Why do I get recurring painful cystic acne?

Doctor's Answers 1

Acne is a chronic recurrent skin condition with varying degrees of severity ranging from comedones to papules, papulopastular to cystic acne.

It is unfortunate that you are getting recurrent cystic acne as these tends to heal with scarring.

The causes are multifactorial and difficult to pinpoint in your case but the basic underlying cause is increased sebum production that leads to clogged follicles. The repeated inflammation and infection leads to the formation of cystic lesions.

As your cystic lesions are recurrent and multiple I would suggest the following:

1. Oral medication like Roaccutane and antibiotics like doxycycline or minocycline. A typical course would usually be for at least 6 months.

2. Topical skincare to control the sebum and inflammation and infection and a appropriate facial cleanser .

3. Treatment with Agnes RF which targets the sebaceous gland directly and treats the underlying cause leading to resolution of the cystic lesions.

4. In more isolated cases of cystic acne intralesional injection of a steroid may be useful

You should weigh the pros and cons of the treatment options with your doctor before deciding on the course of action.

Similar Questions

Should I see a skin doctor for cystic acne on my cheek, or can I use OTC products?

Cystic acne happens when an infection/inflammatory process goes deep into your skin. If a cyst bursts, the infection can spread, causing more breakouts. By definition, cystic acne tends to scar. Hence if your cystic acne looks very red, angry and inflamed like that 2 big zits on the chin: It’s best to nip it in the bud early by seeing a dermatologist/doctor for effective treatment.

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Human

Does 2.0% fusidic acid help to clear up cystic acne? Are there any side effects (such as more breakouts)?

I would stick to Epiduo and Oratane (please complete the course as well). I would not recommend topical Betamethasone and Fusidic Acid as they are not recommended 1st-line treatment options for acne at all. There are other topical antibiotic creams to consider that are more effective against the bacteria in acne such as Clindamycin and Erythromycin. For cystic acne, sometimes it may need to be extracted/ drained and injectable steroids would be more effective at arresting the inflammation and swelling as opposed to topical creams. Hope that helps. All the best!

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Dr Rui Ming Ho

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