Symptoms and Signs of How to Treat Cystic Acne

Medical Author:
Medically Reviewed on 8/19/2021

Doctor's Notes on Cystic Acne

Cystic acne is the most severe form of acne (acne vulgaris), in which the acne forms deep, tender inflammatory, fluid-filled cysts within the skin that often leave scars when healed. Cystic acne most commonly affects the face, but it can also involve the chest and back. Cystic acne is difficult to control and treat, and topical medications or nonprescription medications often do not work to control the condition. Systemic (oral) medication is frequently used to control cystic acne and to minimize scarring. 

Symptoms of cystic acne include the following: 

  • Large, red, tender, elevated soft bumps on the face, chest, and/or back. 
  • Bumps may have one or more pustules within them and the lesions are often tender and painful. 
  • After healing, the area may be permanently scarred or a defect in the skin may appear.

What Is the Treatment for Cystic Acne?

Many of the over-the-counter and prescription creams and cleansers that may work to relieve acne do not work in cases of severe cystic acne. Treatment for cystic acne usually involves oral antibiotics or other treatments. Your doctor can help you decide which treatments will be best in your individual case. Treatment options include:

  • Oral antibiotics
  • Birth control pills to regulate hormones, which may be effective for some women
  • Isotretinoin (formerly known as Accutane
  • Topical benzoyl peroxide
  • Spironolactone, which can reduce oil levels (not given to men because it can promote breast growth in men)
  • Retinoid products to apply to the affected area
  • Steroid injections


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.