Best products for Cystic Acne?

Greetings all.   I come before you with hope that someone will have a suggestion as to what over the counter treatment may work well for cystic acne?  I have seen a dermatologist for this, and they prescribed Retin-A as treatment.  However, it dried my skin out so bad that I had to discontinue after a month's use.  To get that prescription was like pulling teeth from the dermatologist, because she flat out told me that I should just go on birth control and that will solve all of my cystic acne issues. However, at this point - birth control as a form of acne treatment is not an option due to the fact that my gynecologist wants me off of it as an experiment to see if I can rid myself of other female symptoms. make a very long story short, I am at my wits end.


I understand the fact that nothing is truly going to rid me of my cystic acne, but I would be so happy to find a product that would at least shrink the ones I have a little faster, that way they aren't as painful for so long.  I spend most of my day on the phone, and nearly 10 times a day, I'm banging the receiver into my jaw and it hits a cyst and it makes me want to cry! 


As it stands now, I'm using Philosophy's Purity Made Simple, and their new On A Clear Day acne face wash.   For moisturizer, I've been using Fresh's Umbrian Clay Oil Free moisturizer.   As for spot treatment, I have PTR Acne Spot Treatment.  However, I don't feel as though this combination is aiding in riding myself of my usual acne, nor aiding in the healing of my cystic acne.


I'd be ever so happy for any suggestions ya'll might have!  Thank you!


- Jessica

Answers: 7
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Hi missconduct -  Smiley Sad  This stinks! I know exactly how you feel. I know that birth control can be used to clear up acne, though unsure if it will clear up Cystic Acne, you're wise to listen to your 'Groin-acologist' over the Derm) (my name for the gyno is for my friend Swifty, we've lost touch, imagine if she read this? Not likely) I suffered from cystic acne for over a decade, it was a result of medication.. If you've never had it you cannot understand what it's like to deal with.  Many people have probably heard my story, they must get sick of it, but this is what happened to and for me.


I'm the whitest girl on earth, obviously making this acne appear 100x worse than somebody with even a speck of pigment in their skin. There are virtually no concealers, foundations etc light enough for me. I saw the dermatologist and tried many different treatments. I tried Murad, Proactiv and numerous others on my own.


What finally worked for me was Philosophy Purity Made Simple cleanser (you're using that so that's a good start) Philosophy The Oxygen Peel (LOVE IT - if they ever stop making it, I'm a dead woman & I will most likely never leave the house again)Followed by Philosophy Hope in a Bottle (again, please dont ever stop making it) There's another product that I used, I'm trying to find out if the name has been changed or if it's just a new name & package but the same product, can let you know when I find out, it was an On A Clear Day Spot Treatment Product , don't know if it's the same yet.) This is what did the trick for me. I did not set out to use all Philosophy products, it just worked out this way. I also do not work for Philosophy or get any compensation from them, I just love these products, they've been a life saver for me.


I've tried other combos and there's one other product loved and can't find or remember it, it's not by Philosophy. So, I've played around with other brands and products but always come back to this. They also have a product called Help Me (unless they changed that name too) I've not tried it, but i"ve heard it's amazing and surprisingly gentle.


If you try this you have to be careful with The Oxygen Peel, you'll have to remove it carefully because you want to try to avoid opening anything up if possible. This is not like a real 'Chemical' peel, those can be a bit more scary. If you'd like to, you can send me a message I can try to answer any other questions and give you tips, especially on the use of The Oxy Peel..


I still have things that pop up here and there and that you can feel under the skin, but it is **Nothing** like it was. I don't use the Hope Bottle or other one very often, need to get some though. I was always stopped or stared at because of my flawless, perfect complexion, I mean all the time, it got embarassing (I can say that now, since it's a 'Used to be" and not a 'Now') A family of 5 mistook me for a life sized China Doll, weird, longer story. Then the compliments stopped, and I don't have to tell you what the looks are like from family and friends to strangers. You know how painful it is,not just physically painful. Howeverkm after finding this combo and having success with it I started to get more stares and comments, in a good way, people saying how great my skin was looking etc. It will never be what it was, which makes me very sad, but that's life.


