If you’ve ever experienced cystic acne—those golf ball-sized nodules under your skin that are incredibly painful to the touch—you know it’s no fun. And frustratingly, these not-so-little buggers can last even longer than whiteheads and blackheads.
“Cystic acne is without a doubt one of the most painful types of acne out there,” says Dendy Engelman, M.D., board-certified dermatologist at Manhattan Dermatology and Cosmetic Surgery in New York City. “And this is mostly because they don’t have a head or opening [from] which to release the pent-up oil and bacteria that’s causing the extreme pain and discomfort.”
So why do we get them in the first place? “Cystic acne is caused by hormonal fluctuations and acne bacteria,” says Joel Schlessinger, M.D., board-certified dermatologist and RealSelf advisor. “High hormone levels trigger an overproduction of oil, causing pores to swell, and when this oil cannot reach the skin’s surface, it ruptures underneath and causes inflammation to spread to the surrounding tissue.” It’s this lovely series of events that results in the red, tender, irritated, and sometimes even itchy bumps under your skin. But easing the pain is possible. Here are seven solutions that’ll help.
Leave It Alone!
That’s right—stop touching it, squeezing it, poking it, and prodding at it altogether. “Trying to pop cystic acne is one of the worst things you can do for your skin,” says Schlessinger. “This type of acne is so far beneath the surface that you won’t even come close to reaching the bump and, instead, will be left with a painful, bloody spot that’s impossible to cover with makeup.” Plus, picking can lead to serious scarring. Repeat after us: hands off.
Pop an OTC Pain Reliever
“If your acne feels like it’s throbbing, taking an Advil or Ibuprofen can help bring down the inflammation and alleviate the pressure that’s causing the pain,” says Schlessinger. “But this will only work for cystic acne—not blackheads or whiteheads.” Follow the directions on the bottle to make sure you’re getting the proper dose, and try taking them with a meal to avoid upsetting your stomach.
Apply a Warm Compress
The heat and steam from a warm face towel can help improve blood circulation and even speed up the healing process. “Soak a washcloth in warm water and hold it directly on the blemish for five minutes,” says Schlessinger. “Repeat these steps three times a day until the breakout heals.” You can also add aloe gel (an antiseptic) to the cloth and gently massage around the pimple in an upwards stroking pattern, says Rena Rubin, esthetician at Haven Spa in New York City.
Or, Reach for a Cold Compress
This can help reduce inflammation and provide temporary relief by numbing the area. “Hold a cold pack wrapped in a towel to your skin for one minute, remove for five minutes, and then reapply for one more minute,” says Schlessinger. “Repeat three times a day as needed.” For extra relief, Rubin recommends making a compress with chamomile tea instead. “The chamomile will help soothe and calm the skin,” she says. “Make a cup in the morning and leave it in the fridge to steep while you’re at work. Once you get home, soak a paper towel in it and wear it as a mask over the affected area.”
Avoid Drying Acne Treatments
Since cystic acne happens so far beneath the skin’s surface, using drying treatments meant for other types of zits will only deplete moisture from the surrounding area before even getting to the cyst. This could cause irritation and possibly even an infection. “Instead, apply a serum that can be absorbed and layer a balm over it to force the product in like a medical occlusion,” says Engleman. She likes IS Clinical Pro-Heal Serum Advance Plus ($142, dermstore.com) since it contains zinc, which helps with wound healing and Darphin Aromatic Purifying Balm ($70, darphin.com).
Use a Prescription Retinoid
Skip the OTC spot treatments and reach for a topical retinoid instead. “Your dermatologist can prescribe this to help unclog pores, clear acne, and reduce future blemishes,” says Schlessinger. “By unclogging your pores, retinoids also help boost the effectiveness of other topical medications like salicylic acid or benzoyl peroxide.”
Get a Cortisone Shot
Need a fast fix? A concentrated dose of this steroid reduces inflammation under the skin, diminishes signs of swelling, and even speeds up healing time. “Cortisone is a steroidal hormone that’s naturally found in our bodies,” says Schlessinger. “Your doctor can inject the cyst with a shot of this hormone and within six hours your pimple should be gone.”