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Cystic Acne Products

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Cystic acne or acne vulgaris is treatable with oral and topical preparations

What is Cystic Acne?

Cystic acne is also referred to as acne vulgaris. It is a human skin disease that presents with different distinct characteristics including:

  • red, scaly skin or seborrhea
  • blackheads and whiteheads which are also called comedones
  • small papules or pinhead
  • large papules or nodules
  • pimples or pustules
  • scars

Acne vulgaris affects the face, the upper part of the chest and the back.

Because it affects skin surfaces with a lot of sebaceous follicles, it can also be found in other parts of the body where hair grows especially where sweat can also collect.  Therefore, sometimes, cystic acne can extend to the groin area, buttocks and the armpits.

Unlike common acne, cystic acne extends deeper into the skin tissue.

Cystic acne is most common in adolescents. Its development is believed to be caused by the increased production of androgens during puberty.

The major androgens linked with the development of cystic acne include testosterone, dihydrotestosterone or DHT and dehydroepiandrosterone sulfate or DHEAS. The hormone, IGF-1 or Insulin-like growth factor 1 is also linked to acne vulgaris.

Comedones which refer to blackheads and whiteheads are believed to be the one of distinguishing features of cystic acne.

Whiteheads and blackheads are differentiated by the colors of acne spots they form. Whiteheads are observed from the white specks they leave on the skin. They are formed when the skin pores are completely blocked by sebum, dead skin cells and bacteria.

Blackheads are formed by the partial blockage of these pores. Sebum, dead skin cells and bacteria can be pushed to the surface of the skin. The black spots formed on the skin are caused by the oxygenation of melanin, the skin pigment, on exposure to air.

Blackheads are more stable than whiteheads. Therefore, they last longer and are more difficult to treat.

Papules and pustules are similar. They are red, inflamed and tender bumps on the skin. However, papules have no head while pustules have white or yellow heads. Pustules or pimples can be squeezed and popped but papules should be left alone.

In severe cases of cystic acne, nodules and cysts can be observed. These are larger than comedones, papules, and pustules.

Nodules are large, hard bumps found under the skin. They can be painful and cause extensive scarring. Nodules should never be squeezed or they will only come back worse.

Cysts are similar to nodules but they are filled with pus. They can also be painful and cause scars. They also should not be squeezed for the same reason that nodules shouldn’t.

Causes of Cystic Acne

The root cause of acne is the blockage of the hair follicles by a buildup of keratin and sebum.

The first steps in the development of cystic acne are hyperkeratinization and the enlargement of sebum glands. The increased production of androgens during adolescence directly increases the production of sebum. Sebum then mixes with keratin to form plugs that clog the skin pores and the sebaceous follicles.

Therefore, hormonal changes, especially during puberty and menstrual cycles, can increase the formation of cystic acne.

The link between androgens and cystic acne is well established. Anabolic steroids, for example, produce the same effect.

When acne is observed in later years, it is almost always due to hormonal changes. Therefore, cystic acne can occur in pregnant women, and in women with polycystic ovarian syndrome or Cushing’s syndrome.

When acne occurs in menopausal women, it is usually because there is a low level of estradiol. Estradiol which is related to the female sex hormone, estrogen, is a natural anti-acne hormone.

Cystic acne also has a genetic component because it usually affects multiple members of the same family.

Diet can also cause cystic acne. Milk has been associated with acne in some people. In addition, foods with high sugar contents can also cause acne.

Lastly, cystic acne can be caused by skin infection. The bacterium, Propionibacterium acnes, has been identified as a major contributor to the development of acne. This anaerobic bacterium is found in different strains. Some strains make the skin healthy while others cause cystic acne.

Staphylococcus epidermis is another bacterium that has been shown to contribute to the formation of cystic acne.

Options for Treating Cystic Acne

There are different ways to treat cystic acne. Often, the most effective methods use combinations of different solutions.

The simplest treatment for cystic acne is to cleanse and exfoliate the skin and then use a moisturizer. However, this treatment only removes the mixture of sebum, dead skin cells and bacteria clogging the pores without addressing the root problem.

More effective cystic acne treatments can work in any of the following ways:

  • Wipeout Propionibacterium acne and any other bacteria causing the skin condition
  • Return keratinization or shedding of dead cells, as well as sebum production to normal levels and so, prevent the blockage of the pores
  • Reduce skin inflammation which is common in people suffering from cystic acne
  • Reduce the production and effects of androgens

Effective Cystic Acne Products

The most common medications used in treating cystic acne are:

Benzoyl peroxide

Benzoyl peroxide is usually the first medication prescribed for cystic acne especially if it is not severe. It works by killing off Propionibacterium acne. It is available in solutions of the following strengths: 2.5%, 5%, and 10%.

Benzoyl peroxide is just as effective as antibiotics in the treatment of cystic acne. Because it does not cause any antibiotic resistance, it is a preferred choice amongst prescribers.

Side effects of benzoyl peroxide include increased sensitivity of the skin to sunlight (should be worn with a sunscreen) as well as dryness of the skin which can also include peeling and redness of the skin.

Antiseptics and Antibiotics

Hydroxyquinoline salts are antiseptics that are combined with benzoyl peroxide topical formulations to improve the overall efficacy.

