Cystic acne: Symptoms and Causes

Cystic acne is the most serious type of acne which can result from a combination of bacteria, oil, and dry skin cells that get trapped in your pores.

Updated: June 16, 2022

Cystic acne is a result of the most severe types of pore blockages. When pores become blocked by excess sebum, skin cells, and bacteria, an infection can rise up in the pore.  A large, inflamed acne lesions form deep within the skin and result in painful, large bumps visible from the surface. Usually, cystic acne get clear with age. If it doesn't get clear with time on their own, you need to consult dermatologist who can prescribe the medication necessary to help clear your skin.
Cystic acne is an inflammatory type of acne. There are four main types of inflammatory acne, and all four may be present on the skin in cases of cystic acne.

Papules:

When a follicle is blocked with sebum, dead skin cells, and bacteria, the surrounding skin cell wall breaks due to the pressure causing inflammation. Red or pink-colored bumps on the skin are known as papules which are less than one centimeter wide, but can vary in size. These acne lesions do not contain pus or any visible fluids. They are generally not painful but may be tender to the touch.  

Pustule:

Except for the presence of white blood cells, a pustule is similar to a papule. When there is presence of bacteria in a ruptured follicle, white blood cells are send by your body to the area to protect the rest of the skin causing pus to build up and result in a pimple or zit. Pustules are often a yellow or white head at the surface of the skin.

Nodules:

A nodule is a hard acne lesion that is embedded deep within the skin which may persist for weeks and months. During this time, their contents may harden into deeper cysts.

Cysts:

An acne cyst contains a hollow cavity or sac area in which fluid and liquid builds up. Cystic acne lesions are most often felt beneath the skin before they are seen and are generally softer than nodules. As acne cysts are deep within the skin. Therefore squeezing or attempting to self-extract these lesions can actually worsen the condition, slow down the healing process, and may develop permanent and deep scarring.

Symptoms of Cystic Acne:

When the pores of your skin get clogged with oil and dead skin cells and become inflamed, it results in cystic acne. The pore can get ruptures underneath the skin causing inflammation to spill out into the surrounding skin tissue. This will result in spreading more acne bacteria and more breakouts. Due to the acute damage of the oil gland causing intense inflammation and irritation which leads to redness, swelling and soreness, there will be a unique appearance of a cystic acne.  Cystic acne often looks like boils on the skin.
Symptoms of cystic acne include:

  • large, red and painful breakouts on the face, chest, back, upper arms, shoulders and thighs
  • nodules that appear as raised, red bumps that generally do not have a whitehead showing
  • lesions that are usually felt beneath the skin before they are seen
  • more visible acne that produces cysts and nodules in addition to papules and pustules
  • breakouts that are painful to the touch or even when not touched
  • decrease in self-esteem and mood and increase in psychological distress, especially when cystic acne occurs on the face

Cystic acne is easy to diagnose to by a dermatologist and does not require any special tests.

Causes of Cystic Acne:

Factors that can cause cystic acne include genetics, hormonal changes including polycystic ovary syndrome, high levels of humidity and sweating and lifestyle factors such as stress and diet. When blackheads and whiteheads become clogged and infected, the inflammation can lead to papules, pustules, nodules, and cysts. These can develop deep under the skin which can result in permanent scars. You have a greater chance of having it if you have a family history.
When the male hormone called androgens increases in teenage boys and young men, leads to changes in your skin that can result in clogged pores and acne. In case of women the hormonal changes occurs during by menstrual cycles, pregnancy and menopause trigger cystic acne. Cystic acne is also more common among women who suffer from polycystic ovary syndrome(PCOS).


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