If you suffer from cystic acne, we feel your pain. Unlike regular pimples, which arise from clogged pores, painful cystic acne breakouts occur deep beneath the surface of the skin. Caused by hormones, bacteria, and oil, the bumps become increasingly inflamed but don’t come to a head — making them crazy-hard to treat. Remaining large and in charge for weeks at a time, these “pimples on steroids,” as NYC-based dermatologist Neal Schultz of BeautyRX calls them, are infamous for leaving behind complexion-marring scars and hyper-pigmentation. While prescription medications like cortisone injections seek to treat cystic acne from within, the at-home treatment protocol is less straightforward. Keep reading to discover eight tips for managing cystic acne, according to experts.

1. Eliminate dairy products from your diet. “The main causes [of cystic acne] are always linked to dietary foods like dairy, which has been proven in several studies to assist in causing more clogged follicles and inflammatory pustules,” says Jacqueline Schaffer, an NYC-based internist and founder of Schique. Dairy products frequently contain antibiotics fed to the cows, sheep, and goats, which can have an adverse effect on the surface of the skin. To avoid disrupting your hormonal cycle, non-dairy options like almond milk are much less inflammatory. (Photo via PLAINVIEW/ Getty)

2. Consider a prescription medication like Accutane or spironolactone. Cystic acne that pops up around the jawline, chin, or neck area is typically caused by hormonal fluctuations, as higher levels of testosterone — yes, in ladies too — cue more oil production in our glands. Board-certified dermatologist Lily Talakoub of McLean Dermatology and Skincare Center in Northern Virginia explains that the androgen-blocking diuretic spironolactone could hold the key. “Spironolactone is a fantastic medication that [works] at low doses to block the hormones that induce the acne,” she says. “It usually takes three to six weeks to kick in.” (Photo via Oppenheim Bernhard/ Getty)

3. Incorporate Eastern-inspired holistic remedies into your diet. In order to cover all of your bases, take an overseas approach with Ayurvedic tips, which are a solid way to improve the clarity of your complexion. “The [best] Eastern treatments are probiotics, foods rich in zinc and vitamin A, essential oils like tea tree and lavender, [and] a healthy skincare routine,” Schaffer explains. Brit + Co Pick: Evolution 18 Probiotic Lemon Melt Stick Packets by Bobbi Brown ($39)

4. Select gentle, non-drying topical treatments. “Most cystic acne does not resolve with traditional topical treatments or acne skincare,” Talakoub informs us. Avoid those harsh blends that will dry, irritate, or compromise the surface of your already sensitive skin and complicated healing process. Seek out treatments with gentle formulas that reduce swelling, treat infection, and expedite healing times, like celebrity esthetician Renée Rouleau’s cult-favorite solution. The targeted holy grail of topical cystic acne treatments includes a formulation of pure lactic acid to purify the pore, methyl gluceth 20 to reduce inflammation, and citric acid to gently exfoliate dark spots associated with scarring. Together, these active ingredients can resolve breakouts in half the time. Brit + Co Pick: Renee Rouleau Anti Bump Solution ($48)

Lord Jones CBD Body Lotion

5. Stock up on anti-inflammatory skincare ingredients. Since inflammation is what makes cystic lesions so large, choosing anti-inflammatory actives like CBD or cannabidiol can help to shrink it. “Some studies have shown that it helps reduce inflammation in the body,” says Schaffer. Brit + Co Pick: Lord Jones High CBD Formula Body Lotion ($60)

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6. Balance oil with oil. Even if you don’t have oily skin, Schultz assures us that it’s the combination of oil and bacteria that creates acne. When certain phases of your hormonal cycle naturally lead to increases in the amount of sebum in the gland, you become more vulnerable to stubborn breakouts. While you might be wary of adding a facial oil into your routine, skin dehydration will only cue more sebum production, exacerbating the problem. “Facial oils are even more beneficial for dry skin and cystic acne-prone skin types,” Schaffer explains. “They help keep the skin’s mantle better hydrated, which will help reduce irritation [and dryness and keep future cysts from forming].” The key is to choose balancing formulas powered by soothing tea tree, geranium, chamomile, and lavender oils. Brit + Co Pick: Sunday Riley U.F.O. Ultra-Clarifying Face Oil ($80)

7. Use a mineral SPF rather than a chemical one. Michelle Hure, an Orange County-based dermatologist at OC Skin Lab, explains that patients with cystic acne are often prescribed photo-sensitizing topical and oral medications. Because of this, the gentler the sunscreen, the better. “I try to limit the skincare and sunscreen for these patients to products that are gentle and won’t cause irritation,” she begins. “Physical sunscreens containing only zinc oxide and titanium dioxide tend to be the most gentle and well-tolerated among acne and rosacea patients, allowing for frequent reapplications throughout the day.” Brit + Co Pick: Colorescience Sunforgettable Total Protection Brush-On Shield SPF 50 ($65)

8. Treat leftover scars with exfoliation. Don’t let hyper-pigmentation and scarring from cystic acne get you down. Instead, add a few exfoliating acids to your skincare arsenal. According to Talakoub, alpha hydroxy acids and salicylic acid work wonders at lightening and removing the scars left behind by the stubborn bumps. You can also incorporate ingredients like retinol or vitamin A to accelerate cellular turnover and expedite the process. Be sure to do so in moderation (once or twice a week) and go heavy on the SPF (as these ingredients make skin more sensitive to UV rays). Brit + Co Pick: Go-To Exfoliating Swipeys ($35)

Do you struggle with cystic acne? Tell us @BritandCo!

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