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How to Get Rid of Cystic Acne, According to a Dermatologist

Maya Ernest DefaultMaya Ernest Default
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Published on May 6, 2025 • 4 min read
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Photo by Olga Rolenko/Getty Images

Breakouts are bad, but cystic acne can be an even bigger pain—literally. The severe form of acne develops below the skin, causing large painful bumps, which can be harder to treat than your average whitehead or blackhead. Spot treatments and pimple patches don’t often work for cystic acne, since it lives deep beneath your skin and is usually pretty inflamed. 

Still, that doesn’t mean you’re left with no options; there are plenty of ways to treat these painful pimples. We chatted with dermatologist Nkem Ugonabo, MD, to figure out how to get rid of cystic acne, the best treatments available, and how to prevent cystic acne from coming back in the future. Read on for our expert guide to clear, glowing skin.

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Nkem Ugonabo, MD, is a board-certified dermatologist based in NYC.  

Here’s Your Expert Guide to Getting Rid of Cystic Acne

1. Know What Causes Cystic Acne

Any type of blemish usually boils down to one factor: clogged pores. Cystic acne can form when a mix of bacteria and excess oil clog a pore and create inflammation under the skin. While cystic acne can appear anywhere on the face, it usually appears around the jawline area and is triggered by hormones—whether you’re on your period, receiving hormone treatment, or someone with hypersensitive hormones, Dr. Ugonabo tells IPSY. 

2. Treating Cystic Acne

If you’re struggling with cystic acne, don’t stress. You’ve got plenty of treatment options, varying from topical to oral medications. Dr. Ugonabo recommends starting with an over-the-counter treatment, such as salicylic acid, benzoyl peroxide, or adapalene, before looking into a prescription medication like Clindamycin and Dapsone, which you can get by visiting your dermatologist. “Time is definitely of the essence, as this type of acne can lead to significant scarring,” says Dr. Ugonabo. “I recommend going to a dermatologist as soon as possible to get evaluated and put on a treatment plan.”

Still, cystic acne isn’t going to disappear overnight—or even in a few nights. Even the most effective treatments take a number of days to start working. Retinoids (such as tretinoin or tazarotene) may be a powerful tool against cystic acne, Dr. Ugonabo adds, though she says oral medications are often the most beneficial. “Spironolactone can help regulate hormones that may be causing the cystic acne,” she says. “In-office treatments such as a cortisone injection can also help shrink these nodules very quickly.” Make sure to talk through your options with your dermatologist to figure out which solution is best for you.

3. How to Prevent Cystic Acne 

Once you’ve got your breakout under control, how do you keep it under control? According to Dr. Ugonabo, figuring out the cause of your cystic acne will determine how you treat it. Lifestyle choices, diet, and hormones all play a big part in triggering cystic acne, and limiting your exposure to such triggers will ultimately reduce your risk of experiencing cystic acne. 

Dr. Ugonabo recommends keeping your skincare gentle and minimal, as doing too much may trigger sensitive skin. While it’s best to work with your dermatologist to develop a personalized skincare plan, there are plenty of over-the-counter cystic acne solutions that are worth trying, she notes. For people that struggle with chronic cystic acne, Dr. Ugonabo recommends picking up a medicated cleanser. After that, you’ll want to follow up with a spot treatment, or you can upkeep with an everyday product like exfoliating clarifying pads or retinoids. Remember, cystic acne won’t go away immediately, so don’t expect overnight results—always spot-test your products and start slow.  

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