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Acne is among the most common skin conditions in the world, and one of the main reasons why patients consult dermatologists, like Dr. Michele Green. Almost everyone has had to struggle with a painful or annoying zit or acne breakout at one time or another. Acne can cause us to feel self-conscious about our appearance and for many people who deal with recurrent or persistent acne, these pimples are often a major source of frustration and sadness. A cystic pimple is one of the most severe types of acne lesions, is often painful, and difficult to treat on your own. If left untreated, acne cysts tend to cause permanent acne scars. That is why it is so important to treat cystic acne as quickly as possible. The best way to treat an acne breakout is by consulting with a board-certified dermatologist, like Dr. Michele Green, in New York.

The range of acne treatments varies, depending on the cause of the acne cysts, frequency, and the amount of acne scarring. Dr. Green incorporates the best skin care for her patients, from her MGSKINLABs line of products, with ingredients such as benzoyl peroxide, retinoids, salicylic acid cleansers, oil free moisturizers, and more. When severe acne occurs, oral medications such as antibiotics, Spironolactone, or Isotretinoin may be used. Corticosteroid injections, acne surgery, HydraFacials, Oxygen facial, microdermabrasion, VBeam® laser, BLU-U Light, and chemical peels, are just a few of the best acne treatments that Dr. Green utilizes in her discreet NYC dermatology office.

Dr. Michele Green is an expert in acne treatment, cystic acne, and treating acne scars. Dr. Green has over 25 years of experience in treating thousands of patients from around the globe, in her private, boutique New York City office. Her expertise and knowledge regarding skincare and acne treatment, among various other skin conditions, is what brings some of the most discerning men and women in the world to her Upper East Side dermatology office. She takes pride in carefully creating customized treatment plans for each individual patient based on their medical history, their cosmetic goals, and their unique situation. If you are looking for a solution to your cystic acne breakouts, Dr. Green is here to help.

What is Cystic Acne?

Cystic Acne is a severe form of acne that develops deep below the surface of the skin. Cystic acne lesions do not connect with the surface of the skin and typically do not ever form a ‘head’. Acne-causing bacteria, excess oil, and dead skin cells clog the sebaceous glands at the base of hair follicles and become trapped. This process leads to an increasing amount of inflammation in the skin. As the number of trapped bacteria grows and accumulates, the inflammation increases, causing acne lesions to form. Cystic acne is formed as these cyst lesions increase in size and number, and the infections go deep into the skin. These deep acne cysts are largely filled with pus. Cystic acne is often extremely painful and is the form of acne most associated with causing acne scarring. If you develop cystic acne, it is important to consult a board certified dermatologist, like NYC based Dr. Michele Green, immediately to treat the infection and prevent acne scarring. Treatment of cystic acne may require oral antibiotics such as Minocycline or Doxycycline and in recalcitrant cases, Accutane (isotretinoin).

AM 16yo female 5 months before and after Accutane PROFILE R MGWatermark

5 months before and after Acne treatment

What causes Cystic Acne?

Cystic acne lesions develop due to oil glands, at the base of hair follicles in the skin, becoming clogged with sebum, dirt, debris, and dead skin cells. While acne cysts are most often associated with oily skin, those who have normal, dry, or combination skin types can also develop acne lesions and cysts. Cystic acne may develop due to a combination of factors including genetics, hormones, stress, diet, and poor skincare routine. These are some of the most common contributing elements that lead to the formation of acne breakouts and cystic acne.

Much of the cause of acne is genetic; some patients are simply more prone to cystic acne than others due to their skin’s natural oil production, as well as other contributing factors. Due to these hereditary reasons, there is a a tendency for cystic acne to run in families. Hormones and androgens can also play a role in the development of cystic acne. Androgens cause the oil glands in the skin to increase in size and produce excess amounts of sebum. It is the production of excess oil and increased androgen activity that clogs the pores and causes acne. Due to the hormonal involvement in cystic acne, Dr. Green will do a thorough hormonal evaluation for your cystic acne.

What can a dermatologist do to help me get rid of cystic acne?

