It’s maddening when you’ve got a clear skin streak for months and then BAM. You develop one or two giant blemishes on the day of an important event. Now, imagine having to go through that your whole life, with little to no signs of your skin clearing up despite your best efforts.
According to the Acne Management Guidelines by the Dermatological Society of Singapore, cystic acne is seen more often in adults and it affects up to 69 per cent of the female population in their adulthood. In a lot of cases, the problem of cystic acne goes beyond skin deep—it can also cause a lot of mental distress such as low self esteem and depression, especially in this social media era where looking good, clear skin and all, is considered a commodity. So how then can we keep this issue in check? Dr Vincent Tan, aesthetic doctor at Vincere Aesthetics Clinic sheds light on the matter.
First things first—what sets cystic acne apart from other types of blemishes?
Dr Tan explains that cystic acne is typically characterised by deep, painful, pus filled nodules, and are triggered by multiple factors, including genetics, poor hygiene and hormones.
“As a general rule of thumb, acne appearing around the chin and jawline are often connected to the hormones. The fluctuation of hormones can increase the production of sebum on your skin, including areas where blemishes don’t typically appear such as the chin and jawline,” he points out. He also shares that cystic acne occurs when bacteria enters the pores, causing swelling, inflammation and the formation of pus. “Unlike cystic acne, nodular acne do not contain fluid, and feels solid,” he says.
As the T-zone has more oil glands than other parts of the face, it’s little wonder why this area is more prone to black and white heads. He reveals that these are signs of clogged pores, and said that blemishes on rest of the face, such as the cheeks, do not reveal much about the underlying causes.
“All in all, a thorough consultation will help to identify its cause more specifically.”
Best ingredients to treat cystic acne
When it comes to skincare, Dr Tan advises against using oil-based skincare products as they can exacerbate the clogging of pores. He suggests opting for water-based products instead.
Where skincare ingredients are concerned, he put benzoyl peroxide and azelaic acid at the top of the list. “The former helps to reduce bacterial activity and unclog blocked comedones while the latter promotes gentle exfoliation and diminishes the appearance of dark spots,” he shares.
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Healing from the damage
Dr Tan admits that the ingredients mentioned above can be quite harsh on the skin and could potentially cause more harm than good. For good measure, he suggests including skincare with healing and restorative ingredients such as squalane, hyaluronic acid and ceramides in your regime, as they help to counteract the harshness of the acne controlling ingredients.
“Squalane is a ‘stable’ form of squalene (a lipid produced naturally by our bodies), and helps with promoting skin hydration while offering antioxidant protection. Hyaluronic acid helps to restore hydration to the skin, because acne-controlling treatments can strip the skin of moisture. Ceramides help to seal moisture in the skin, preventing the skin from further drying out,” he explains.
When to seek medical help
In severe cases, Dr Tan encourages making a trip to the clinic, saying that getting prescription medication from an expert will help in preventing the development of cystic acne.
“When your skin starts to break out into papules and pustules more often, it is advisable to quickly seek medical advice and get it treated. This will help to control your acne (including cystic ones) better and prevent potential scarring. Treatments include getting a prescribed topical or oral medication from a trained professional,” he proposes.
Facials: To go or not to go?
On the subject of facials, Dr Tan is not opposed to the idea of those with cystic acne going for them to help manage their complexion. He reasoned that facials help in the unclogging of pores and thus prevents the development or worsening of breakouts.
“However, it is important to be prescribed an appropriate facial, as some serums/products may worsen the condition,” he warns.
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Cystic acne surprise: At-home treatment or clinical attention?
When cystic acne makes a surprise visit on your face, an over-the-counter pimple cream with benzoyl peroxide or azelaic acid is a reliable and affordable solution to address the issue if you have a few days to spare.
“However, those who seek immediate attention can consider corticosteroid shots at a trusted clinic,” he says.
Keeping cystic acne at bay
When your complexion has cleared up, Dr Tan says that getting regular facials will help with pore purification. “For long term results, maintain a healthy lifestyle, use non-comedogenic products, and practice good hygiene,” he adds.
For those with scars and blemishes he recommends getting laser, radio frequency or micro-needling treatments at a clinic.
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Controlling cystic acne with lifestyle choices
“There are studies that suggest a diet low in sugar and cow’s milk may reduce the occurrence of cystic acne, as these food sources are linked to hormonal imbalances,” Dr Tan recalls.
“However, I would suggest that you observe your own food triggers, as everybody’s body functions differently. Above and beyond, maintaining a balanced and healthy lifestyle will certainly help to improve one’s cystic acne as well as your general well being.”
Cystic acne takeaways
First things first, Dr Tan insists on keeping your skincare regime simple. “Avoid using too many products at once,” he advises.
He also reminds us that acne control or treatment is a journey. It will require patience and periodical review to adjust your skincare regime and prescription medicine accordingly. He also adds that there is no quick solution to this, but trained healthcare professionals can certainly help you find the light at the end of the tunnel.