Acne is hard enough to deal with on its own, but things only get worse from there if you deal with cystic acne. Deep, painful, and stubborn, these blemishes are much more difficult to treat than your everyday breakout. In most cases, even your most reliable creams, cleansers, and serums won’t touch the spot– Instead, it will continue to become larger and more painful in defiance of your best efforts to fight back.

So, what can you do? First, it’s important to understand the enemy before you create your plan of attack.

What is Cystic Acne?

In most cases, cystic acne starts like any zit. As bacteria, oil, and skin cells clog your pores, your body responds with a rush of white blood cells to get rid of the supposed “foreign invader.” Typically, this would form a small whitehead blemish that would be a small annoyance, but would be relatively short-lived.

When the infection goes deeper, though, you end up with cystic acne. Instead of forming a head and eventually expelling the bad stuff, the bacteria gets trapped, building up a thick, protective barrier that makes it seemingly impossible to get rid of. In fact, the same cyst can last for months, growing larger and more painful.

Cortisone for Cyst Injections

First, this procedure is not appropriate for typical blemishes. It does not work to get rid of the bacteria and cell build up that forms a blemish. Instead, it should be reserved for very stubborn flare ups of cystic acne that are proving particularly long-lived or tender.

While there are oral medications that are used to treat cystic acne, those are more appropriate if the condition is chronic. For occasional flare ups, particularly painful blemishes, or those that are at a higher risk of scarring, cortisone cyst injections offer fast relief.

In a quick office visit, your dermatologist will inject a diluted glucocorticoid steroid into the cyst. It will go to work acting as an anti-inflammatory, shrinking and healing the infected tissues under the surface of your skin. Within 24-48 hours, your cyst will soften, shrink, and flatten. With the help of the steroids, even a stubborn blemish will heal itself within a week.

While this procedure is safe, without the usual side-effects associated with using steroids orally, there is a small chance that the skin at the blemish site appears “pitted.” If too much cortisone is used, or the dilution is incorrect, it can cause healthy tissue to thin, leaving a small depression. While this condition usually resolves on its own, there are cases where the scarring was permanent.

The best way to get all of the benefits of cortisone shots without the side effects is to trust a board-certified dermatologist to perform the injections. They take into account factors like skin-depth, proper dilution ratios, and your skin’s susceptibility to scarring to determine if the treatment is right for you.