Dr. Michele Green is a world-renowned expert in dermatology, especially when it comes to treating acne breakouts and acne scars. Dr. Green has over two decades of experience managing varying skin conditions, including acne, acne scars, psoriasis, skin cancer, and more. The first step in developing a customized treatment plan for your unique situation is by performing a complete medical history, which will be completed during your consultation with Dr. Green. The medical history typically details any personal and family experience with acne breakouts, including any previous acne treatments. A physical evaluation of your skin is then performed to determine which combination of in-office treatments and specially formulated at home skin care products will be best suited to resolving your unique situation. Whether you are experiencing whiteheads, blackheads, pimples, pustules, or cysts, Dr. Green is here to help resolve your acne and provide you with a blemish-free, clear, smooth, beautiful complexion.

What are the best treatment options for cystic acne?

There is a myriad of treatment options available when it comes to dealing with cystic acne. The right treatment or combination of treatments that’s right for you and your skin may depend on several factors including your skin type, the type of acne you’re dealing with, the underlying cause of your acne, and your medical history. Instead of suffering through endless DIY acne treatments, schedule an appointment with a dermatologist, like Dr. Green, who can help you determine the best way to resolve your acne permanently and produce a clear, smooth, healthy complexion that lasts. Below are some of the treatments available that Dr. Green often recommends to her patients who struggle with acne.

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Acne treatment – 1 and 6 months after.

Oral acne medications to treat cystic acne

Depending on the underlying cause of your acne, there are several prescription medications available that may help resolve and control breakouts. It is often recommended to use some form of oral medication to best treat cystic acne breakouts, especially if you are prone to recurring cystic acne.

Oral antibiotics such as Doxycycline and Tetracycline are great for helping to resolve cases of mild to moderate and even severe inflammatory acne, including cystic acne. The frequency and strength of your prescription may depend on the severity of your acne condition. These antibiotics are advised when topical acne treatments have failed. Oral antibiotics need to be taken for a period of time prescribed by Dr. Green, and the completed course will be ascertained. Probiotics are generally recommended while taking oral antibiotics to improve gut health.

Oral Isotretinoin is one of the most effective treatments for severe acne, helping to prevent new nodules from forming as well as keeping acne scars from developing. In the past, Accutane (brand name for Isotretinoin) was reserved for only the most severe cases of recalcitrant cystic acne. However, Accutane’s use has expanded to include moderate cases of acne, or chronic acne breakouts which have not responded to other treatments. More dermatologists are recommending Accutane in order to best prevent permanent scarring and to achieve blemish-free skin more effectively. There can be various known side effects related to Accutane and your acne treatment should always be supervised by a board-certified dermatologist, like Dr. Michele Green. Women who are taking Accutane for their cystic acne are required to get monthly blood tests to make sure that they are not pregnant. Strict sun avoidance and sunscreen use is required while taking Accutane, as it can make you very to sunburns during the course of your acne treatment.

Spironolactone (brand name Aldactone) is a medication that can be used to help to combat hormonal changes or imbalances that may be contributing to the development of acne breakouts. Spironolactone has historically been used as a blood pressure medication, although it has been found to controls androgen levels as well. When the levels of androgens are increased, this can lead to an overproduction of sebum within the skin, creating cystic acne lesions. Acne prone patients, when hormonal involvement is the cause, or patients with Polycystic Ovary Syndrome, typically find great relief of their acne breakouts by taking spironolactone. For other patients, this medication greatly helps to regulate the hormonal fluctuations which can cause adult acne.

Oral contraceptives/birth control pills can help regulate the hormones that spike during a woman’s menstrual cycle and control the acne flares associated with those changes. Birth control pills are used to prevent hormonal acne by keeping hormones in balance. Oral contraceptives have been approved by the FDA to treat women who struggle with hormonal acne. Two of the most popular brands of birth control pills that are used to treat acne are Yaz and Ortho Tri-Cyclen, which combine estrogen and progestin. Unfortunately there are some potential side effects associated with taking birth control pills. Possible side effects include weight gain, nausea, mood swings, and an increased risk of blood clots. Women should avoid cigarette smoking while on oral contraceptives as this further increases your risk for developing blood clots.

