We have all had them. These large, hurting, and most of all impossible to hide bumps. That stays around forever. And even worse, that sometimes leaves you with a scar.
They are called cystic acne and they develop a lot deeper than regular acne. Therefore they also need a different treatment.
I get so many questions about acne scarring so I thought I would write this post to explain how to reduce the risk of getting one in the first place. And that is to shrink the cystic pimples as fast as possible. Since these are the ones that grow deep into the dermis and cause a scar if you’re unlucky.
Before I get started I want to urge one thing. If you are experiencing cystic acne on a regular basis and have a severe amount of them. Then you must seek a dermatologist.
The advice in this post is mostly aimed at those of you who experience a cystic pimple every once in a while (even though the guide will be helpful for everyone).
This is what I’ll cover:
- What is cystic acne?
- How to shrink a cystic pimple – The do’s
- How to shrink a cystic pimple – The don’ts
- How to avoid outbreaks in the first place
What is cystic acne?
Cystic acne is a severe and painful type of acne that develops as large bumps under the surface of the skin. It can range from mild cystic acne (meaning one or two bumps) to very severe cases where most of the face is affected.
Cystic acne also has a subset called nodulocystic acne. And these nodules a more firm to the touch and usually take even longer to heal.
*Please note, this post contains affiliate links, and I may receive a small commission if you purchase through any of those links. It doesn’t cost you any extra and I only recommend products I truly love and use myself. You can read my full disclosure here.
Cystic acne characteristics
Cystic pimples are very different from regular pimples. Those start with a pore getting clogged. And as bacteria get involved, the area becomes red and swollen.
With cystic acne, this infection goes much deeper within your skin. Causing a larger and more painful bump. Usually without a whitehead.
Since cystic pimples go so deep into the dermis, the risk of getting a scar is much more pronounced. These scars can be either so-called icepick scars (tiny holes) or larger indents.
Women tend to get cystic pimples on the lower part of the face. While the more severe cases of cystic acne are more common in men.
How to shrink a cystic pimple – The Do’s
Here are the treatment options I recommend. Since they have all given me dramatic results in shrinking a cystic pimple fast. You can combine them or try just one of them each.
Medical grade Manuka honey
You may often see honey listed on home remedies for acne. Nothing I have personally found successful. But there is one exception. And that is medical grade Manuka honey from New Zealand.
Manuka honey has very antibacterial properties. And that is thanks to its uniquely high content of something called methylglyoxal (MG). This is a compound that is found in other types of honey as well. But in much lower quantities.
This special type of honey has become more common in medical use for treating minor wounds and burns. And for that use it has to be a medical-grade product so it’s guaranteed to be free from contaminants.
Manuka honey is not just anti-bacterial but it is also powerful in reducing inflammation. And its effect goes deeper than just surface level. Why it will help with reducing cystic pimples fast and speed up healing.
I have seen dramatic effects myself with using manuka honey and I actually use it on every tiny piece of pimple that ever shows up. AND I have also had great success with using it on old red post-inflammatory marks from old pimples. Nothing has helped me to get rid of them as quickly as manuka honey.
Another good fact to know about Manuka honey is that it is also a great antioxidant. And has been shown to help reduce UV-damage to the skin.
If you want to try this honey for yourself (and I truly recommend it) then make sure to get a medical-grade product. That way you’ll know it will be safe to use in the face and have much more effect.
If you live in the US I recommend First Honey. You find them on this link and if you use the code AYOUNGERSKIN you’ll get 30 % off.
If you don’t live in the US, or if you prefer a larger package (in a jar), then this is another example. The link will give you 10 % off if you are a new customer to Iherb (or 5 % if you are a returning customer). And Iherb ships worldwide.
And in case you wonder about what UMF (Unique Manuka Factor) stands for, it’s a scale for rating the potency of Manuka honey. Usually, a product will need a rating of 10 UMF or higher to be marketed as UMF Manuka Honey.
Sulfur is an incredible mineral when it comes to the skin. And especially to fight any kind of acne. Thanks to its antimicrobial and anti-inflammatory properties it has actually been used for centuries to treat acne as well as other skin problems. Such as rosacea.
