“Are acne cysts caused by the same things as whiteheads and blackheads? And how can I prevent them?”

Acne cysts differ from whiteheads and blackheads. White heads and black heads (comedones) form due to clogged pores. Hair follicles of the skin (pores) become blocked with excess sebum (oil) and dead skin cells. Bacteria can infect the plugged follicle, which then becomes inflamed and irritated. Whiteheads are clogged follicles that are closed, while blackheads are clogged follicles that are open, which exposes the oil clogging the pore to air, causing it to turn brown. Comedones are one of the main lesion types associated with “common acne” or mild to moderate acne.

Acne cysts are large, solid, painful bumps or lumps that form beneath the surface of the skin and are associated with cystic acne, which is a severe form of acne. Acne cysts form when the inflamed hair follicle ruptures below the surface of the skin, which spreads the contents of the hair follicle more widely and deeply.

Factors that contribute to the development of acne are essentially the same for common acne and cystic acne (genetics; hormones; the use of occlusive cosmetics and skin care products such as creams and lotions; sweating; environmental conditions such as heat and humidity; and certain medications such as steroids); however, hormones and genetics may be a key factors in the development of cystic acne. As well, squeezing acne lesions may force bacteria and sebum deeper into the skin and cause the inflamed follicle to rupture below the surface of the skin, which can increase the risk of an acne cyst developing.

Cystic acne generally warrants an aggressive treatment approach with oral medications, due to the risk of scarring with the condition. Keep in mind that mild to moderate acne is more commonly encountered than cystic acne and that a good skin care routine may help prevent many different types of acne lesions and includes:

• Washing the face twice daily with a mild, soapless cleanser using lukewarm water
• Maintaining skin hydration (excessive drying can cause flare-ups)
• If using a moisturizer, choosing one that is light and noncomedogenic
• Washing your hands prior to washing your face and using a clean face cloth at each washing
• Shampooing the hair at least every other day or on a daily basis
• Avoid contacting the forehead and hairline with hairstyling products

If you have more questions or concerns about cystic acne, don’t hesitate to ask your community pharmacist.