How to Get Rid of a Cystic Pimple That’s Deep and Painful

Jenna Ryu
·9 min read

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The panic of waking up with a giant, underground zit—then desperately Googling how to get rid of a cystic pimple ASAP—is something most of us can relate to. And if you’ve had one of these angry face bumps, you know just how hard it can be to find an at-home fix.

Acne cysts aren’t like classic pimples. They form much deeper in the skin and may not come to a head, making them notoriously tricky to tackle, Ife Rodney, MD, board-certified dermatologist and founding director of Eternal Dermatology Aesthetics in Fulton, Maryland, tells SELF.

While you shouldn’t expect your stubborn nodule to disappear overnight, that doesn’t mean your only option is to resign yourself to living with it for (what feels like) forever. Here, dermatologists share a few cystic acne treatments that might make a difference.

But first, what is cystic acne?

Before you figure out how to get rid of a cystic pimple, it’s important to know what, exactly, you’re dealing with. To get technical, any type of acne—be it a tiny closed comedone or an angry, pus-filled pimple—occurs when a hair follicle (or pore) gets clogged with sebum (oil) and dead skin. But “more superficial acne lesions like whiteheads and blackheads are located closer to the skin’s surface, which is why they’re noninflammatory,” Dr. Rodney explains.

Cysts, on the other hand, develop when all that buildup gets trapped underneath your skin (meaning, they can’t be “popped” or extracted as easily), Mamina Turegano, MD, board-certified dermatologist at Sanova Dermatology in New Orleans, tells SELF. To make matters worse, they can grow even bigger and harder if the pore bursts from all the congestion, causing a boil-like lump to form—your body’s way of containing the inflammation so it doesn’t spread.

If you’re wondering what causes these nuisances to develop in the first place, the experts we spoke with point to a few potential factors—some of which you can’t control. For example, hormonal changes (related to the menstrual cycle, say, or menopause) can trigger these annoying breakouts. Also, you may simply be cursed with genes that make you prone to producing excess oil.

What are the best topical treatments for cystic acne?

As a reminder: It’s important not to expect overnight miracles (no matter what your favorite beauty blogger or TikTok influencer says). “Most things you put on the surface of your skin can’t penetrate down to the level where the buildup actually is,” Dr. Rodney says.

That’s why stopping cystic blemishes from forming in the first place is key. According to the derms we spoke with, regularly using a chemical exfoliant can help prevent clogged pores (though note that the ideal acid and frequency will depend on your specific skin type and sensitivity). And another way to keep your face smooth and clear is by introducing retinol into your routine to “turn over” the dead skin cells blocking your follicles.

But chances are, you’re reading this article because you’re already stuck with a cystic pimple. If that’s the case, here are a few home remedies that can gradually (we repeat: gradually) shrink a sucker that refuses to budge.

1. Do. Not. Pop.

Maybe you’d rather deal with a flat acne scar than a giant, swollen rock that’s impossible to hide. But trust us, messing with your face is a terrible idea for a few reasons.

“Again, cysts are deeper in the skin, so when you think you’re squeezing out the pus, you’re really just rupturing the follicle and pushing the inflammation even deeper,” Dr. Rodney says, which can make your pimple bigger, more painful, and all-around worse. Not to mention, the open wound you created is an entry point for bacteria, which, she adds, could lead to a more serious infection. (So take this as your sign to keep your hands, Q-tips, or zit extractor away from your face.)

2. Dab the spot with a warm compress.

Pressing a warm, damp washcloth or towel onto your trouble spot can be a great way to bring down the swelling. That’s because heat can soften the hardened buildup inside the cyst, which should bring that trapped gunk closer to the surface (and make it easier to clear out), Dr. Rodney explains.

The best way to go about this, according to the American Academy of Dermatology (AAD), is to soak a clean cloth in warm water. Then, apply it to the affected area for 10–15 minutes, three times a day. Doing this consistently for about a week should lead to some improvement in swelling, Dr. Turegano says. (Just make sure that the compress isn’t scalding hot—Dr. Rodney warns that too much heat can burn your skin and cause even more irritation.)

3. Spot treat with a thin layer of benzoyl peroxide.

“The reason why cysts can get so big and angry is because they’re really inflamed,” Dr. Turegano says—and that’s where an anti-inflammatory hero like benzoyl peroxide can come in handy. This active ingredient works by killing acne-causing bacteria (specifically, Propionibacterium acnes) that can trigger your immune system to create that huge, painful lump.