Acne treatments for cystic acne

Chemical Peels for cystic acne treatment 

A chemical peel is a procedure that is designed to help with increasing the rate of skin cell turnover, encouraging dead skin cells, debris, and dirt to be sloughed off more quickly than they would on their own. A chemical peel can help to unclog the pores and reveal a healthier complexion that is more even in tone and texture, as well as be used to prevent or eliminate acne. There are a wide variety of chemical peels that can be used to target different skin concerns depending on the solution and the strength of that solution. During your consultation, Dr. Green can select the appropriate chemical peel, for both your condition and skin type, to help treat acne breakouts and prevent acne scars from forming.

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Cosmelan 10 weeks before and after

HydraFacial for treating acne breakouts and cysts

The HydraFacial is a three-step medical-grade facial that focuses on gently exfoliating, deep cleansing, and intensely nourishing the skin. One of the greatest features of the HydraFacial is that it can be customized to cater to the individual skincare needs of each patient. By incorporating specially selected serums, or ‘boosters’, the HydraFacial can serve as a targeted acne treatment and work to reduce acne breakouts. The first step in the HydraFacial treatment is the cleansing of the skin. The HydraFacial utilizes a handheld device to deliver a combination of serums through vortex fusion tip, applying the ingredients to the skin in a concentrated manner while simultaneously suctioning dirt, debris, and dead skin cells away.

The second step in the process is the administration of a chemical peel. This second step helps to increase the rate of skin cell turnover, which is exfoliating and is typically designed with a combination of salicylic and glycolic acids. Both of these ingredients also happen to be beneficial for acne treatment and can help to break up the oil that is clogging the pores and contributing to acne. Different grades or strengths of chemical peels can be incorporated into this step, depending on the degree of acne breakouts. In addition, Dr. Green has medical grade acids that she can incorporate into this crucial second step.

The third step of the HydraFacial is the infusion of rich antioxidants that nourish the skin and help to reinforce the skins’ natural protective barrier. This third step helps to enhance necessary moisture retention and keep any toxins or environmental irritants from penetrating the skin. Different boosters can be incorporated at this time, for redness, hyperpigmentation, or other skin brighteners.

Blue LED (BLU-U®) light therapy is the final step of the HydraFacial process. The blue light works to eliminate acne-causing bacteria as well as improve the overall appearance of oily skin and clogged pores. When you a schedule a HydraFacial with the office of Dr. Green, she will work with you to customize your HydraFacial so that it addresses your primary skin concerns and leaves you with a healthy, radiant, glowing complexion.

Acne surgery to treat acne breakouts

Acne surgery is an in-office procedure that entails creating an opening in active acne lesions, removing the contents using a comedonal acne expresser, and then providing corticosteroid injections directly into the emptied lesions in order to help to relieve inflammatory acne. Steroid shots can also help relieve some of the inflammation that is commonly associated with cystic acne lesions. This treatment method is a quick technique that can be used to remove sebum and dead skin cells that are trapped within the pores and causing acne.  Extracting the contents of the active acne lesions prevents acne scars and allows the skin to heal.

VBeam Laser for acne treatment, acne scars, rosacea, and redness

The VBeam laser operates on a wavelength that exclusively targets any red pigment within the skin. This energy is converted into heat in the skin and absorbed by the atoms which are responsible for this red color, leaving the surrounding skin untouched. By incorporating Vbeam laser treatment with your acne treatment, the redness and inflammation associated with acne breakouts can be effectively diminished. As an added bonus, there is no downtime associated with VBeam treatment, meaning that you can resume your normal daily activities immediately after completing a treatment session. Additionally, there is a Dynamic Cooling Device with the Vbeam laser. This is designed to cool the skin prior to emitting the burst of light, making the procedure pain free.