Antibiotics can be taken orally or topically to treat cystic acne. Some antibiotics used in this way include tetracycline and its derivatives as well as clindamycin and erythromycin.

Due to the increasing incidence of antibiotic failures in cystic acne therapy, antibiotics are no longer commonly used. This is due to the rising antibiotic resistance of the bacterium, Propionibacterium acne.


Cystic acne can be treated in women with hormone therapy. The aim is to reduce androgen production or increase the levels of female hormones.

Therefore, women placed on the contraceptive combinations of estrogen and progestogen see improvements. However, a more effective treatment option is the combination of estrogen with the cyproterone, a drug which reduces the levels of androgen in the body.

These combinations and some other oral contraceptives can be prescribed for cystic acne treatment in women especially when there is an elevated blood level of androgens.

Spironolactone, a potassium-sparing diuretic, is also a known anti-androgen medication that is effective for treating cystic acne in low doses.

Oral and Topical Retinoids

The major oral retinoid used in the treatment of cystic acne is isotretinoin. Isotretinoin is a derivative of Vitamin A. It is a very effective anti-acne medication which is normally taken for 4 - 6 months.

It has been shown to be effective in treating severe cystic acne in 4 out of 5 patients. It can also “cure” cystic acne.

However, some patients do experience acne relapse a few months after treatment. For such patients, a second treatment is recommended but not immediately after. A third and fourth treatment may also be advised even though the success rate diminishes with subsequent treatments.

Oral retinoids can cause dry skin and nosebleeds because they dry up the mucosal surface of the nasal passage.

Care should be taken when using isotretinoin. There have been unconfirmed reports of liver damage and depression attributed to the use of the drug. However, it has been confirmed that isotretinoin affects the blood levels of triglycerides and can be teratogenic.

Because of this second side effect, female patients are required to use multiple forms of birth control when taking the drug.

Topical retinoids, on the other hand, have far milder side effects. However, they can irritate the skin and cause facial flushing and the worsening of the acne at the beginning of treatment.

They are also Vitamin A derivatives and are only available as prescription medications.

They act by returning the growth cycle of follicle cells to a normal rhythm. Therefore, they prevent hyperkeratinization and blockage of the skin pores.

Anti-inflammatory Drugs

These drugs are usually used for treating mild to moderate cystic acne.

Vitamin B3 formulated as a gel is effective for reducing inflammation due to acne. It increases the production of collagen too and can help fade away acne scar by reducing hyperpigmentation of the skin.

Ibuprofen and tetracycline are oral drugs sometimes combined to reduce skin inflammation caused by cystic acne.

4 Combination Cystic Acne Products

Clear Skin Max

Clear Skin Max contains 6 different acne treatments. The kit includes a cleansing gel, a tea preparation, creams, lotion and a vanisher mask.

The cleansing gel contains tea tree oil and extracts from chamomile and bladderwrack. This herbal gel is effective for killing the bacteria responsible for acne and for rehydrating the skin.

There is also Melanin Expel Essence which is made from algae and plant extracts as well as vitamins. It opens up the skin pores and clears away the sebum and dead skin clogging them.

The Acne Vanisher Mask also helps clear the bacteria, sebum and dead skin cells from the pores as well as fade scars. The Conditioning Lotion is a cosmetic addition to improving the health and appearance of the skin.

The Acne Emergency Treatment helps reduce the pain and itching associated with cystic acne.

Lastly, there is the Anti-acne Tava Tea. Drinking 6 to 8 cups of the tea every day will help treat all systemic causes of acne.


ClearPores contain plant extracts that help cleanse the body. This herbal preparation treats acne by helping to restore hormonal balance. It also includes a Deep Facial Wash that helps clean pores on the face and clears away acne blemishes.


Differin is available in 3 forms: a 0.1% and 0.3% gel and a 0.1% cream.

The active agent in Differin is Adapalene, a topical Vitamin A derivative. It affects the growth cycle of follicle cells, therefore, it is effective for reducing hyperkeratinization.

Differin can cause skin irritation. For this reason, contact with the eyes, mucosal surfaces, and soft tissues should be avoided. It can also increase the skin’s sensitivity to sunlight. Therefore, a sunscreen should be worn when using the product.

Differin is effective for cystic acne but it does not clear off all the spots after acne lesions heal. It also takes a few weeks before its effects are seen.


Actimine is an oral acne product containing vitamins A and E; zinc and selenium; and methylsulfonylmethane (MSM) and gum guggul.

By combining vitamins, minerals and herbal extracts, Actimine can effectively address both the hormonal and bacterial causes of acne while serving as a safer alternative to regular acne medications.

The active ingredients of Actimine are carefully selected to provide maximal benefits. The inclusion of each ingredient is backed by years of clinical research into its efficacy in acne treatment.

These ingredients also improve the effects of one another.

For example, selenium and the two vitamins are known antioxidants but the combination of these 3 nutritional supplements have been shown in different published studies to provide an even greater benefit than the sum of their antioxidant effects.

In addition, gum guggul extract and zinc are known to be particularly effective for treating cystic acne.

Over 90% of Actimine users report great results. It further proves that the unique formulation of safe and effective supplements in Actimine makes one of the very best anti-acne products in the market.

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