How To Treat & Prevent Acne Cysts: Advice From Dr. Herzog

Dr. Herzog shares some very helpful advice on treatment and prevention of acne cysts in answer to the following question by a Family Savvy reader.

Dr. Jo,

I have been dealing with what appears to be cysts on the center of my chin. The bacteria within them lies deep within my skin; therefore, it is very hard to stop them from reappearing. On a positive note, they cause no pain. I’ve never had terrible acne during my lifetime, but I do get my fair share of blemishes. These elevated bumps first appeared 11 months ago and have been visible ever since. I went to my dermatologist and began washing my face with Cetaphil face wash in the morning and a benzoyl peroxide wash in the evening. I was very disciplined about not picking at my face, but I admit there were a few times that I tried to pop them — unsuccessfully of course. Attempting to get rid of the reappearing blemishes on my chin, I tried Neosporin, a dissolved aspirin pill, triple antibiotic ointment, benzoyl peroxide gel and many other methods. Unfortunately, these methods made my face dry, oily and red. I’ve also tried many different brands of face wash like Neutrogena, Clean and Clear, St Ives, Aveeno and Clearasil. Scars have developed on my chin as well. I would love some accurate suggestions. Are there any remedies, preferably not too expensive, that I can try?

Thanks so much,

EK

Dear EK,

Thanks so much for sending in your question. Your problem is very common, and my answer should be able to help a lot of other women who suffer with this issue.

Acne cysts, especially those that keep recurring on the chin/jawline area, are often hormonally driven. I do not think that bacteria is the main culprit. Hormonally driven acne is even more likely in someone like you who reports not really having had any other facial acne problems. Topical washes and creams are not as effective in these cases as they are with some other forms of acne. The treatment approach often has to be quite different.

For those women that have occasional bumps on the chin, it is sometimes easier to treat the occasional bump then to prevent it from happening. If a cyst develops and it is persistent, large, or painful, I often just inject it with 1% Kenalog (a mild steroid shot). This will decrease the inflammation, and the cyst should resolve more quickly.

When bumps are more plentiful or occur more often, I like to try to prevent them. One way of doing this is to use an oral antibiotic. Yes, I just said that I don’t think that bacteria is the main cause of these. So, why do I want to use an antibiotic? Here’s why. I think that a huge reason that antibiotics can be effective in this area is that many of these drugs have anti-inflammatiory activities. Another way of treating these is with oral contraceptives and with spironolactone. Both of these treatments tackle the hormonal changes that probably help drive this problem. Of course a combination of the above can be used if needed.

Do not pick!!!!! Picking causes scars.

Hope this answers your questions,

Have a great week,

Dr. Jo