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Vbeam® laser treatment before and after

Skin Care for Cystic Acne

Anyone who has dealt with cystic acne knows that managing breakouts can be a challenge. To best prevent cysts from forming, acne-fighting ingredients should be included in your skin care regimen. Careful selection of topical products for treating acne, whether they are purchased over-the-counter or if they are prescription lotions or creams, is critical. Benzoyl peroxide, salicylic acid, glycolic acid, and topical retinoids are some of they key ingredients to look for when creating a skincare regimen that’s targeted to treat and control acne. Below are some of Dr. Green’s recommendations for skincare when you’re struggling with cystic acne.

When you have cystic acne, a cleanser that contains benzoyl peroxide or salicylic acid will be helpful for eliminating acne-causing bacteria from the skin and shrinking acne lesions. Cleanse your skin twice a day without excessive scrubbing. Scrubbing too hard or over washing the skin can actually cause your skin to overproduce oil as a response. Additionally, if you have sensitive skin, ingredients like benzoyl peroxide may be too aggressive for you and cause a negative skin reaction. Dr. Green’s specially formulated pore minimizing cleanser is made with salicylic acid and glycol acid, designed to treat acne prone skin and effectively eliminate acne lesions. This Pore Minimizer cleanser from MGSKINLABs, Inc. removes oil and sebum from deep within the skin, minimizing the appearance of pores and leaving behind clear, smooth, healthy looking skin.

In terms of topical acne treatments, Adapalene (Differin gel) and tretinoin (Retin-A), along with other topical retinoids, are derived from vitamin A and are commonly used in the treatment of inflammatory acne and cystic acne. Azelaic acid is another topical cystic acne treatment. Azelaic acid has anti-inflammatory properties, and can use both to treat cystic acne and improve hyperpigmentation from acne breakouts. These topicals are beneficial for acne prone skin because they help exfoliate away dead skin cells and sebum that cause the pores to become clogged. Those who have sensitive skin may not be able to tolerate retinoids as they can cause dryness and skin irritation.

Noncomedogenic, oil-free moisturizer and sunscreen are essential for those who have acne prone skin. The term noncomedogenic indicates that the skincare product won’t cause the pores to become clogged, reducing the incidence of acne development. Anyone with oily or acne prone skin may be averse to the idea of applying a moisturizer to their skin for fear of triggering a breakout, however, hydration is important for all skin types, including oily and acne prone. By keeping your skin well moisturized you can ensure that the natural protective barrier of the skin is healthy and that your skin has the appropriate nutrients and strength to remain healthy and fight acne causing bacteria. Additionally, the harsh UV rays from the sun can exacerbate breakouts and create the appearance of dark marks where acne lesions are. In order to prevent the development of these dark marks and avoid worsening the appearance of your breakout, SPF of at least 30 should be used and reapplied often. While some sunscreens may clog the pores and create pimples, there are some which are designed for acne prone skin. It is best to incorporate a sunscreen that is oil free with a dry finish to prevent an exacerbation of your cystic acne.

How to treat cystic acne while pregnant

It is common for women to experience cystic acne breakouts while pregnant due to an increased release of various hormones, including androgens. These hormones can impact the amount of sebum produced in the skin, leading to excess oil accumulation within the skin, which then clogs the pores and causes cystic acne lesions to form. Pregnancy is a very special time and it is extremely important to be careful with what skincare products and medications are used during this period to ensure safety of both the mother and developing fetus. Consult with both a board certified dermatologist, like Dr. Green, and your obstetrician prior to use of any topical skincare products or oral medications for use in treating acne while you are pregnant.

While there are many products which are safe to use while pregnant, other medications such as retinoids and antibiotics such as tetracyclines, can cause potential birth defects. If you choose to breastfeed, many of these same medications should be avoided, since the effects can be passed to your infant. Again, it is always best to check with your obstetrician or pediatrician, when breastfeeding, to ensure any medication is safe for your baby.

One of the most important things to remember is do not pick at your acne! Picking at pimples only leads to worsening the acne, causing sebum to be pushed deeper into the skin and inflammation surrounding the lesion to increase. The increased amount of inflammation is what can cause permanent damage to the skin and lead to the formation of acne scars. Acne scars are often even more difficult to treat than the acne itself. While pregnant, consult with Dr. Green as to which cleansers and skincare products are safe to use. After delivering your baby, schedule a consultation with Dr. Green to discuss the best acne treatment options that are available.