Sulfur is not just good at fighting the bad bacteria in your skin. It also helps in reducing excess sebum and helps to unclog your pores. And since it’s effective in reducing inflammation, it also helps with deep cystic pimples and nodules.
Another great thing about Sulfur is that it is considered safe for most skin types, and rarely causes any irritation. AND on top of that, it is an essential part of the production of collagen. So it can help strengthen your skin and prevent aging.
The reason sulfur isn’t more popular than it deserves to be, is due to its odor. It does have a less fashionable smell. But personally, I don’t feel bothered about it at all. I can hardly feel it. And I am a person who is really sensitive to smells.
My favorite Sulfur cream is from Iherb. It costs almost nothing and you can choose between different sizes. I have the smallest one and a little goes a long way. But if you want to use it as a mask, I recommend a size larger.
This link will you a 10 % discount (or 5% if you are a returning customer to Iherb).
Buffering Lotion – Mario Badescu
This is also one of my favorite products for shrinking a cystic acne. It is a spot treatment, designed specifically to target large under-the-surface bumps.
I found it especially effective if used right when the very first signs of a cystic pimple is starting to arise. If your pimple has been there for a while already, I think you are better off with the other treatment choices.
This buffering lotion is very very lightweight (watery) and you do not need a lot. The instructions are to use at night time. But I use it both in the morning and night whenever I feel a cystic pimple is about to develop.
It dries quickly and you can use your regular skin care products on top.
You find Buffering lotion from Mario Badescu at Sephora on this link. Where you’ll also see the many reviews of other users.
I do not like the fact that it has parabens in it. But other than that, this product is indeed pretty magic (if used early in the treatment). And since I use it so rarely (I hardly get any pimples at all anymore thanks to these actions) I think it’s worth it.
Just to be clear though. This product should NOT be used on regular pimples. For smaller acne bumps, try the drying lotion in the same series. Or just go with the manuka honey or sulfur since those can be used on all kinds of acne.
Besides the ointments above, there is another method I would like to mention. And that is the microcurrent device called ZIIP.
It is a lot more expensive. But on the other side, it is a one-time investment, and it can be used as a powerful anti-aging treatment too.
I have a whole separate blog post about microcurrent technology and what devices I recommend for home treatments. In short, it’s an amazing way to get a more toned and lifted face, and increased collagen and elastin production. And to reduce acne.
You find the blog post here.
What is special about the ZIIP device is that it offers a program that is especially good in reducing acne.
Ziip also has a program that specializes in lymphatic drainage. And many more treatment options that will be beneficial for your skin.
I have a discount code (ziipwithann) that will give you 20 percent off if you want to try this device. This link will take you the their site.
So these are my secrets on how to shrink a cystic pimple fast and effectively. There are other tips and home remedies out there promising to help treat cystic acne. Such as putting ice cubes (in a cloth) on the pimple, teabags, etc. For me personally, none of these has helped even a tiny bit. And I have tried all of them. Instead, they have done the situation worse.
Now let’s talk about what you mustn’t do when you get a cystic pimple. Read this list carefully in order to prevent scarring.
How to shrink a cystic pimple – The Don’ts
Let’s briefly mention what you definitely must not do if you want to shrink a cystic pimple effeciently and risk-free.
1 – Don’t wait with the treatment – start as early as possible
The earlier you start with the treatment options above. The less chance to develop a scar. IF you ignore the first signs of a cystic pimple and hope it will go away by itself (it never will). You just increase the risk of getting an even larger one.
2 – Do not pop
Since a cystic pimple forms so deep down within your skin, it simply cannot be drained by squeezing it.
Instead, if you apply any pressure at that area you will most likely spread the infection and make the sitation even worse. And a larger infection in the dermis means a higher risk of getting a scar.
Also, any poking and pinching of the skin can cause a scar even with regular pimples. When it comes to a cystic one, any attempt to pop it will almost inevitely leed to a scar.
