Cystic Acne: My 3 Must-Follow Rules For Keeping It Under Control

After 10 years of unpredictabe cystic acne, I've found a skincare routine that keeps my face and mind as calm as possible.
Publish date:
August 5, 2013
acne, face creams, cystic acne, irritation, Garnier, La Roche-Posay, prescriptions, cleaners

When I was 14, I was super-pissed off at my skin: awful, inflamed cysts seemed to pop up every day, despite all the pills and topical creams I was using.

One very sad and crazy evening, I took a sewing needle to several cysts on my forehead and burst them. It was a terrible idea and left me with little resultant holes in my forehead. “Ice-pick scars,” in dermatology speak.

That was almost 10 years ago and while I still have unpredictable, hard-to-manage acne, I’ve made peace with it. I don’t mutilate my face out of abject rage. I’ve learned to control the uncontrollable really well using products from easily-found pharmacy brands.

The acne I have doesn’t follow any hormonal pattern and is unresponsive to most traditional and untraditional medicine, dietary changes and quasi-medical salon treatments. The current situation on my face: although there is quite a bit of scarring, my acne has reduced massively in the last three years, particularly around the jawline.

I won't touch on how to “pop zits correctly” or go to town on skin that's already struggling by scraping it over with an extractor. Skin with cystic or severe acne needs kindness, not full-on assault. Leave extractions to the professionals. A burst garden-variety zit isn’t the end of the world, but if it’s a burst cyst, we’re talking more of a weeping sore: difficult to treat, heal or conceal with any kind of makeup, and might leave you with a scar.

It's easier to conceal a hard bump than it is to conceal an open, bloody hole. So the rule of thumb is that if you're in doubt as to whether or not you should squeeze something, just don't. Your skin has a hard enough time without you going crazy making holes in it; it needs care more than anything.

That is why I made a move away from inflicting hard-core punishment on my skin. In 2010, I couldn’t lie with the pillow touching the side of my face because it was so painful and covered in hard bumps. Even something brushing off my jawline hurt!

Since I started a gentler skincare routine with a couple of products, things have calmed down considerably and are still improving, so if you’re struggling with acne, I’m really hoping that this easy-to-follow routine can help you too.


Effective, gentle cleansing that doesn’t leave your skin feeling tight or sore is ideal for acne-prone skin. Garnier Simply Essentials Soothing Cleansing Lotion gets rid of every scrap of makeup without tearing up your skin, and is free from perfume, parabens and irritants.

Vichy Normaderm Cleansing Gel, containing salicylic acid and totarol, has powerful microbial agents and a peeling effect to cleanse deeply and reduce sebum, making you less shiny and oily. Cleanse every bit of makeup off with the lotion before washing with the gel.


Prescription medications work differently for everyone: isotretinoin, the daddy of acne treatments, didn’t work for me. One prescription treatment I do come back to now and again is Differin gel, a topical adapalene that works well if used as a targeted treatment for particularly bad cystic areas.

Be aware, though, that Differin is drying to the extreme. You’ll also need to be very careful in the sun and keep it away from your nostrils, lips and eyelids. I use tiny dabs to spot-treat the worst cystic areas. I also get more bang for my buck that way because this stuff's kind of expensive for a teeny tube!

If you want to save a few bucks by avoiding the charges for a doctor/derm appointment, you could give an OTC topical a whirl. La Roche-Posay Effaclar Duo claims to work “as well as the leading prescription treatment”. I tried it a while ago and it calmed the angrier cystic areas fairly noticeably.


Not too long ago, I had gone a few rounds with isotretinoin and ran crying into my local pharmacy: I was a raw, inflamed, cystic mess and my face was peeling so bad, I looked as though I’d been administering home chemical peels made of salt and battery acid. I needed something sent from God, and he delivered La Roche Posay Cicaplast Baume B5.

This stuff is a multitasker, marketed as a soothing, repairing balm. It’s recommended for healing baby bottoms, helping repair skin after a chemical peel, and it’s perfect for skin that’s at risk of becoming dry from acne treatments. I use it as my day-and-night moisturiser now; it’s instantly soothing and cooling, non-greasy and works great as a primer too!

Have you dealt with long-term cystic acne? What's worked for you? What hasn't?