Why do I have cystic acne on my cheeks?

Is every deep lump a cyst?

Both acne nodules and cysts are deep breakouts that can feel tender or painful. A cyst contains pus, while a nodule does not and usually feels harder. You can have these alongside blackheads, whiteheads and smaller pimples. A clinician can examine your skin to confirm whether the lumps are acne; testing is unnecessary in most cases.145

What could be contributing to cheek breakouts?

• Hormones influence oil production. Changes during puberty, periods, pregnancy and menopause can contribute to acne, and acne can begin or continue in adulthood.
• Family history matters. Having a parent or close relative with deep, painful acne increases your risk of developing that type.
• Oily makeup, skincare and hair products can worsen breakouts. Repeatedly touching, resting on or rubbing the skin can also trigger acne.
• Certain medicines can contribute, including steroids and testosterone. Include your medicines and hormonal contraception when discussing new breakouts with a clinician.
• Stress can worsen existing acne, rather than cause acne by itself. Too little sleep can also worsen it.
• Diet is a possible contributor, not a settled explanation. Dairy and refined sugars have been linked with acne in some people, but the connection remains controversial.

Noncomedogenic means a product is formulated not to clog pores.3

What should I do now?

1. 1Wash gently twice a day with a mild cleanser. Avoid scrubbing or repeatedly washing the area.
2. 2Remove makeup at the end of the day and choose noncomedogenic cosmetics and skincare.
3. 3Keep oily hair away from your face and review greasy hair products that contact your skin.
4. 4Do not squeeze, pick or scratch deep lumps. Doing so can cause infection, slower healing and scars.
5. 5Arrange a medical appointment for deep, painful breakouts, especially if they recur or leave scars. Do not wait several months to seek help for cysts.

Water based formulas are another option for cosmetics and skin creams, without requiring a matching collection.4

What treatment can help deep cheek acne?

Treatment depends on severity, how long the acne has lasted and what you have already tried. Options include medicines applied to the skin, oral antibiotics and hormone treatments for suitable patients. Persistent or severe acne can require isotretinoin under medical supervision. A dermatologist can inject an extremely painful cyst or nodule to reduce pain and help it clear faster.156

Isotretinoin must not be taken during pregnancy because it causes severe birth defects.4

How long will the lumps and marks last?

Deep nodules can persist for months, and acne treatment can take 6 to 8 weeks to show a response. Flat pink, red, purple or brown marks left after a breakout are not necessarily scars. These marks can fade on their own, sometimes taking a year or longer; true acne scars can be permanent.146

Seek medical help for worsening acne, scarring or emotional distress. Hot, swollen skin with redness can signal infection; redness can be harder to see on brown or black skin. Fever, joint pain or ulcerated, extensive lesions need urgent assessment.345

Why do I have cystic acne on my chest?

The same blocked follicle and deep inflammation process can affect your chest. Sweating and humidity can trigger acne. Wear loose, breathable clothing, especially during exercise, and seek treatment for deep or scarring chest breakouts just as you would for cheek acne.345