cycle (it’s another side affect of PMS for me).
While I’m happy the tide of cysts has subsided, they still pop up every few months. I’ve come to accept that there is no way for me to entirely prevent them, so I have a patented plan of attack for the moment I feel one of these pimples from hell coming on. (After a few rounds with cystic acne, you should notice the little spidey-sense tingling exactly at the spot where the next one is about to pop up.) If you, or a friend or family member suffers from the same problem, try these steps for some relief:
Do Not Pick! I really mean it this time. Yes, we know we are not supposed to pick at pimples, but we all do it. Cystic acne is different. It is impossible to get into all of the infection and bring it to the surface. You will only serve to anger the pimple even more! Picking often times leads to more redness, bigger infections and a longer healing time.
Take some ibuprofen. I didn’t pick this up until years into my siege, when the nurse at the dermatologist’s office advised me to take two Advil twice a day until a particularly large cyst subsided. Doh – that totally makes sense – a few Advil’s will help with the pain and can help reduce swelling as well.
Ice it down. Soon after the ibuprofen suggestion, I had an epiphany – ice is great for pain and swelling! Let’s ice my jaw line (where my cystic pimples like to hang out) and see what happens. Halleluiah – I felt instant and long lasting relief and noticed the cyst was half it’s size after 15 minutes of applied ice. I recommended taking 15 minutes every morning and night to ice down any “active” cyst.
Avoid topical acne products. In my experience, they have no effect on cystic pimples and tend to aggravate more than relieve. I have found one, blessed exception and that is the Renee Rouleau Anti-Cyst Treatment. I was lucky enough to test this brilliance in a bottle (it was what prompted me to write this post sharing my “wisdom” on cystic acne) and, after 10 years of searching, discovered a topical product that actually helped treat my cystic acne. You can see my review here.
If all else fails, get thee to a good dermatologist. It can be expensive, but is worth it when it comes to this problem. I can’t recommend antibiotics or accutane (both must be prescribed by a derm), as the antibiotics failed to help me and accutane just scares me. But, every case is different and others may find some relief with them. Also, it’s great to have a good derm on hand for when the situation calls for an injection. (Most sympathetic docs will squeeze you in for a few minutes between scheduled appointments during an emergency flare up )
Shoot it up. If you can handle a needle to the face (and most cystic sufferers will try anything for a cure) there is no better “instant” solution. A good pop of cortisone to the center of the pimple should cause a drastic reduction in swelling and pain and helps to shorten the life span of the cyst.
Don’t beat yourself up. I know, cystic acne really sucks. Don’t blame yourself because there’s not a thing you can do if you’re predisposed to suffer from them. So try not to let it rule your life. And, never, ever, change or cancel plans because you can’t go out “looking like that.” Make up, hairstyles, scarves and wraps can do wonders to hide your temporary imperfection. Do that best that you can to hide it in plain site and than get out there!
Are there other cystic acne sufferers out there? Share your coping skills and solutions with us!