There is acne, and then there is cystic acne. One is not like the other, although one can lead to the other. Acne terms are thrown around quite often without a full understanding of the nuances of them, but we're here to help you navigate all that. Read on to learn how to classify any blemish you find on your face and what to do about it.
1/ Different types of acne.
- Regular acne consists of whiteheads and blackheads. These can appear and disappear fairly quickly without much fuss.
- A blackhead occurs when a pore is clogged with excess skin cells that your body is trying to shed along with the oil that is naturally produced by your body. Blackheads are clogged pores that are still open on the surface of the skin.
- A whitehead occurs when a pore is clogged with excess skin cells and oil, but it is closed on the surface of the skin (this is why white heads “pop” when they are picked at).
- Sometimes, after a whitehead or blackhead is formed bacteria that lives on your skin can migrate inside the clogged pore and cause the skin around the pore to become red, infected and inflamed. Cystic acne happens when this infection goes deep into your skin, creating a bump that's full of pus. If a cyst bursts, the infection (bacteria) can spread, causing more breakouts.
- Even cystic acne has two forms, acne cysts and acne nodules. Acne cysts are filled with pus, while acne nodules are solid and harder than acne cysts because they don’t contain fluid.
2/ How acne and cysts are formed.
- Everyone has sebaceous (oil) glands that are attached to their hair follicles. The areas with the most hair follicles (face, shoulders, upper back) have the most sebaceous glands (and no surprise, where most acne forms). You are constantly shedding skin cells, but sometimes these skin cells get stuck in your hair follicles. When those skin cells get stuck during a time when your body is producing excess oil (thanks hormones), it causes a clogged pore (typically expressed as a whitehead or blackhead).
- If the whitehead or blackhead bursts inside of the hair follicle, it creates a sac of yellow or white pus surrounded by red and inflamed skin -- these are pimples and papules (which can still heal on their own pretty well). However, sometimes the whitehead or blackhead erupts deeper inside of the skin, causing large, tender, hard nodules or cysts under the skin.
4/ Causes of Cystic Acne
- Hormone changes. We typically think of teenagers to be the ones who deal with hormone fluctuations, but unfortunately hormone fluctuations continue with us throughout our life. Particularly in our mid-30s as woman and during menopause.
- Stress. Stress can cause enough change in our hormones to create acne.
- Family history. Much like grey hair or the shape of your nose, being prone to cystic acne is also hereditary.
5/ How to treat cystic acne.
- DO NOT PICK AT THEM. Please. We beg you. Cystic acne is not a simple blackhead and picking at them can cause scarring, or cellulitis, which is a bacterial infection of your skin and tissue beneath your skin.
- Cystic acne should be handled with care. A dermatologist is one way to proceed. They may prescribe oral medication or topical creams. For particularly bad cysts, they may inject it with a cortisone shot, or open it with a lance to drain it. (Again, this is NOT to be done at home!)
- Others promote a more holistic way to treat cystic acne with diet and lifestyle changes to help regulate hormones.
- Acupuncture has also been shown to help regulate hormones and thus curb the onslaught of cysts.
Above all, be gentle with yourself and your skin as you start to heal your cystic acne. Give it time and patience, there are no quick fixes (as much as we wish!) just commitment to the routine that works best for you.