How to get cystic acne to the surface

How to use a warm compress

1. 1Wet a clean washcloth with warm water. Use warmth, not scalding heat.
2. 2Hold the warm, damp cloth over the bump for 10 to 15 minutes, three times daily. Use a clean washcloth each time.
3. 3Leave the bump alone between compresses. Do not press harder, rub it or squeeze it if a white head appears.

Look for the bump becoming smaller and less painful, rather than treating a visible head as the only sign of progress. A compress can help healing, but there is no fixed timetable for a deep bump to reach the surface.2

Will acne treatments or patches help?

Topical acne treatments work better when the pimple is at the surface. Options include adapalene, azelaic acid, benzoyl peroxide and salicylic acid. Apply a thin layer and follow the product directions rather than adding extra applications to hurry things along. These products can cause redness, dryness or excessive peeling; more product can mean more irritation.14

A hydrocolloid patch can protect the area and help healing, giving the term 'acne sticker' a more useful job than decorating the bathroom cabinet. Patches also discourage picking. If your skin is sensitive, choose an unmedicated patch rather than one containing benzoyl peroxide, which can irritate sensitive skin. Tea tree oil is less well studied than standard acne treatments and can cause allergic reactions.12

Wash gently morning and evening, remove makeup before bed, and avoid scrubbing or repeatedly washing the bump. A mild cleanser is the useful purchase here, not a product name that sounds like laboratory equipment. Use noncomedogenic skincare, meaning products designed not to clog pores. Protect exposed skin with broad spectrum, water resistant SPF 30 or higher, since inflammation and sun exposure increase the risk of dark marks.1345

What if you already squeezed it?

Clean the area with mild soap and water, then leave it alone. Squeezing can push contents deeper into the skin instead of removing them, increasing inflammation and delaying healing. Get medical help if the area becomes hot, swollen and red, or you notice other signs of infection. Redness can be harder to see on brown and black skin.256

When should you see a dermatologist?

Arrange an appointment for multiple deep, painful bumps, a persistent bump, worsening acne or scarring. A dermatologist can inject one especially painful cyst or nodule with a corticosteroid to reduce inflammation. Most flatten within 48 to 72 hours. This is not a treatment for numerous blemishes, and only a doctor should perform it. A dermatologist can also drain a cyst with sterile equipment when appropriate.146

Treating ongoing cystic acne can take three months or more and often requires prescription creams or gels and oral medicines. Do not wait months to seek help for deep, painful or scarring acne. If isotretinoin is considered, it requires medical monitoring and must not be taken during pregnancy because it causes severe birth defects.34

Why do people get cystic acne?

Oil and dead skin cells block a pore, bacteria become trapped, and inflammation develops deep in the skin. Family history, hormonal changes and stress can contribute. Certain medicines and oily skincare or hair products can also trigger acne.35

Why do I get cystic acne on my cheeks?

The face has many oil glands, making it a common place for cystic acne. Cheek location alone does not identify a particular trigger. A dermatologist can examine recurring deep bumps and help choose treatment rather than relying on their position to explain them.3