Acne is the most common skin condition in the United States, affecting up to 50 million Americans every year according to the American Academy of Dermatology.
Cystic acne is the most serious form of the disease, and fortunately, is not nearly as common. The Centers for Disease Control and Prevention (CDC) estimates that about two in every 1,000 people are affected.
The condition is, however, very distressing to those people who suffer from it. It’s similar to general acne, in that it still involves blocked pores, infection, and inflammation. What’s different is the severity.
While those with general acne may suffer from a few pimples here or there, those with cystic acne suffer many more pimples, as well as cysts, inflamed papules and pustules that can sometimes be painful. It can also create visible scarring, including small, deep pits and shallow depressions in the skin.
Because it’s so pervasive on the skin, cystic acne can wreak havoc on a person’s confidence and self-esteem, and is believed to have just as many detrimental psychological as physical effects. Treating cystic acne is a challenge, and often takes a multi-pronged approach involving careful skin care and self-care to help reduce breakouts and manage those that do occur.
Dermatologists often recommend benzoyl peroxide to help control moderate cases, but it can be drying and may backfire for some people, as skin that becomes too dry can overproduce skin oils to compensate, setting up a vicious cycle of more acne.
Severe cases are often treated with medication like isotretinoin, but it has some serious side effects, including the potential for joint pain, depression, dry eyes, and elevated lipid (cholesterol and triglyceride) levels. Because of this, it’s often prescribed for only short periods of time. It’s also not recommended for pregnant women, as it can harm the baby.
If you suffer from cystic acne, you may be looking for natural alternatives. Is there a way to get a handle on this disease without resorting to harsh acne products or prescription drugs?
We have a few ideas that may help.
Why is Cystic Acne So Hard to Treat?
Cystic acne is caused by the same bacteria that causes general acne, but the resulting lesions are more plentiful and painful. Often, they actually rupture beneath the surface of the skin, which means that regular, topically applied products are less effective as they can’t penetrate deeply enough to get to the source of the problem.
Even dermatologists will tell you that traditional acne treatments are largely ineffective for this reason.
What causes all this havoc on the skin? Scientists aren’t sure, but they believe it has a lot to do with the hormonal changes that occur at puberty, as adolescents are the most affected group. (Pregnant women sometimes suffer with it, too, because of hormonal changes.)
We don’t know why the skin’s oil glands become so hypersensitive to the changing hormones, but they definitely do, often producing so much sebum that the oil gland becomes swollen and hardened. It then bursts and creates a mass (nodule or cyst) under the surface.
If you have cystic acne, you probably already know it, but here are some common symptoms:
- Raised, red bumps under the skin
- Less likely to have a “whitehead” showing, but some may
- Almost always painful to the touch
- Often felt forming beneath the skin before you can see them
- Red, flaky, scaly skin
- Excess oil production—“greasy” skin
- Inflamed cysts that can remain for weeks to months
Natural Remedies for Cystic Acne: Four Steps
To effectively treat cystic acne, we have to approach it from several angles. The following steps are critical:
- Continuous careful skin care
- Stress relief
- Dietary changes
Here are some tips on each of these steps.
Continuous Careful Skin Care
Getting to know your own skin is imperative to improving its condition. In general, those with cystic acne need to take the following steps on a regular basis to help skin cope. The key is regular—follow your skin care routine religiously. Don’t go even a day without taking each step!
- Deep clean: The key here is not to be too harsh. We tend to think a lot of scrubbing is what’s needed, but that can actually increase irritation and inflammation, making the problem worse. What you need are deep cleansing products that are also gentle. Our cleansing products fit the bill, but whatever you choose, try to steer clear of harsh products with fragrances and preservatives that will simply dry out your skin and make scars worse. You can also try natural bacteria-killing ingredients like lemon, honey, apple cider vinegar, calendula, neem, and tea tree oil. Cleanse every morning and night. Don’t go to bed with your makeup on!
- Absorb extra oil: Regularly absorbing that extra oil can help balance the skin. Try purifying masks that contain ingredients like clays (betonite clay), mud (our Dead Sea Scrub with mud from the Dead Sea is great), baking soda, Epsom salts, egg whites, and Fuller’s Earth. Homemade masks with tomatoes, lemon, apple cider vinegar, honey, and avocado can also help. Mask 2-4 times a week, depending on how your skin reacts.
