A cyst is a closed pouch of tissue that may be filled with pus, fluid, air or other material. Cysts may form within any tissue in the body but are not very common. Cystic involving the skin is a tender, sensitive and deep painful lesion that has the potential of producing long-term scarring. Cystic acne, caused by the overactivity and plugging of the sebaceous glands (skin’s oil glands) requires immediate treatment to prevent further complications.

A variety of oral medications used to clear cystic acne include antibiotics (tetracycline and erythromycin), oral contraceptives and cortisone. Tetracycline and erythromycin are effective broad-spectrum oral antibiotics used to treat moderate to severe inflammatory acne. Tetracycline reduces inflammatory lesions of acne but is contraindicated in pregnant and breast feeding women, and children of less than 8 years of age. Doxycycline and minocycline, the synthetic derivatives of tetracycline are important therapeutic oral agents in the treatment of acne.

Appropriate oral contraceptives that are valuable adjuncts in the treatment of acne in females include ethynodiol, norgestimate, norethindrone and norethindrone acetate. They act by inhibiting the overactivity of sebaceous glands (oil glands).

In an attempt to treat cystic acne, the dermatologists might also opt for acne surgery, followed by flushing much-diluted cortisone gently through the cyst. Also, one might benefit by topical application of warm water, which often compresses cystic acne.

In situations where other treatments fail to produce an improvement in the patients with severe inflammatory acne, isotretinoin (Accutane) may be prescribed. Isotretinoin (a derivative of vitamin A) is a very effective oral drug that can help prevent scarring. It acts by reducing the size of the sebaceous glands thus preventing the excess secretion of oil and decreasing the growth of bacteria. It has been estimated that up to 90% of patients’ treatment with isotretinoin result in complete or almost complete recovery from cystic acne. Since isotretinoin can cause birth defects in the developing fetus, it is important that women of childbearing age are not pregnant and do not get pregnant while taking this medicine.