I hope and pray that you receive some relief, maybe this combo will work for you, Maybe the Oxygen Peel and then a different treatment product would work for you, it's nearly impossible to figure out what works. (BTW, if you do this program, I'd do the Oxy Peel followed by nothing the first few times, I also like what Philosophy calls a 'Boot Camp" for your skin, including the Oxy.) Then add the treatment product a few days in. Hope we chat soonl I wish you all the best, hang in there and just know you are not alone. There is something else I'd like to share with you, but would rather tell you in a Private Message if that's okay with you. Send me one or let me know if it's okay to send you one. It's perfectly fine if you'd rather not, don't worry about it. Still wishing you all good things and just so you know, I think your picture looks beautiful. Smiley Happy


ps dont ask why, I'm just wondering if the Phil, On a Clear Day Cleanser may not be right for you, maybe a little harsh. Never used it myself though.


pps - have you tried Clarisonic yet? I think it would be helpful to you, but think you should wait until you get things a little more under control.


Hiya missconduct - I feel your pain, I have been battling a particular bad case of re-occuring cystic acne since about March.  Last week I finally switched to a benzyl peroxide based product (Clinique Emergency Gel Lotion) for spot treatment and added a retinol product (PTR Retinol Fusion PM) as a treatment for the entire face. Before, all the products I was using, regardless of the brand, were salicylic acid or sulfur based (for spot treatment).  The new combo has been helping and some of the particular bad cystic acne on my jaw area is starting to shrink away.  I also wanted to say, since you said that you were using a Retin-A that you had to discontinue due to dryness, that retinol is a gentler formulation than retin-a.  I have mild rosacea and using the PTR over the past week hasn't caused any dryness or increased redness.  The product also doubles as a moisturizer.  To be on the safe side though, I don't use the PTR on my the area of skin around the apple of my cheeks because that area is prone to redness but I do use the PTR on my forehead, chin, and jawline area.  I then put moisturizer on the areas that need it, i.e. cheeks and after about ten minutes to let those products absorb, I use the Clinique spot treatment directly on the spots, only need a tiny bit.


I think different products work differently for everyone and its sometimes a matter of trial and error.  I also think your skins gets use to stuff and with acne treatments you may find yourself having to change it up every few months.  Last year I had been using Kate Somerville's EradiKate (sulfur based) with some success, but then that stop working as well.  Good luck!


I was on the pill for 10+ years and went off it about a year ago after getting married. After about 6 months I started getting really red painful cystic acne on my chin and jaw line. I would get them all month long with a major outbreak about a week before my period. I was so miserable, It really took a toll on my confidence.

I got online and tried pretty much everything I could think of, gentle cleansers, Benzoyl peroxide, apple cedar vinegar, ice, aspirin masks, Retin A, Proactive. You name it I tried it!

Someone on Make-up Ally mentioned breaking open Evening Primrose oil caplets and putting it directly on the skin. I tried this for a few weeks and found that while it kept the cystic acne at bay it made me break out in small white heads so I stopped. Cystic acne came back within a month. I still had a whole bottle of EPO so I started taking 1000mg in pill form a day.

It's been 6 months and while I still get at least one zit around my TOM I am pretty much breakout free the rest of the month.

It has literally changed my life, it also has the added benefit of managing cramps and other menstrual symptoms.


Hi missconduct, sorry to hear about what you're going through. I can definitely relate. Have you talked with your dermatologist about taking an oral Isotretinoin (Accutane, Amnesteem, Claravis, Sotret)? In severe acne cases, these are usally the last line of defense, however they require ongoing medical monitoring while taking them (typically for 6 months) to watch out for side effects. You will have to get your liver examined monthly while on an oral isotretinoin and be weary that they can cause you to experience mood disorder, which can range from minimal to severe. When I was on Accutane in college, I became severely depressed; but I managed to continue on with treatment for the 6 months I was to be on it and I no longer felt depressive symptoms once off it. Accutane permanently cleared the acne on my back and shoulders and took care of the acne on my face. Other side effects are skin dryness/redness/flaking, so make sure to use a water-based, noncomedogenic moisturizer and sunscreen (at least with spf 15). I remember my corneas (part of the eye) got dried out while on Accutane, which was helped by eye drops. This stuff is serious, so make sure you talk with your doctor about ALL possible side effects and if its appropriate for you to take. Obviously if you plan to get pregnant, stay away at all costs.