3 – Do not use regular spot treatments
Do not use regular anti-acne treatments since they simply won’t help. Instead, they can cause more irritation to your skin.
A cystic pimple is too deep to be affected by over-the-counter products like benzoyl perioxide, salicylic acid, and all the different kinds of pimple patches (zit dots) that are out there. All these are targeting surface-level breakouts. And will not affect the deep cystic pimples that form in your dermis.
Instead, these products can often irritate your skin and cause more damage than good. Which is not what you need when you are already suffering from a cystic pimple.
One ingredient to be extra careful with is tea tree oil. It does have some inflammatory properties but is also a strong irritant and can hurt the skin barrier quite a lot. I would suggest, especially if you have sensitive skin, to avoid it. There are so many better options as explained above.
4 – Don’t think that a Cortisone shot is risk-free
You may have heard the option of having your dermatologist give you a cortisone injection to quickly get rid of your cystic pimple. This is of course an option. But I wouldn’t personally recommend it.
Cortisone shots (such as Kenalog) may bring on side effects like insomnia (which isn’t favorable for your beauty sleep), dryness, scaling, and even acne.
There is also a small risk of getting an indentation in the skin. That in some cases can become permanent.
I know getting a cortisone shot is a popular solution for shrinking a cystic pimple very fast. But I want you to be aware that it may have consequences. Personally, I wouldn’t dare to take the risk.
How to avoid outbreaks in the first place
The very best option for treating cystic acne is of course to prevent it from even arising.
Unfortunately, this condition has many different causes (and it varies among different people too). And the research on this topic is extremely scarce.
I still want to help and give you some possible triggers that you should take a look into and evaluate. Hopefully, you may find at least a few triggers that you can avoid. Personally, I rarely have any outbreaks at all these days after knowing what my triggers are.
First of all – Have your hormones checked with a doctor
Cystic acne is very often called hormonal acne. And that is because hormones definitely seem to play a role in the development of these kinds of underground pimples. I recommend you have your hormones checked with your doctor, to see if there is an imbalance that can be treated.
Also, be aware that many different factors can affect our hormones more or less, depending on the individual. This is why some of the factors listed below may be a cause for some. But not for others.
This may come as a surprise for many of you. But a large amount of vitamin B12 can, for some people, be a trigger of acne outbreaks. Including cystic ones.
If you are taking supplements with B12, this might be something to look into. I take vitamin B12 supplements myself and I have learned the hard way that large doses of cyanocobalamin definitely are a trigger for me. And I have had my worst cystic pimples from this supplement.
Cyanocobalamin is a synthetic form of B12, and the most common one found in supplements.
Methylcobalamin, which is a natural form of B12, is a much better option. But I still need to avoid the largest doses. I actually open the capsules they come in and only use a portion of it a few days a week. That seems to work for my skin.
Intolerances against certain foods can contribute to acne and cystic acne for some people. Me included.
I get small acne breakouts and millia from certain foods like coconut and dairy. And I get those terrible cystic ones from eating eggs, soy products, and cacao.
Regarding cacao, there is old and misleading information circulating about this food. Saying that there is no proof that cacao itself can cause acne. And instead, acne is caused by the dairy and sugar that it usually comes with (as chocolate).
Now, in many cases that is true. And the culprits are usually the milk and sugar. BUT, newer research has shown that cacao itself is also a trigger for acne-prone persons.
If you are prone to acne I would definitely test and eliminate chocolate for a while to evaluate its effect on your skin.
For me personally, since I used to love chocolate, I simply tested to only eat 100 % cacao chocolate to see if it gave me breakouts. And sadly it did. Every time. Terrible ones.
How to start
In order to know your triggers, make a food diary. Exclude all the foods that you suspect may be causing you skin problems for at least 1-2 weeks. Then try eating them one per week to see what happens. And you may need to do this several times as you discover new suspects.
Definitely start by eliminating all dairy products, since dairy is one of the most common acne triggers according to research. The reason is still not fully understood but the milk proteins whey and casein seem to play a significant role.
