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Post in Acne-Prone Skin

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


Re: Best products for Cystic Acne?

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 😉 ).


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!  

There are a lot of different kinds of vitamins that can h...

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.

I was on the pill for 10+ years and went off it about a y...

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 thr...

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.



While I've never had acne like this, not as f...

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.

Re: While I've never had acne like this, not as f...

Is it the fact that I'm sporting braces in my default photo that gives off the impression that I need parental consent for prescriptions? Probably so, seeing as how I do get carded for Rated R movies. But, in fact....I'm 26! No consent needed. When it comes to Accutane, my hair dresser is using that currently and she's had amazing results. However, she is dealing side affects and has to go get blood work done every 3 months. Seems like a pretty big commitment for a prescription. No sun for 6 months? That's pretty hard for living in Florida. At this point, I think I want to exhaust all of my options topically before I buckle down with Accutane. Thanks for the suggestion though. It definitely is something to think about!

Hi missconduct -  :(  This stinks! I know exactly how you...

Hi missconduct -  😞  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. 🙂


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.

Re: Hi missconduct -  :(  This stinks! I know exactly how you...


I cracked up when I read groin-acologist! That is just too perfect! I'll have to use that one when I go to see my doctor next week. I'm sure he'll appreciate that. 🙂 You mentioned that your cystic acne was a result of medication, but what medication (if you don't mind my asking) caused it?

Girl, and here I thought I was the whitest girl on earth! Are you also very pink complected too? That makes the acne redness so much worse when you're already pink to begin with. (Sometimes, I wish I was more yellow skin toned, because the redness would probably be easier to hide).

I never tried the Oxygen peel, but I did have the microdelivery peel many, many moons ago. I did like it, however, I felt like it made me more oily which is the last thing I want to do. But, I'd love to try the oxygen peel. I'm probably going to make a Sephora run since I have the day off (Thanks America!) I think the Philosophy changed their On a Clear Day, to Clear Days ahead. The spot treatment was altered a little bit. Now, it's with salicylic over glycolic? But, don't go by me. My memory often fails me. I think the Clear Days Ahead face wash only has 1% salicylic acid so it doesn't seem like it's been hurting the skin too much. But I only use that a few nights a week and work primarily with Purity. The Purity Made Simple face wash is just so nice, and not too rough on my skin. I don't think I'll ever stray from that. Plus, it works wonders on removing eye make-up. Can't beat that!

In regards to the Clarisonic, I do have that and LOVE IT. Hasn't helped all too much with the acne, but it definitely had helped with my blackheads and my pores. At least that's something I don't have to think too much about now.

Okay, now I'm going to shoot you a private message , lady!

Thanks for all of your suggestions!

Ouch! ok, warning, do NOT ever Google image "cystic acne"...

Ouch! ok, warning, do NOT ever Google image "cystic acne" because it will give you the super severe cases that are horrifying.


Anyways, I wanted to confirm what it was before giving advice since I'm not sure my acne were that type. First of all, as the other poster said, have you tried retinol? If you haven't and is hesitating to spend the money, Sephora online promo code "ptrserum" will get you a free .4oz sample of PTR retinol PM. A less irritating alternative to retinol would by glycolic acid, so try cleansers or toners with glycolic or AHA/BHA in it. Lastly, do you use any masks? clay/charcoal/mud kind for acne? about once a month, I would get a giant angry pimple with pus inside and it stubbornly stayed there for weeks, and sometimes I get bumps under the skin that you can't see but can feel and when it comes out it's red and it hurts. I use either Murad clarifying mask or Origins Charcoal mask as continuous spot application and it went away in ~3 days. Murad mask dries it up so they become hardened tiny balls of oil that falls out of your pores when I wipe with toner. Origin charcoal mask is less drying and it draws the liquid up to the surface without hardening it so it doesn't stretch the pores and the area looks the same afterward with no scarring (for me). I highly recommend trying either one of those. Murad is a bit drying, but if you want to try it, promo code "forall" have the deluxe sample of Murad mask + acne spot treatment available with your online purchase. On days when you are not using the treatment, I hope you are using a toner?


