Acne cysts can occur on the face, neck, chest & back. Cysts can range from small cysts, called microcystic acne, thru to large inflammatory cysts. Microcystic acne is best treated with extractions, whilst inflammatory cysts are best treated with simple anti-inflammatory cortisone injections
- Cysts are commonly seen in acne cases
- Superficial cysts are treated with anti-inflammatories
- Deep cysts are best treated with extractions
- Extractions are painless
- Once removed, deep cysts do not recur
- Early & effective management will reduce acne scars
Cyst Treatments; removals & extractions at a glance
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Topical retinoids are first line treatments for acne. Retinoids are to be applied to acne prone areas, not just spots
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Chemical peels including salicylic acid & retinoic acid are excellent methods to reduce acne lesions
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Superficial cysts are easy to see, deep cysts require some detective work. These cysts are termed microcystic acne or submarine comedones. They occur on the chin, cheeks, jawline & mouth areas.
Deep cysts are usually multiple & measure 1 to 2 mm in diameter. They are more prominent if the skin’s surface is stretched. Another way to identify them is to put your tongue to the area & push. They are more visible with outward pressure.
Most cases of cystic acne do not respond to creams, especially if they are deep. You can try the usual anti-acne creams.
Remember retinoids are best to prevent acne cysts, whilst lotions can reduce the inflammation of cysts. Your dermatologist may prescribe you an anti-inflammatory cream for short periods of time to reduce swelling & early cysts. Be guided by them.
The ideal treatment depends on the level of the cyst within the skin. They can be classified as superficial or deep.
Anti-inflammatory cortisone injections are best for superficial cystic acne.
Laser treatment: are best for deeper cysts including microcystic acne. We use both erbium & CO2 lasers for this job.
Cyst removal with surgery: We enrol the assistance of a plastic surgeon to remove deep & persistent cysts. We suggest a non-surgical approach before excision.
Anti-inflammatory medications- A dermatologist will discuss medications if you have lots of inflammatory cyst, especially if you are on acne medication.
With precision & skill we use an ablative laser with a one-millimetre spot size to drill a tiny hole down to the level of the cyst. This enables a track from the skin’s surface to the middle of the cyst. We then carefully extract all the contents from that cyst.
Laser destroys the cyst wall, so recurrence is rare. The procedure is painless as we use numbing gel prior. This is a precise, scarless method of deep cyst removal.
Our nursing team can handle most cyst scenarios. They have been doing cyst extractions & injections for many years & are super slick at their job. Alternatively, if you would like to see a dermatologist for cyst removal, you will require a referral from your GP.
Book a free consultation with our team. T&C applies.
For deep cysts, once the cyst wall is destroyed, the treated cyst will not recur. Note that new cysts may form adjacent to the treated cyst. Your dermatologist will discuss ways to prevent recurrence.
Inflammatory cysts may require additional treatments, especially in cystic acne.
Cysts occur in over half of acne cases. True cysts are lined with skin cells & occur due to inflammation.
Non-inflammatory cysts include deep ‘submarine comedones’ that lie in the dermal layers of skin. These are frequently seen in PCOS & occur around the mouth area.
Treatments are well tolerated. For deeper extractions we use super strength numbing gel for 30-60 minutes prior to extractions.
For superficial extractions & injections, treatments are pain free.
Superficial large inflammatory cysts do resolve without treatment (1-3 weeks), however if inflammation is severe, scars are often seen.
Deep cysts usually do not resolve unless treated or extracted.
You will get improvement with only one session; however, it really depends on the number of cysts. As a guideline, most require between 1-3 sessions. More sessions if-
- Cysts are deep
- Extensive acne
- Extensive whiteheads & deeper submarine comedones
Our dermatologists can apply anti-inflammatory medications to markedly reduce the size of cysts within 24 hours. Deep acne cysts can be extracted using erbium & CO2 lasers. This can markedly reduce flare ups & accelerate acne clearance.
Recovery depends on the level of the cyst.
- Superficial cysts associated with cystic acne, recovery is immediate, with a significant reduction in inflammation after an injection of cortisone.
- Deep cysts that require extractions have a recovery time of 2-5 days, depending on the depth.
You have three options to be seen urgently for cyst treatment-
- Book a consultation with our senior nurses for evaluation & treatment. The consultation is free. T&C apply.
2. Ask your GP to refer you to refer you to our clinic. A referral enables you to claim a fee from Medicare.
3. See our dermatologists for an appointment. You can book a consultation without a referral however you cannot claim the appointment, or your injection fee from Medicare.
In many cases, yes. Unlike teenage acne, hormonal acne, or female adult jawline acne, presents as deep cysts around the mouth, & as the name suggests, jawline.
This form of acne is different from more superficial acne in teenage years. Hormonal acne can be resistant to topicals & frequently require the help of a dermatologist.
Chemical peels are a great way to treat blackheads & pimples, but they are of limited value for treating true cysts. Our clinicians combine high strength salicylic acid peels with manual extractions, or with a laser.
Salicylic acid peels start at only $120 & can markedly reduce pimples & congestion
Purging is a term used to describe transient & temporary worsening of acne. It’s most associated with retinoid use. Think of it as squeezing out the context of oil glands from underneath the skin.
Purging is not uncommon & can be seen with both topical retinoids including retinol, as well as prescription topicals such as. Acne medication can also flare up cystic acne, however your dermatologist may prescribe you concurrent anti-inflammatories.
You have 2 choices for flare ups:
- Stick with it, purging usually subsides within 2-6 weeks.
- Drop your dose or frequency of retinoid use. If you are on acne medication, check with your doctor.
Some acne medication is a synthetic retinoid, which is a form of vitamin A. It works on cystic acne by-
- Reducing skin inflammation within the cyst
- Reducing oil production
- Killing bacteria associated with acne
- Normalizing the amount of shed skin in the oil gland
It is difficult with natural treatments as cysts lie deep in the dermal layers of skin. If you would really like to give DIY home treatments a go you can try-
AM: Salicylic acid wash 2%
PM: Retinol & niacinamide. Option to add azelaic acid if inflamed
We don’t encourage popping at home, but we also realise that patients will do it regardless. We have all had zits, so we understand the urge to purge & squeeze. Here is out tip-
Step One: Identify what cyst can be safely treated. The cyst must be ‘ripe’ & superficial. Treat too early & you run the risk of scarring.
Step Two: Clean the area with a soap free wash. Cetaphil, Cerave, La Roche are all good brands. Find one with 2% salicylic acid.
Step Three: Apply a warm compress to the cyst. Heat encourages the trapped substance to work its way out of the hair follicle. Do this 2- 4 times a day to bring the pimple or cyst to the surface.
Step four: Sterilization. Use a sewing needle or better still a hypodermic needle. Prick the cyst gently in the middle. Don’t go too deep.
Step five: Use two cotton buds to gently remove the contents of the cyst or pimple. Do not use your fingernails.
Step six: Cover with a hydrocolloid dressing. These cost $4-$6 from Chemist Warehouse.
You can repeat the above steps, but understand it is all about timing. We do encourage you to see a dermatologist if you have recurrent cysts as early & timely management markedly reduces the chances of long-term acne scars.