Alcohol intake is also something you should try to limit. Since alcohol can not just disrupt your hormone levels. But also disturb your sleep, leading to increased inflammation in your skin (see this post to learn more about how sleep affects your skin).
Saturated fats in large quantities (such as from red meat and fast food, but even coconut) is also something I recommend you try to limit. Since that has been shown to affect acne too.
And then we have the sugary foods. Definitely avoid the sweets if you want a better complexion. Except for fruit since these superfoods are extremely beneficial for your skin (this post explains why). Fruits do not raise blood sugar levels.
Refined carbohydrates, on the other hand, lead to high insulin levels, which in turn increase androgen hormones. Leading to an increase in sebum production as well as making your skin cells grow more rapidly. Not good for acne.
As mentioned above, it may also be a good idea to cut out cacao from your diet and see what happens.
Besides these general tips, it is also a possibility that you may have other food sensitivities that could be just about anything. When you eat certain foods that you don’t tolerate, your immune system will attack. Which leads to an increase in pro-inflammatory molecules throughout your body. And in some cases that can cause aggravated skin problems.
Again, you will need to try eliminating whatever you suspect could be a trigger, for about two weeks. And then reintroduce it and see how your skin reacts.
As sad as it may sound because we all love our food, this is something that can save your skin tons of problems. I cannot say how thankful I am for finally finding my own food triggers!
Stress is a major culprit when it comes to putting our hormones out of wack. So if you experience a lot of stress in your life. And especially if you are having problems with getting enough quality sleep per night. Then seek help.
You can also see my post about Beauty sleep where I include a bunch of tips for a better and deeper sleep.
Cyclopentasiloxane (and other siloxane-silicones)
This is a skincare ingredient that is extremely common and is usually found at the top of ingredient lists of serums, primers, and foundations
The reason is that it is very cheap and at the same time makes your product feel really silky smooth and great to put on your skin.
Well, for some people (me included) Cyclopentasiloxane and other so-called siloxane-silicons, are a huge trigger for acne.
I have noticed it does work fine on my upper part of the face. But I still avoid it completely.
One reason this ingredient may cause problems for some individuals is that it very often contains trace elements of its brother Cyclotetrasiloxane. Which in turn is a known hormone disrupter.
Cyclotetrasiloxane is classified in the EU as toxic to reproduction. And anything that can mess with our hormones, may cause cystic pimples too. This might be the explanation of why some people react.
Low Molecular Weight Hyaluronic Acid
This is another quite common skincare ingredient. LMWHA is a hydrolyzed lab-created Hyaluronic acid that unfortunately has been shown in recent studies to promote inflammation in the skin. It can therefore be a trigger for all kinds of acne.
Personally, I have had some really bad experiences with this ingredient. And I have a whole separate blog post explaining the different kinds of hyaluronic acid used in skincare. And how they can affect your skin. You find the post here.
Do you have a damaged skin barrier?
If your skin barrier is damaged/irritated, you will most likely experience many different skin problems. And acne can be one of them.
This can happen due to over-washing and over-exfoliating, using too many strong products, medications, treatments, etc.
I suggest you read my post about skin barrier repair if you think your skin barrier needs a reset.
Tip: I have a new favorite product with Bakuchiol, that is not just good for sensitive skin and anti-aging, but also for all kinds of acne. See this post to learn more.
– Cystic pimples are a much deeper and more painful type of acne than regular pimples. They also need a different kind of treatment.
– The methods I have found most effective to shink a cystic pimple is applying medical-grade manuka honey, sulfur ointment from De La Cruz, Buffering lotion from Mario Badescu, and using the microcurrent device called ZIIP. They can be either combined or used each on their own.
– You should always start the treatment as soon as possible to hinder the risk of getting a scar. And you must never try to pop the cystic pimple, or use regular acne treatments.
– Cortisone injections can shrink a cystic pimple fast but may also cause some serious side effects. There is even a risk of getting an indentation that can be either temporary or in worst case permanent.
– Try finding your cystic pimple triggers to avoid outbreaks in the first place. Stress, certain foods (see explanation above), and even vitamin B12 can be possible triggers.