I searched for "cystic" on Sephora and got these 2 result:

I know you say you already use the Fresh moisturizer, but if you like how it feels, I suggest giving that kit a shot. When I first brought Clinique Moisturizing gel, it was blah and didn't live up to the hype, but when I used it with their 7 day scrub, cleanser and toner 2, the bumps on my skin miraculously disappeared.


Lastly, make sure to clean your phone or anything you put near your face of course. Have you noticed if it's worse when you eat certain food? If it's partly caused by inflammation (junk food or spicy food etc), it might help if you cut those out and eat anti-inflammatory food like blueberries (I think it's similar to what Chinese people do. When I lived in China, or any of your friend who's raised by Chinese parents prob knows too, it's common knowledge that food with "hot properties" like any kind of chili or pepper, lamb, spearmint, lychee and orange will cause acne when eaten in great amount (everybody's tolerance is different), they are best eaten in winter since the cold cancels out the effect, and food with "cooling properties" like duck, watermelon, pear, yogurt, lotus seed/roots, and mung beans will bring the balance back down and thus ease the acne and best eaten in the summer).


That's all I know about acne from personal experiences. Good luck with your skincare! I know it annoy the hell out of me when I get the monthly giant painful acne. Oh, err, for temporary relief, I wrap an ice cube in 2 layers of paper towel or a facial towel and the cold helps shrink the big ones a bit.

Re: Ouch! ok, warning, do NOT ever Google image "cystic acne"...


Took the plunge today, and bought a Origin's toner. It's not the Zero Oil, but the United State balancing toner. Hope it helps!

Re: Ouch! ok, warning, do NOT ever Google image "cystic acne"...

@beautytester I usually hate apples too unless they're super crunchy.
@missconduct I have acne-prone skin and I use the Origins Zero Oil Purifying Toner. I've used Olay and Clinique's toners and I didn't like them, but the Origins's one has salicylic acid and Saw Palmetto, and it takes off so much gunk! I used to think toners were unnecessary, but this toner has changed all that because it isn't drying at all contrary to the name of the product.

Re: Ouch! ok, warning, do NOT ever Google image "cystic acne"...

Hm, I'm surprised no mention of toner. I guess many people thought toners are unnecessary or very drying. Toners are mostly for combination and/or oily skin so it usually contain something that controls acne (witch hazel, salicylic or glycolic acid) and thus can be drying to some people (or even to me when my skin is especially dry). Personally anything that contain salicylic acid makes my skin drier and flaky-er (many drugstore cleansers and toners), anything with witch hazel is perfect for me (Clinique Toner 2), and anything with glycolic is excellent at smoothing out my skin without making it dry.

If you have combination/oily skin, I strongly recommend trying some. All the acid in the cleanser gets washed away and are thus not really effective. Spot treatment can be harsh, so toner is like a gentler form of treatment that sinks into the skin better. It also wipe away remaining dirt/oil after the cleanser and prep the skin for moisturizers (sometimes due to environment and/or season, moisturizers don't get absorbed, so this solves that problem). I would suggest trying Clinique Toner 2 (if you are not opposed/allergic to mint, alcohol or witch hazel. This is my standby for 5 yrs), or DDF toner if you like glycolic.

Why do girls always have these problems? ohhhh lady, that is the question I ask myself every month when I have (TMI) menstrual cramps and alternate between silent cries of pain and cursing the world. As for cystic acne, some of my guy friends have that problem too, some don't care, one uses Proactive, but I don't think it's working =X.

Re: Ouch! ok, warning, do NOT ever Google image "cystic acne"...