How to get rid of cystic acne quickly

The fastest way to resolve cystic acne is by consulting a board certified dermatologist, like Dr. Michele Green. By combining in-office treatments such as acne surgery, with oral medications like isotretinoin, you will see your acne heal much more quickly than it would with any DIY method or homeopathic remedies. Working with an expert in dermatology will always be the quickest, safest, and most efficient way to tackle cystic acne breakouts and help prevent any acne scarring. To help resolve active cystic acne, Dr. Green may prescribe oral antibiotics that work internally to eliminate acne. She may recommend chemical peels, intralesional steroid injections, or acne surgery, to get rid of your cystic acne quickly.

Do spot treatments work on cystic acne?

Unfortunately, spot treatments that typically work wonders for whiteheads, blackheads, pimples, and pustules just do not work on cystic acne lesions. Most of your topical skincare products, no matter how targeted the ingredients are and how miraculous they may be for treating other forms of acne, are ineffective when it comes to addressing cysts. Cystic acne sits deep within the lower layers of the skin, making it especially difficult for topical spot treatments to penetrate the skin at the depth necessary to effectively treat the cyst. If you think that you feel a pimple coming on, it may be helpful to apply a bit of spot treatment to the area even before the lesion fully forms. This can potentially help manage skin inflammation before things get too out of hand. It would be ideal if a spot treatment existed that could handle cystic acne lesions. As of yet, there is nothing of the sort exists. Consulting with a board certified dermatologist, like Dr. Green, is the best way to manage cystic acne and prevent the formation of acne scars.

Do pimple patches work for cystic acne?

First of all, what is a pimple patch? A pimple patch is a hydrocolloid bandage that can be used to cover an inflammatory acne lesion, drawing out the sebum and oil that’s clogged within the pores. Hydrocolloid bandages work to dry up any surface level pimples and pustules, and many pimple patches are even medicated with additional acne fighting ingredients to help further minimize breakouts. While a pimple patch can be an effective method for removing the contents of an acne lesion that is on the skin’s surface, they are essentially worthless when it comes to addressing acne that forms deep beneath the surface of the skin, like cysts. Applying a hydrocolloid bandage to a cyst might be able to help with reducing the size of the lesion, although it is highly unlikely that it will successfully and completely eliminate a cyst. If you insist on using a pimple patch to treat this type of acne, then opt for a brand that offers medicated patches as opposed to regular unmedicated hydrocolloid bandages.

vbeam laser in use

Home remedies for cystic acne

While a Google search might highlight a slew of possible homeopathic remedies designed to cure your cystic acne, the very best treatment that is available for any form of acne (especially cystic acne) is found through treatment with a board certified dermatologist, like Dr. Michele Green. It is incredibly important that cystic acne be addressed swiftly and professionally since cystic acne lesions are the most likely to leave behind permanent acne scars. Acne scarring typically occurs after cystic acne breakouts because of the sheer amount of intense skin inflammation associated with cysts. This skin inflammation causes damage to the skin tissue that, unfortunately, the skin is unable to repair on its own. The result is usually an area of depressed skin that is tethered by bands of scar tissue. In order to actively prevent acne scars from forming and in order to clear cystic acne as quickly, safely, and effectively as possible, one should always meet with a board-certified dermatologist who can promptly diagnose your skin condition and prescribe you the appropriate combination of medications, topical skincare products, and in-office treatments to help you achieve a blemish-free complexion that lasts.

That being said, by making some slight adjustments in lifestyle, it is possible that you could potentially alleviate some of your acne symptoms. Cystic acne vulgaris can be exacerbated by different triggers, and identifying them can be a way to help reduce some of the breakouts. Cystic acne is largely genetic and can not, however, be attributed to one singular causal factor. Acne is largely genetic, though some external factors may cause a flare. Your dermatologist can help you identify factors that may be contributing to your cystic acne breakouts.