I would recommend doing the following and being disciplined with it every day: change your pillow case nightly (or alternatively, place a new towel on your pillow every night); disinfect the phone you are on daily and before each use (if you can use speaker phone, I would highly recommend that to avoid having the phone come anywhere near your face); don't touch your face for whatever reason (if you absolute have to, make sure your hands are clean); keep your hair out of your face (this includes when sleeping - pull it back and wear a head band); stay away from dairy and processed foods and foods with high sugar content (including foods with naturally high levels of sugar like pineapple) and eat LOTS of rich green vegetables - raw is a good way to go; drink 2 liters of water with some natural lemon squeezed in it daily; try the Cetaphil for all skin types cleanser; use the Origins charcoal/clear improvement face mask to draw out impurities (i'd say use it 2-3 times a week, you likely won't be able to use this if on oral isotretinoin); stick to noncomedogenic make-up (the line biodroga has an awesome tinted moisturizer, which is a great alternative to foundation); consider taking a fish oil supplement for omega 3 fatty acid, which can help keep skin irritation at bay, especially if taking medication; and try not to stress - I know that can be hard but stress can impact your hormones and can, in general, cause a whole slieu of negative health effects (it can also increase sebum production). Things like exercise can help mitigate stress.


In general, your derm is recommending birth control because she/he believes your hormones are causing your cystic acne. I've never heard of birth control being prescribed for severe acne and without doing medical testing, your doc won't know if in fact you have hormonally induced acne.


Good luck and I hope this info helps. If you decide to take an oral isotretinoin, Clarins lotus oil will act as a very good nightly moisutrizer.



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While I've never had acne like this, not as fire dad acne pretty bad and she used Accutane. Now this was the west time at first getting used to it, but it cleared her face and she was forever rid of it since. It does come with some serious side effects, but I've not heard of anyone experiencing the more serious ones. Maybe this is something to talk to your parents about and see if it's an option for you.
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There are a lot of different kinds of vitamins that can help your skin, like vitamin A, vitamin B and zinc. But vitamins aren't the only things you'll need to achieve healthy clear skin.

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Hi there -

I'm an Herbalist student and an Aromatherapist so my advice deals with treating the problem from the inside AND out. Cystic acne is a hormonal issue - which is why your doc wants you on birth control (which you probably figured out Smiley Wink ).


Topically, I would highly recommend using a yarrow-tincture on your skin (a quick google search will lead you to where to purchase all of my recommendations - i do like Herb Pharm and Ancient Indigo Herbs - the latter of which is found on Etsy, and cheaper).  

Do a bit of research online - many people have had a lot of luck.


Internally (which is the real path to clearing cystic acne) i like Stinging Nettle teas/infusions.  Again, very cheap to purchase in bulk online and easy to make.  It is incredibly good for the skin and can help clear you up by helping with the hormonal imbalances that play a major part.

Caffeine can exacerbate cystic acne so cut down or even cut OUT if you can. 


These remedies take time to work but if you are patient you should see some results if you are diligent about doing these things.


For immediate results a dermatologist can do dry ice treatments and even cortisone shots.  I find that a topical cortisone cream can help when i get occasional cystic bumps due to hormone fluctuations - use along with a yarrow tincture (which you apply like a toner, basically) and see what happens.  As it can be drying, i recommend hemp-seed oil afterwards. I make my own cream with it and it is incredibly healing, and doesn't break me out at all - but you can use it straight up.  Just the oil.  


Burdock root is another good one, along with the stinging nettle, to make teas/infusions from.  It helps with purifying the blood from excess estrogen (hence your doc wanting you to go on birth control pills - this is a much milder way of achieving that). 


I had cystic acne for MANY years and these are the things i personally feel are helpful.  I am completely clear now with the exception of one or maybe two bumps every 6 months or so.  

I hope this helps and that you get relief soon!  

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