Hello! Thanks so much for such an in-depth response!
Thanks so much for the code for the same of the Retinol. I never would have thought to try it since it's usually linked to anti-aging products, which isn't my main concern. But if it's noted to treat acne, then sign me up! 🙂
As for cleaners, the only thing I seem to have my in bag of tricks are cleansers primarily with the main ingredient of salicylic acid. I've used glycolic acid as a spot treatment, with good results. I guess it would make sense to try that as a cleanser as well.
In regards to masks, I've been using the Fresh Umbrian Clay Bar. So far, I really like to use this about twice a week for about 5 minutes because it has been reducing the redness caused by all of the inflammation. It works really well before I put my make up on, especially if I have a big outing and want to make my skin look as good as possible. I've even read online that you can use it as a spot treatment, but I haven't quite tested that out since I don't know how I feel about having clay all over my pillow.
I've seen a lot of estheticians in regards to my cystic acne, and no one has suggested the use of the toner. Maybe due in part because I have combination skin? So many different factors to take into consideration!
I wish I could say that my acne was because of junk food, but I really think it's all hormone related which is probably why the dermatologist had recommended birth control as a form of clearing it up. That would probably help too, considering when I was on Yaz a year ago, the cystic acne had gone away. However, when I do go back on birth control in the future, it more than likely won't be Yaz, but for something that is made more for endometriosis. Oiy veh. Why do girls always have these problems? Wish I was a guy sometimes!

Yay Chinese united! I like your username btw. If I had kn...

Yay Chinese united! I like your username btw. If I had known this is permanent, I would've made a cooler, less generic username. =/

Orange are good for you cuz of the Vitamin C and fiber, but too much orange and ginger makes me feel a tad flushed and fever-ish like I'm about to have a nosebleed so I can only eat them in the winter. I do get pimples when I eat too much greasy food. I think the western explaination would have something to do with inflammation from increasing blood circulation and over producing oil and such.

I haven't heard the thing about Apples since I hate them and I usually eat: mango, banana, strawberries, blueberries, pears, and white flesh peach when they are in season and pretty much no other fruits (baked goods with chocolate chips, black sesame, peanut butter or matcha in the winter when there's no fruit aside from apples. I got a GIANT sweet tooth).

Re: Ouch! ok, warning, do NOT ever Google image "cystic acne"...

I'm Chinese and I know exactly what you're talking about. My mother would always say I have "hot air" because I eat too much greasy/junk foods. I would say, however, that I think oranges are good for you. Apples, on the other hand, are bad...for your skin that is. At least that's what I have been told.

Hiya missconduct - I feel your pain, I have been battling...

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!

Re: Hiya missconduct - I feel your pain, I have been battling...

I decided to go with the Korres Quercetin & Oak Antiaging Antiwrinkle & Firming Face Serum because it's the all natural version of retinol. It may take more time to turn over cells, but I'd rather use a more natural product for long term use. So far though, this serum paired with using the Oxygen Peel for three days has made a big difference in skin texture. The left side of my chin is already starting to clear up! Hopefully the right side, and my forehead will catch up soon enough. 🙂

Re: Hiya missconduct - I feel your pain, I have been battling...

You're very welcome hun. I see you got some other suggestions as well. Goodluck! Oh and I forgt to tell you, as beautytester said you can get a .4 oz of the PTR Retinol Fusion PM with the offer code PTRSerum. Its quite a huge bottle, a little less than half the size of the regular full-sized bottle.

Re: Hiya missconduct - I feel your pain, I have been battling...

Hello Elizabeth!
Sorry you're going through the cystic acne trauma. It really is horrid to have to deal with. Thank you so much for your suggestions. You're the second person to mention retinol as treatment, which I never would have thought of since I see it labeled for anti-aging products. But using that would totally make sense. A light bulb just went off on my head! I'm definitely going to be headed to Sephora today to get a sample of some products to try, that's for sure. 🙂
When it comes to the sulphur based products, I feel like they do nothing for me! I have the PTR Acne Treatment with sulphur and it doesn't really do much but smell. But I keep using it in hopes that one day it will miraculously work. Plus, it's too late for me to return it.
I'm definitely going to put the PTR Retinol Fusion PM on my list of things to sample today, as well as the Clinique Emergency Gel lotion. I'm so glad you mentioned that the retinol doesn't cause redness, because my skin is always pink-hued to begin with. Pair that with acne redness, and you've got yourself a really pinky red girl. No good. There is no amount of Smashbox green primer to counteract what I've got going on. Haha.
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