From pain and discomfort to the risk of lasting, long-term scarring, dealing with cystic acne can be a stressful, extremely difficult experience.
Luckily, it’s not one that you need to go through forever. From topical products to hormonal acne medications, a variety of treatments can help you fight back against cystic acne and enjoy clear, acne-free skin.
If you’ve looked into cystic acne treatments, you’ve probably heard of tretinoin. Widely used as an acne treatment for decades, tretinoin is a topical retinoid that’s scientifically proven to reduce acne lesions when used consistently.
Most studies of tretinoin look at its results as a treatment for hormonal acne. Far fewer look at it as a potential treatment for severe, cystic acne.
Below, we’ve explained how tretinoin works as an acne treatment, as well as how you can use it alone or in combination with other medications to eliminate cystic acne and enjoy clear, healthy and acne-free skin.
Cystic acne is a particularly severe form of acne that involves the development of inflamed and infected cysts beneath the surface of the skin.
Unlike regular whiteheads and blackheads, which develop when a pore becomes clogged with sebum and dead skin cells, cystic acne nodules are large blockages that also contain bacteria.
Over time, these blocked pores can develop into painful, uncomfortable cystic nodules that can damage your skin. People with severe cystic acne are often left with obvious, lasting scars as a result of elastin and collagen damage.
Our guide to cystic acne goes into more detail on how cystic acne happens, as well as the key symptoms that differentiate it from more common outbreaks of hormonal acne.
In use since the 1960s, tretinoin has one of the longest track records of any acne treatment. It’s scientifically proven to reduce acne lesions over the course of eight to 12 weeks. Combined with other medications like clindamycin, it outperforms almost all other topical acne treatments.
It’s also extremely safe, with a “low incidence of reported adverse effects” and few side effects apart from skin irritation.
In short, when it comes to results, tretinoin is one of the safest and most effective topical acne treatments on the market. Despite this, the data on tretinoin’s effectiveness as a treatment for severe, cystic acne is a little limited.
Tretinoin works by speeding up your body’s skin cell turnover cycle. This means that your body sheds old, dead skin cells faster than it normally would. Since dead skin cells can easily collect inside your pores, this makes it harder for acne-causing blockages to develop.
Contrary to popular belief, topical retinoids like tretinoin don’t affect your body’s production of sebum, meaning you’ll still produce just as much sebum as normal. However, for most people, the effects of tretinoin on skin cells are enough to make it an effective acne treatment.
With cystic acne, things become a little more complicated. Cystic acne is caused by a range of factors, from dead skin cells to sebum production and bacteria. Target one and you’ll produce an improvement, but it might not completely treat your cystic acne.
Because of this, dermatologists usually prescribe tretinoin in combination with other medications to treat cystic acne. Some of the most common combinations include:
Because there’s no “best” treatment for every case of cystic acne, dermatologists will prescribe the most suitable treatment for you based on your medical history, your lifestyle and the severity of your cystic acne.
Beyond its benefits as an acne treatment, tretinoin is widely used as an anti-aging and general skincare medication.
There’s also some evidence that tretinoin can help to heal acne scars. A study from 2004 shows that regular use of 0.05% tretinoin gel, often in combination with a 5% trichloroacetic acid (TCA) solution, can produce some flattening of acne scars.
According to this study, the best results occured in relatively young scars, with superficial and ice pick scars usually improving the most over the course of treatment.
Does this mean that tretinoin is a flawless treatment for acne scars? Not quite. While this study is promising, there’s very little complementary research on tretinoin as a treatment for scarring from cystic acne.
In short, if you have cystic acne scars, tretinoin is worth considering. Just don’t expect the same results as you might be able to achieve with dermal fillers, laser resurfacing, punch excision and other, more established scar removal treatments.
Tretinoin is one of the most thoroughly researched, tested and proven acne medications on the market, meaning you’ll probably experience a significant improvement in your cystic acne if you add it to your skincare routine.
With this said, tretinoin on its own isn’t totally proven as a treatment for cystic acne. This means your dermatologist might recommend using an antibiotic, a birth control pill or a combination of the two along with tretinoin for optimal results.
If you have severe cystic acne, you might also get better results by using an oral retinoid, such as isotretinoin (Accutane). Your dermatologist will choose the best combination of medications based on your specific symptoms, medical history and needs.
Cystic acne outbreaks can be a horrible experience, affecting everything from your skin to your self-confidence. Luckily, a range of safe, effective and proven treatment options are available to help you take control of your acne and enjoy clear, smooth, acne-free skin.
Our guide to cystic acne covers all of the most effective treatments for cystic acne, from topical retinoids such as tretinoin to oral retinoids, hormonal medication, antibiotics and more.