- Exfoliate: With cystic acne, the infection and inflammation form underneath the skin. Exfoliation, therefore, can help you shed that hardened layer of dead skin cells, making skin more pliable and less likely to trap bacteria and impurities below. Use a natural, gentle exfoliating scrub like our Dead Sea Scrub, or others with ingredients like natural fruit acids, minerals, and fine-grain sugars. Exfoliate 2-4 times a week.
Stress produces an excess of certain hormones, and can make your breakouts worse. They key is to work out a stress relief program that you can fit into every day of your life. Choose activities like exercise, time with good friends, meditation, yoga, tai chi, a regular daily walk, art or music therapy, or whatever works for you to help you relax. Whenever you feel your muscles tightening up, try to remember to relax them, particularly your jaw, shoulders, and neck.
Also do your best to get at least 7-8 hours of sleep per night. It’s one of the best ways to counteract stress and to help your skin repair itself.
We used to think that there was no real dietary connection to acne, but recent studies have provided some evidence that certain foods may make acne worse for some people. Dairy foods, sugar, greasy fatty foods, and even gluten (for sensitive people) can contribute to internal inflammation, which will show up on your skin.
It’s important to do all you can to “clean up” your diet to help fight your cystic acne from the inside, out. Choose more fresh fruits and veggies, and cut back on processed foods. Here are some additional steps to try:
- Cut out dairy completely. Try this for a period of about two weeks to see if it helps. Remember that this means cheese! Some people respond really well to this method. If you don’t detect any difference, than dairy isn’t the issue for you, but you may find that limiting it reduces your breakouts.
- Limit sugar: Most Americans eat way too much sugar. It’s not just in our desserts and treats, but in our soups, breads, yogurts, condiments, and more. If you check your food labels you may be surprised at how much sugar you’re consuming on a daily basis. Shop organic, as it often has less added sugar, make more meals at home, and try to substitute fresh fruit desserts for your usual cakes and cookies.
- Consider cutting back on gluten: Those with celiac disease or who are sensitive to gluten may find that their skin benefits by cutting back. You can give it a try to see. Try cutting it out for a couple weeks to see if it has any benefit.
- Try veggie smoothies: They’re a great way to get more veggies into your daily diet, and that can help your skin. Veggies are full of healthy antioxidants, vitamins, and minerals that can help your skin battle the disease.
- Follow a low-glycemic diet: Eating high-glycemic foods can spike blood sugar, which some studies have found can also have a detrimental effect on your skin. Try following a low-glycemic diet for a couple weeks. Choose foods high in fiber that break down slowly in the bloodstream. Check this chart for more information.
- Keep a food diary: This can help you to see what foods may be exacerbating your acne. For a couple weeks, keep a detailed diary of what you eat and drink and when, and how your skin reacts. Doing this for a month can give you a good amount of data that you can then use to modify your diet in the hopes of improving your skin.
We now know that some supplements can help improve skin’s condition, and may even help reduce your breakouts. Here are a few you can try:
- Omega-3 fatty acids (fish oil): These have been shown to help reduce inflammation, and are particularly helpful for people with eczema and rosacea. The same effect may help you to reduce breakouts, as inflammation plays a large role in cystic acne. Eating more foods rich in omega-3s may help too—try fatty fish, flaxseed, chia seeds, walnuts, and olive oil.
- Selenium: Some studies have shown that the selenium in our soils has been depleted over the years, resulting in lower levels in our foods. This mineral is a powerful antioxidant and has been shown in some studies to help reduce acne breakouts, particularly in those people who are deficient in the mineral. Eat more Brazil nuts, lima/pinto beans, shiitake/white button mushrooms, chia seeds, brown rice, and sunflower seeds, or try supplements.
- Probiotics: Some very intriguing research is showing a strong connection between the bacteria in the gut and a number of other systems in the body, including the skin. Many of us don’t have a good balance of good and bacteria, because we’ve taken antibiotics over the years or because our diet isn’t supplying enough of the good stuff. Some research has suggested that probiotics may help to treat cystic acne. They naturally support the immune system, help tame inflammation, and protect from bad bacteria. Try eating more foods that contain probiotics, like kefir, yogurt, sauerkraut, miso, and sour pickles, or choose a quality probiotic supplement. Do be patient—it will take a few weeks of supplementation to see results.
Have you found natural treatments for cystic acne? Please share them with our readers.
Chris Kresser - “Nutrition for Healthy Skin: Vitamin E, Pantothenic Acid, and Selenium,” September 2012.