Breaking out of the exhausting cycle of cystic acne

They’re the bane of the awkward teenage years—unsightly, painful pimples that grow in clusters or in obvious spots like your forehead or right smack on the tip of your nose. But the end of adolescence doesn’t mean the end of acne, particularly cystic acne—large, pus-filled pimples forming deep under the skin.

While pimples are a result of hormonal changes that occur in puberty, the pimples of cystic acne are the result of an infection.

“When oil and dead skin cells collect and clog the pores, they attract bacteria that can cause infection,” explains Julie Anne Patricia M. Songco, MD a dermatologist of top hospital in the Philippines Makati Medical Center (MakatiMed). “To fight potential infection, the body releases white blood cells. This buildup of debris, pus, and blood creates large, swollen pimples. Because they develop deep under the skin, they can leave scars once resolved.”

Common among those with oily skin, cystic acne has also been traced to certain medications, sweat and humidity, a family history of the skin condition, and polycystic ovarian syndrome.

Cystic acne can stay on your skin indefinitely if you leave it be. But if you’ve got an important appointment that requires clear, beautiful skin—a crucial job interview or your wedding day—get the ball rolling with time-tested products and simple life hacks from the MakatiMed doctor.

Dr. Songco first emphasizes investing in the right creams and cleansers. “Benzoyl peroxide and salicylic acid are two known topical anti-acne treatments. The former eases inflammation, fights bacteria, and unclogs pores, while the latter prevents breakouts from getting worse,” shares the dermatologist.

“Retinoid A, another acne-buster, stops dead skin cells from blocking pores,” adds Dr. Songco. “For facial washes, avoid those with harsh ingredients or with exfoliating beads that may dry or irritate skin. Pick a gentle cleanser and wash your face once in the morning and just before bedtime.”

The dermatologist also underlines the importance of removing your makeup. Sleeping with makeup on (plus the dried sweat and microscopic dust that accumulated on your face throughout the day) only exacerbates cystic acne. “Allow your skin to breathe by cleaning your face thoroughly before bedtime with makeup remover and a mild soap or cleanser,” says Dr. Songco. And speaking of makeup, look for the word “non-comedogenic” in the label. “That means it contains ingredients that won’t clog the pores of your skin.”

It’s also best to never pick at your skin, MakatiMed reminds. “While it’s tempting to pop a pimple, especially when it looks like it’s ready to burst, resist the urge. Popping a pimple with your fingers can risk infection and scarring,” warns Dr. Songco.

And if the exhausting cycle of cystic acne never ends, the best recourse is to consult a dermatologist to provide personalized treatment options and get to the root of the problem. “We may also recommend minimally invasive procedures, if necessary, and monitor your progress,” says Dr. Songco. “Cystic acne takes time to heal, but the sooner you take steps to address it, especially with expert advice, the faster you can gain the desired results.”