When it comes to home remedies for cystic acne, there are a few treatments that may help and can even be used as a supplement to your acne medications, skincare products, and in-office treatments. Tea tree oil is a helpful homeopathic remedy for reducing acne lesions, including cystic acne. Tea tree oil is naturally anti-microbial and anti-inflammatory, making it a beneficial topical treatment for acne lesions. There are some patients who love to incorporate clay face masks into their acne treatment routines, since clay can deeply penetrate the pores and remove impurities like sebum, oil, and debris that contributes to acne lesions.

What makes cystic acne worse?

Picking at your pimples is always guaranteed to make them worse! The problem with attempting to extract your pimple at home on your own (rather than having an acne surgery procedure done in a dermatology office, performed by a board certified and trained skin expert) is that you can exacerbate the inflammation surrounding the lesion, force the sebum in the pore even deeper into the skin, and potentially create permanent scarring. All of this is especially true when it comes to cystic acne lesions. Why is it so harmful to try and pop a cyst? It can be particularly damaging to the skin to try and extract a cystic acne lesion because cysts form far below the surface layer of the skin. Cystic acne develops at a level within the skin that prevents the lesion from connecting to the surface of the skin, making it essentially impossible to manually extract the cyst by popping it. Should one attempt to pop a cyst, the result will unfortunately be a lesion that is even more inflamed, red, and painful, with the cyst still remaining below the top layers of irritated skin. Do not try and pop your cystic acne! When you visit the New York City office of Dr. Michele Green, she will discuss which combination of products, procedures, and medications will help you get rid of your acne cysts as quickly, safely, and painlessly as possible.

Trying to pop a cystic acne lesion is not the only thing that can make them worse. No one can deny that cleansing your skin with the appropriate products is an essential part of preventing and treating acne. However, over washing the skin or scrubbing too aggressively while cleansing can also be a cause of worsening your cystic acne. The skin naturally produces oil and sebum to act as a necessary lubrication for the skin. When harsh cleansers or exfoliants are used in excess or incorrectly, they can potentially strip the skin of all the essential oils it produces to act as moisturizer. The skin typically responds to this by over producing additional sebum and oil in order to try and rehydrate the skin and compensate for the stripped oils. It is important to keep this in mind when selecting your skincare products and to adapt your skincare regimen to ensure that you are not exacerbating your acne, causing your skin to produce excess oil by over washing, or causing other types of skin irritation. This is especially important if you are someone who has sensitive skin. This is because there are many acne fighting ingredients which can be potentially irritating to your skin. Your skin needs to retain essential oils and nutrients in order to remain healthy and combat acne! During a consultation with Dr. Green you will have the opportunity to discuss which skincare products would be best suited to your skin type and skin situation and the appropriate ways to use those products.

While cystic acne flares can mostly be attributed to ones genetics, there are some external factors that might trigger their onset. Some of these triggers include hormones that are in flux (particularly the sex hormones, androgens), lack of sleep, high levels of stress, as well as a diet that is rich in sugar, dairy, and fat. With Dr. Green you will delve into your medical history and identify any potential triggers that may be in part leading to your cystic acne breakouts. She may request that some blood work be sent to the lab in order to evaluate for abnormal hormone levels. In addition to the customized treatment plan for cystic acne that you develop with Dr. Green, she may possibly recommend slight lifestyle adjustments that will help you to avoid external factors that could be triggers to your cystic acne breakouts.

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Acne Treatment – 6 months before and after

How do I get started with cystic acne treatment today?

Whether you are struggling with just a single pimple, facing a full breakout, or suffering from severe cystic acne lesions, Dr. Michele Green in New York City is here to provide you with personalized solutions to strategically rid you of your bothersome blemishes. Consulting with board certified and world renowned expert in dermatology, Dr. Green, is the safest and quickest way to achieve lasting smooth, clear, and healthy skin. She will develop a customized treatment plan for your acne breakouts based on your skin type, tone, and  skincare needs. When you discuss your unique situation with Dr. Green, she will recommend the absolute best skin care products for you to eliminate your acne and as well as the most effective in-office treatments to help you. To get started with your individualized acne treatment and learn more about how Dr. Green can help you achieve beautiful clear skin, please contact us online today or call our New York City based dermatology office at 212-535-3088.

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