That’s it! Hope you found this post helpful, and please let me know in the comments below if you have any questions. Or any own experiences of how to shrink a cystic pimple. Would love to hear!
Until next time, love your skin!
This Post Has 21 Comments
Hi! I recently discovered your page while looking for cons on hyaluronic acid. Your content has helped me so much! Thanks a lot!. I usually get cystic acne on my nose but I found out that LMW HA triggered them too ;(. Now I am trying to figure out other triggers, I stopped using HA.
One question, for how long do you leave the manuka honey on? do you cover it with something?. I will try to buy it soon and also the sulfur ointment. Thanks again!! 😀
Happy to help Ivonne! 🙂 I use manuka honey before I go to bed and sleep with it 🙂
Hi! I discovered this blog site recently and find it interesting and informative, definitely learned some new things here 🙂
I am wondering, since you mentioned you had some previous breakouts, did you get scarring afterwards and how might you have dealt with that? Because your skin looks so smooth and I have some scars (small indentations, but also the red ones and a few dark spots too) after a bad breakout last year, and I didn’t know if it may be possible to heal!
Thank you for any tips 🙂
Happy to help, Reese 🙂
Yes, I did get some very shallow scarring. But it is not very visible thankfully. Mostly I got red marks that stayed for quite a while, but it got better with time. Have patience 🙂 And use SUNSCREEN every day of the year. That will help prevent them from getting permanent. Also, I found that manuka honey (I mention it in this post) is better than any cream or serum for pigmentation issues like these 🙂
I agree with B12, when I first started taking it I notice bumps on my forehead and then I research that it cant be taken daily as it can trigger pimples! Agh those stubborn pimples, lol. Thanks for this article very informative on how to treat cystic pimples
Thank you for your comment, Jeannie! Yes B12 sure is tricky for many of us. I have learned that for me the best option is to take small doses of methylcobalamin. I actually open up the capsules and pour out just a bit of it in a glass of water. That way I can take it daily 🙂
I didn’t know about the honey or sulphur treatments. Just thinking about cystic acne makes me cringe. Appreciate your informative post!
Thank you so much, Lisa! 🙂
I just have to give you an update, Ann. I purchased the manuka honey and the sulfur ointment upon your recommendation. I had been suffering from breakouts across my brow for the past 3 years. (I was able to hide it because I wear bangs.) It was getting worse, spreading up my forehead and down the sides of my nose and under my eyes. Then the past month or two I developed cystic acne, very painful. I am so thankful this article “fell” into my lap because after using these 2 products for just one week my pimples have all but cleared up. And the honey is working to fade my red spots and blotchy complexion. These products are truly a miracle!! Thank you so much! p.s. Still don’t know my triggers.
Wonderful to hear Janice! 😀 You’re so welcome, and thank you so much for the update! <3
Didn’t know what was wrong with me until reading about cystic pimples. I need to figure out the triggers. Thanks for all the info.
Thank you for sharing Janice! Hope you find your triggers <3
Thanks for sharing! I always put lime/lemon on it hoping it will dry them out. However, I do notice when I use moisturisers everyday, I tend to break out more.
Oh that’s not good 🙁 You should definitely change your moisturizer. Do you know if it contains silicones (such as Cyclopentasiloxane)? That could be a potential trigger.
This is really useful – bookmarking it to revisit later. I get cystic acne from time to time since the birth of my twins, and it’s so painful! I really thought there was nothing to do for it. Thank you!
Thank you so much Sarah! Happy to help 🙂
Excellent information Ann. One of my sons had problems with cystic acne when he was in his teens and into his early 20’s. I’m not sure if he still has any issues with it now. If so, I will be sure to pass on this great info. Thanks!
Thank you so much for your comment Julie! 🙂
There is such great information in this post, as usual. I cannot wait to create a skin care routine from all of your great articles! Thank you so much. ?
Thank you so much Robyn! ☺️?❤️
Ugh, I dislike even thinking about cystic pimples. Thanks for all of the tips.