Cysts are another troublesome type of acne to treat successfully without the help of a doctor. A cyst forms similar to a nodule—way beneath your skin’s surface. However, cysts are thought to form from pustules because they contain pus. They are painful when touched resemble a boil. They appear to be a large, red, swollen lump on the skin surface. People who are prone to them may get one large cyst or a clump of cysts.
One of the best face washes for sensitive skin, this soap-free, fragrance-free, non-comedogenic cleanser works to remove excess oil from your skin without irritation. It’s great for oily and combination skin types, as it cleans and purifies without making the skin taut and dry. Its formula is glycerin-based for a gentle cleanser that won’t provoke even the most sensitive of skin types.
First, it’s a cleansing oil, not the typical gel wash or liquid. Next, it has a potent blend of salicylic, glycolic, and lactic acid for superior exfoliation. Third, it contains natural ingredients that repair damage to the skin and get rid of acne. For example, soapwort extract dissolves oil without the need for drying sulfates. Then, vitamin B and lavender combine to reduce oil secretion and inflammation. Finally, watercress is full of antioxidant vitamins that heal damage caused by the sun.
Accutane is especially good for cystic acne in women and body acne in men. “Oral vitamin A basically shuts down your sebaceous glands. If you suppress [them] for a long enough period, you can cure someone of their acne, and about 50 percent do hit that cure rate,” says Linkner. A course of Accutane can take about six to nine months. Sometimes patients need to repeat the course at a higher dosage in order to truly eliminate acne.
Getting rid of stubborn pimples, blackheads and whiteheads starts with thorough but gentle cleansing of the skin. Try my recipe for Homemade Honey Face Wash to cleanse skin without causing irritation. It features apple cider vinegar, honey, coconut oil, probiotics and essential oils (like tea tree oil). The honey soothes the skin, the coconut oil helps to fight bacteria and fungus, and the tea tree oil helps to invigorate the skin. Dampen skin with warm water, and massage into face and neck. Rinse well and pat dry. Do this each morning and evening and, if needed, after workouts. Refrain from cleansing more often, as this can irritate the skin and cause an overproduction of oil.
For example, if you have acne on dry skin, you need something gentle enough to cleanse and exfoliate but not dehydrate, like a Neutrogena cleanser. If you have oily skin, you’re looking to exfoliate and combat oil production with a product like Cetaphil. If you have combination skin, you need something that can treat your unique skin and balance it out, like Exposed Skin Care.
“Cult-fave for a reason — simple, cheap, and effective. Dries down fast, alcohol-free, and incredibly convenient to use. Even with my normal-dry skin, I find that the drying effects of this product are easily mitigated with moisturizer (obviously your mileage may vary). This has seriously helped manage whiteheads, sebaceous filaments, and those little red inflamed buggers.”
Considerations: Side effects are generally mild and short lived. Most common, in 1-5% of people are itching, burning, stinging, and tingling. Other side effects were reported in less than 1% of people. There have been a few reports from darker skinned people of lightening of the skin. Azelaic acid has not been well studied in people with dark complexions.1
Accutane (isotretinoin) has a mixed reputation, but among dermatologists it’s the finisher for patients with severe acne. “If you have an acne patient that doesn’t respond to anything, [Accutane] can really be a game changer,” board-certified dermatologist Adam Friedman tells SELF. Accutane is an oral retinoid, and it has all the same benefits of a topical retinol but is even more effective.
“I use it approximately three nights a week either layered over my moisturizer or directly after cleansing. It has reduced my overall breakouts, decreased the time it takes for my breakouts to heal, and helped overall to even my skin tone and minimize pore appearance. I also think it has made my skin slightly less oily, as long as I moisturize properly. I do not use any chemical exfoliation currently, but use a konjac sponge occasionally to help with any dead skin or texture. I have not experienced any excessive dryness or flaking, and also did not ever purge. It is my HG for my acne and I plan on repurchasing until the end of time.”
Dermatologists aren’t sure why azelaic acid is so effective at clearing up inflammation, but it’s often used as an option for sensitive skin or pregnant patients. Linkner says the ingredient is good at treating malasma, acne, and rosacea. Your dermatologist can prescribe a foam product with azelaic acid, and you can also find beauty products with very small amounts of this active ingredient.
The dermatologist Dr. Dennis Gross did a major study on water and its effect on skin and he found that the heavy metals in tap water can actually ruin the benefits expensive lotions and serums do for skin. Some cities (New York and L.A., for example) have worse water than others (Seattle, for example). While some dermatologists aren't buying his claims, (Patricia Wexler for one), you can fight the drying effects of water on skin by cleansing with cold cream, a practice common with European women.
In 2007, a study published in the American Journal of Clinical Nutrition found that glycemic load can greatly affects acne. 43 males with acne, aged 15 to 25, were separated into two groups. For twelve weeks, one group ate a diet that was 25 percent protein and 45 percent low-glycemic carbohydrates. The other group ate carbs without any control of glycemic index, resulting in a higher glycemic diet. At the end of the study, the acne had decreased in the low-glycemic group by almost twice the rate of the high-glycemic group! (17)
While a face mask isn’t totally necessary to clear your acne, sticking to just once a week won’t further irritate or dry out your skin if you like using one. This drugstore treatment from L’Oreal utilizes the power of kaolin clay, which absorbs excess oil, draws out impurities from the skin, and gently exfoliates to speed the healing process of breakouts, according to a review of research published in International Geology Review. It won’t completely wipe out your acne overnight, but it can help control the oil that leads to more pimples and dry out bumps that are particularly stubborn. Plus, it gives you an excuse to pamper yourself.
Combined oral contraceptives. Four combined oral contraceptives are approved by the FDA for acne therapy in women who also wish to use them for contraception. They are products that combine estrogen and progestin (Ortho Tri-Cyclen, Yaz, others). You may not see the benefit of this treatment for a few months, so using other acne medications with it the first few weeks may help.