Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 7/16/2021
Dealing with any type of acne can be a frustrating experience. However, few breakouts are as stressful, annoying and painful as those that feature cystic acne.
Cystic acne is a severe form of acne that develops deep inside your skin. It’s often painful and unpleasant.
Even when cystic acne clears up, it often leaves behind scars that can affect your appearance and self-esteem.
Like other forms of adult acne, cystic acne usually develops on your face and can often form on your chin.
Although cystic acne can be tough to deal with, it’s almost always treatable with a combination of science-based acne medication (which can include topical treatment options and things like the good old birth control pill) and good skin care habits.
Read on to learn why cystic acne often develops on and around your chin, as well as steps you can take to get rid of cystic pimples.
We’ve also shared a few preventative tips to help you stop cystic acne from returning.
Cystic acne, or nodulocystic acne, is one of the most severe forms of acne. Like other acne, it’s caused by a combination of three things: sebum, dead skin cells and bacteria.
Sebum, a type of natural oil that’s produced by your skin, can gradually build up on the surface layer of your skin. When it mixes with dead skin cells left behind by your skin’s cellular turnover process, it can become stuck inside your pores and cause blockages.
Several different factors play a role in this process behind the scenes, including hormones that control your production of sebum.
Cystic acne and other forms of severe acne develop when bacteria multiply inside your clogged pores, causing them to become infected and inflamed. Our guide to cystic acne offers more information about this process, as well as the effects it has on your skin.
As for why cystic acne on your chin develops in the first place: Experts believe that it’s likely related to your levels of certain acne-causing hormones.
For example, research suggests that hormonal acne—the kind of acne that’s linked to fluctuations in specific hormone levels —tends to concentrate in the lower third of your face, near your chin and jawline.
Cystic acne can be difficult to treat.
Because it develops deep beneath your skin, many topical facial cleansers, creams and other acne products available in drug stores may not be able to help, and you might need prescription-strength alternatives.
If you’re prone to cystic acne, you may have tried over-the-counter treatments before with little or no success.
Although cystic acne can be tough to treat, it isn’t untreatable. However, as a very severe form of acne, it almost always requires the use of prescription medication.
Currently, dermatologists use several different medications to treat cystic acne, including cystic acne that affects the chin and jawline.
The combination of oral antibiotics and topical acne medication is often one of the most popular treatment options for cystic acne.
This approach targets cystic acne from two angles. First, the antibiotic works by preventing the growth of acne-causing bacteria.
Second, the topical acne medication (such as tretinoin) works by preventing blocked pores from developing in the first place. This can help keep your acne breakouts from coming back. You can find more information on tretinoin for treating cystic acne here.
Common oral antibiotics used to treat acne include doxycycline, minocycline, amoxicillin and erythromycin. In some cases, your healthcare provider may instead suggest using a topical antibiotic, such as clindamycin.
Another medication used to treat cystic acne—including cystic acne that affects your chin and jawline—is isotretinoin (previously sold under the brand name Accutane®).
Isotretinoin is almost always effective for treating acne, including the kind that doesn’t improve with other medications. In fact, around 85 percent of people who use isotretinoin find their acne clears by the end of the prescribed treatment period.
Although isotretinoin is effective, it’s more likely to cause side effects than other medications for acne. It’s also not safe to use during pregnancy.
To keep yourself safe if using isotretinoin, and reduce your risk of pregnancy, you’ll need to take part in a monitoring program called iPledge and use two forms of birth control during treatment.
Several combination birth control pills have been approved by the FDA as treatments for acne, including the medications YAZ®, Estrostep® and Ortho Tri-Cyclen®.
These medications work by regulating your body’s production of certain hormones, including those that can stimulate sebum production and contribute to acne breakouts.
Your healthcare provider may suggest using birth control on its own as an acne treatment, or in combination with a topical acne medication.
You can learn more about the effects of birth control on your skin in our full guide to birth control for treating acne.
If your cystic acne is caused by a hormonal issue, your healthcare provider may suggest using medication to control your production of androgens, or male sex hormones.
One anti-androgen that’s sometimes prescribed to treat acne is spironolactone, which works by blocking the effects of the hormone testosterone.
Spironolactone can cause side effects and isn’t safe for use during pregnancy. Our full guide to spironolactone for acne goes into more detail about how the medication works, its effects on acne breakouts and more.
If you have severe cystic acne on your chin or jawline, your healthcare professional may opt to treat it manually in a clinical setting.
Healthcare providers use several techniques to treat severe cystic acne. They may inject medication into your skin to reduce swelling or use a sterile needle to remove the contents of the cyst from under your skin.
It’s important to visit a professional for these treatments, as attempting to remove cystic acne at home may cause pain, infection and increase your risk of developing acne scarring.
While cystic acne almost always requires medication to treat it, simple habits can reduce your risk of developing acne again in the future. Make sure to:
Wash your face twice daily. The American Academy of Dermatology
recommends washing your face twice a day with a gentle cleanser, as well as after you sweat. Keep it simple by washing in the morning and once before you go to bed.
Avoid touching your face. This can spread oil and bacteria onto your skin and increase your risk of developing acne breakouts. If you need to touch your face, wash your hands first using soap and warm water.
Use your medication consistently. If you’re prescribed acne medication, make sure to keep using it after your breakouts stop. This helps keep your skin clear over the long term and prevents your acne from coming back.
Avoid products that can clog pores or cause irritation. If you get acne easily, look for non-clogging products labeled “oil-free” or “non-comedogenic.” If you have sensitive skin, try to avoid astringents and other skin care products that contain alcohol.
Remove makeup before you sleep. Makeup can clog your pores and cause acne breakouts, especially if you sleep in it. Use non-comedogenic makeup remover pads or other skin-friendly products to remove your makeup before you hit the sack.
Stay positive and focus on the long term. Getting rid of acne requires time, even with the very best acne medication. Stay focused and use your medication consistently, as it may take several weeks before you see improvements in your skin.
Cystic acne on your chin can seem like a nightmare, especially when you have regular, heavy breakouts.
However, with the right combination of science-based medication and good habits, even severe cystic acne can be treated successfully and you can enjoy clearer skin.
You can find out more about treating this stubborn, severe form of acne in our detailed guide to cystic acne. You can also access a full range of acne treatments online, including hers’ custom Prescription Acne Cream for treating and preventing stubborn breakouts