“Put a little dab on the spot and leave it on overnight,” Dr. Rodney recommends. “This won’t make cystic breakouts disappear, but I do find that it can shrink and dry them up faster than just waiting it out.” If you have really sensitive skin, derms previously told SELF to start with a lower concentration like 2.5%, since benzoyl peroxide can be pretty harsh. You could also opt for something stronger, like 5% or 10%, but if you go that route, it’s a good idea to layer a non-comedogenic moisturizer underneath, Dr. Turegano suggests, to lower the risk of irritation.

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4. Or try sulfur, a gentler antibacterial ingredient.

If you’re not a fan of benzoyl peroxide, sulfur spot treatments are another option worth considering. “[Sulfur] may not be as fast-acting, but it’s usually less irritating for those with sensitive skin,” Dr. Turegano says. Plus, research shows that it also has anti-inflammatory properties that can help minimize the size and discomfort of a cystic zit brewing beneath the surface.

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Important to note: As tempting as it may be to use both pimple killers at once, the derms we spoke with recommend sticking to just one anti-acne active per night. Overdoing it will probably be irritating and make things worse, Dr. Turegano warns.

5. Consider slapping on a microdart pimple patch.

Plain old hydrocolloid stickers may also help, but they’re usually more effective at absorbing fluid from open wounds or zits that have already come to a head. That’s why Dr. Turegano recommends covering your cyst with a microdart-covered patch instead.

There isn’t much research showing that, or how well, these stickers (or any acne patches, for that matter) work. But theoretically, microdart patches are different because they feature tiny, dissolving microneedles. If you just cringed, note that they aren’t sharp or big enough to actually pierce or damage the skin. Instead, they’re supposed to penetrate the area just enough to deliver active ingredients (like salicylic acid and niacinamide) into your pimple.

Before you try one though, don’t get your hopes up too high: Some derms previously told SELF that microdart patches likely aren’t effective enough for a burgeoning hell-cyst. However, Dr. Turegano says they could be worth trying since there’s relatively little risk. (Plus, it’ll at least stop you from touching—and aggravating—the spot.)

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6. Consider an OTC hydrocortisone cream.

If your goal is to address the redness or tenderness of your cystic pimple, Dr. Turegano recommends applying an OTC hydrocortisone cream. For full transparency, not all experts agree with this tip: Some, like Dr. Rodney, question whether a steroid ointment that only sits on the surface of your skin can actually do anything for a deep-down bump. Also, using hydrocortisone too frequently can thin out and damage your skin.

In Dr. Turegano’s experience, though, “a 1% over-the-counter cream can at least help soothe inflammation for particularly angry pimples,” especially if you’re experiencing pain or tenderness. “However, it’s a short-term fix, and it’s not something to apply regularly,” she adds—meaning you shouldn’t use it more than once or twice daily for two days, max.

How can a dermatologist treat cystic acne breakouts?

There are plenty of reasons why “just go to a dermatologist” isn’t the easiest advice to follow. Like most medical visits, derm appointments can be expensive and a pain to schedule, and not everyone has access to these specialists. But the reality is, getting professional advice from a board-certified dermatologist is the best move if you’re looking to banish a stubborn cyst—especially if you’ve already exhausted all the options in your bathroom cabinet.

For starters, these skin experts can figure out if an underlying health issue (like polycystic ovary syndrome, or PCOS, for instance) is responsible for your chronic flare-ups. They can also prescribe stronger treatments, including prescription topical retinoids (like Tretinoin), oral antibiotics, and medications like spironolactone that can regulate hormones (namely testosterone) and reduce sebum production. (Despite its well-studied efficacy, however, note that this anti-androgen pill may come with side effects like irregular menstruation, dizziness, and headaches, so consult your derm to assess whether it’s the best option for you.)

“Another in-office treatment that works well—and fast—is a steroid shot,” Dr. Rodney says. Basically, a derm will inject a corticosteroid directly into your cyst, which should flatten it within 24–48 hours, Dr. Turegano explains. As miraculous as that sounds, this treatment option is more for the occasional lump versus chronic cystic breakouts (since it doesn’t address the root cause of your acne). There’s also a chance that your pimple could shrink too much, leaving you with a dent. “Thankfully, the divot wouldn’t be permanent,” Dr. Turegano says, adding that it should go away in a month or two. But still, it’s a possible side effect to consider before scheduling a shot.

We get that this advice may not be the instant fix you were hoping for. But just know that sticking with some of the above treatments “can minimize the cyst slowly but surely, as long as you’re consistent and patient,” Dr. Rodney says. And if after two, maybe three, weeks you’re not seeing any improvement, it’s time to—you guessed it—call in a pro.

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Originally Appeared on SELF

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