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Cystic acne

Skin Conditions, Teenages | January 13, 2018 | Author: Naturopath

Skin conditions, acne

Cystic acne

Most individuals will be affected by acne at some time in their life. But if you have multiple large, red, painful bumps deep within the skin, it could mean you’ve developed something called cystic acne. It’s more severe than your typical acne and can occur in puberty and adulthood. Complications of cystic acne can include severe scarring and there are often symptoms that are psychological and emotional in nature. Depression, anxiety, low self-esteem and avoiding social situations can result from having this condition. Thankfully there are lots of strategies you can implement topically and to promote balance from the inside—allowing you to have clear skin once again!

What is cystic acne?What is cystic acne?

Also called nodulocystic acne, cystic acne is a severe from of acne that results in large and inflamed cysts and nodules under the skin. It commonly occurs on the face, especially on the jawline and chin in women. It can also appear on the back, chest, upper arms and shoulders.

Who can get cystic acne?

Cystic acne is more common in young boys during puberty, where it can continue into adulthood. Women can experience cystic acne and symptoms can worsen at certain times during the menstrual cycle. However, cystic acne is more common in males than females

What causes it?

Implicated in the pathogenesis of cystic acne is:

  • Hormonal imbalances—particularly androgens
  • Increased sebum overproduction
  • Colonisation of the intrafollicular duct by bacteria
  • Genetic predisposition
  • Immunological disorders
  • Stress, poor diet and environmental factors

Natural cystic acne treatments

Eat low GI

The chronic consumption of foods that are high glycaemic index (GI) leads to increased levels of insulin, insulin resistance, insulin growth factor and androgens. Elevated levels of these hormones increase sebum production and keratinocyte (a type of skin cell) proliferation.

Eat low GIYoung males who followed a 12-week low GI diet found a significant decrease in factors that exacerbate acne such as androgens and elevated insulin levels and experienced an improvement in acne.

Low GI foods include wholegrains, fresh vegetables and certain fruit. Protein sources added to a meal lower the GI content and include natural yoghurt, lean meat, fish, lentils, beans, nuts and seeds.
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According to a recent study, foods to avoid in acne include:

  • Cow’s milk—this can increase levels of androgen-mediated sebum production
  • Chocolate and sugary foods—high GI foods can predispose to high blood sugars and insulin levels which aggravate acne
  • Foods high in omega-6—found in cooking oils and processed foods. On the other hand, foods high in omega-3 reduce inflammation.

Hands off

An important aspect to consider in cystic acne is to keep your hands off it! Touching your face will transfer bacteria to the skin which is one of the driving forces behind this condition. Another thing to avoid doing is to pop the pimples. Cystic acne is so deep within the skin and doesn’t usually come to a head like a regular pimple. If you do try and squeeze a pimple you will not only be increasing the inflammation but spreading the infection and extending the healing time.

Simple skincare routine

Simple skincare routineTry a simple skincare routine using natural products morning and night. Implementing a tea tree wash and moisturiser can help to provide antibacterial action on the skin. Findings from two clinical trials have reported that the application of a 5% tea tree oil gel is significantly more effective than placebo and as effective as 5% benzyl peroxide in reducing the severity and number of acne lesions.

Make sure the products are oil-free, unscented and gentle. For scars a natural vitamin C product can help.
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Reducing stress levels

Significantly higher levels of stress and hormones involved in the stress response have been found in sufferers of cystic acne in one study. Trying to find a balance in life between work and play is crucial. Implementing regular exercise, yoga and meditation may help to achieve this.

Chaste tree

Chaste tree, otherwise known as vitex, is traditionally used to decrease levels of androgens and balance hormones. This action may provide an explanation as to why it was so beneficial in a clinical trial which included 161 subjects with acne. After 12 weeks there was a significant improvement in the signs of acne. Other herbs such as peony and liquorice are traditionally used in the reduction of testosterone levels and may be beneficial if this is a causative factor in cystic acne.

Zinc and vitamin CZinc and vitamin C

Zinc and vitamin C are both important for wound healing, reducing infections and providing the body with a source of antioxidants.

For skin support 500mg of vitamin C twice daily and 25-60mg of zinc per day are the recommended doses for cystic acne.

Vitamin A

Evidence suggests that individuals with acne have significantly lower plasma levels of vitamin A compared to healthy subjects. This is not surprising as vitamin A is important for skin cell health, collagen synthesis and immune function. 5,000 IU per day is what is recommended for maintaining healthy, unblemished skin.


Not many clinical trials have been conducted on natural therapies in cystic acne but myrrh is one such exception. Myrrh exhibits a variety of actions which are beneficial in cystic acne including antimicrobial, anti-inflammatory and vulnerary (improving skin health). A small randomised controlled trial involving 20 patients with nodulocystic acne demonstrated that gugulipid extract from myrrh that was administered twice daily for 3 months was as effective as oral tetracyclines antibiotics in reducing the number of inflamed lesions.


Echinacea may be helpful to boost the activity of the immune system and fight infection on the skin. According to one clinical trial Echinacea can reduce the activity of P.acnes which is one strain of bacteria implicated in cystic acne. Not only is echinacea anti-microbial but can help to facilitate wound healing and stimulates the action of the lymphatic system to remove waste products from the body.
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Hechtman L (2014). Clinical Naturopathic Medicine. Churchill Livingstone, Australia

Ozdarska K, et al. Diet in pathogenesis of acne vulgaris. Pol Merkur Lekarski. 2017 Oct 23;43(246):186-189

Schulpis K, et al. Psychological and sympatho-adrenal status in patients with cystic acne. J Eur Acad Dermatol Venereol. 1999 Jul;13(1):24-7

Mahmood SNBowe WP. Diet and acne update: carbohydrates emerge as the main culprit. J Drugs Dermatol. 2014 Apr;13(4):428-35

Ozuguz P, et al. Evaluation of serum vitamins A and E and zinc levels according to the severity of acne vulgaris. Cutan Ocul Toxicol. 2014 Jun;33(2):99-102

Thappa DMDogra J. Nodulocystic acne: oral gugulipid versus tetracycline. J Dermatol. 1994 Oct;21(10):729-31

Sharma M, et al. The potential use of Echinacea in acne: control of Propionibacterium acnes growth and inflammation. Phytother Res. 2011 Apr;25(4):517-21

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