How Can I Get Rid of Severe Acne?

Treatments for severe or cystic acne can include prescription medication, birth control pills, acne removal, non-abrasive cleansers, not picking at pimples, diet modification, and more.

Acne (short for acne vulgaris) is a common skin condition characterized by chronic or recurrent development of pimples, papules, pustules, or nodules on the skin. Severe acne can cause many breakouts that may affect the face, chest, back, and other parts of the body.

Severe acne breakouts are often cysts and nodules that extend deep into the skin and can be painful. Severe acne frequently leaves a scar when it finally heals. 

14 Treatments for Cystic Acne

Severe acne can be stubborn to treat and it does not respond to over-the-counter (OTC) acne treatments. To get rid of severe acne it can take time and usually requires treatment prescribed by a dermatologist. 

• Medications 
  • Antibiotics plus a topical medicine applied to the acne 
    • The antibiotic can fight infections and reduce inflammation
    • The topical medication also helps fight bacteria and can reduce clogged pores
  • Isotretinoin (Accutane) 
    • This is a strong medicine that helps with bacteria, clogged pores, excess oil, and inflammation
    • One course of this medication helps clear acne in about 85% of patients, according to the American Academy of Dermatology
    • But the medication has some very serious side effects so it’s not right for everyone
    • Anyone taking isotretinoin must enroll in a monitoring program
  • Birth control pills 
    • For females only
    • Can help regulate hormones 
    • May be used alone or with spironolactone or an antibiotic
  • Spironolactone 
    • Also for females only
    • Used to regulate oil production
  • Low-dose prednisone
    • A corticosteroid prescribed to treat a serious type of severe acne called acne fulminans as well as pityrosporum folliculitis, an itchy, acne-like rash
• Medical treatments 
  • Acne removal
    • For large cysts or nodules
    • Steroid shots injected directly into cysts
      • Used to help reduce and relieve inflammation and lessen pain quickly
      • Indicated for large, painful, deep acne breakouts
      • Usually only used to treat a few severe acne breakouts due to possible side effects such as scarring
    • Incision and drainage
      • Used to drain large, painful acne cysts or nodules unresponsive to medicine 
    • Acne extraction 
      • Used to remove whiteheads and blackheads that do not respond to medical treatment

Home treatments that may help prevent or manage severe acne include: 

• Topical over-the-counter (OTC) creams
  • Retinoid A (adapalene)
• Warm compresses can relieve inflammation and may help encourage pus to come to the surface
• Wash twice daily and after sweating; rinse with lukewarm water
• Use gentle, non-abrasive cleanser and apply with fingertips
  • Don’t scrub your skin and avoid washcloths or sponges that can irritate the skin
• Use gentle products on the skin
  • Use alcohol-free products
  • Use products that don’t cause acne — look for these words on product labels: 
    • Non-comedogenic
    • Oil free
    • Won't clog pores
    • Non-acnegenic
• Don’t pick, squeeze, or pop pimples
  • Picking at acne can make it take longer to go away and may increase the risk of scarring
  • If needed, cover cysts with an adhesive bandage and keep nails short to discourage picking
• Diet modification
  • A low glycemic index (low GI) may help in some cases
  • Limit or avoid high GI foods such as white bread, pasta, and potatoes
  • A plant-based vegan diet may benefit patients with severe acne
• Avoid homemade acne “remedies” that can irritate and clog pores, and do not work to get rid of severe acne, such as:
  • Baking soda
  • Honey
  • Sugar 
  • Toothpaste