Acne cysts can occur in many locations including the face, neck, chest and back. Acne cysts can range from small cysts, called micocystic acne, thru to large inflammatory cysts.
Microcystic acne most often occur on the forehead, cheeks and chin areas and are best visualised if the skin is stretched. They lie deep in the dermal layers of the skin, out of reach from creams, chemical peels and microdermabrasion.
Large cysts are usually inflammatory and maybe associated with scarring acne. Large cystic acne is best treated with injections and tablets, whilst microcystic acne is best treated with laser.
Specialist Perspective on treating acne cysts
The treatment of acne cysts will depend on the type of cyst. Large inflammatory (red and angry) cysts are treated with a course of steroid injections and antibiotics which can reduce inflammation. Smaller, more resistant cysts located on the cheek, and chin areas are best extracted. These small cysts (microcomedones) lie in the deeper layers of the skin, and are usually resistant to chemical peels, microdermabrasion and creams. We use a technique called erbium drilling (sounds painful, but it isn’t) to extract these cysts. A 1mm erbium spot laser is used to drill a very tiny hole in the skin’s surface. The laser provides an avenue to extract the cyst wall and it’s contents, and once treated, cysts are gone! Laser acne treatment of cysts are painless because we use a local numbing cream, and side effects are very, very rare. Deeper isolated cysts that are hard and lumpy are best excised. I usually work in with a plastic surgeon to remove these type of cysts. Of final note, preventing cysts from recurring is very important, vitamin A, either in a cream or tablet can be very effective.
Acne cysts are very common, and occur in over 50% of acne cases. Cysts form as part of the ‘skin surface’ occurring under the skin. Cyst are usually lined with a cyst wall, consisting of skin cells and lie in the deeper parts of the skin.
Acne cysts are commonly seen in patients with moderate to severe acne, but can also occur in milder forms of acne. Acne cysts are lumps on the skin that range from 0.5 mm (microcysts) thru to 2-3 cm inflammatory cysts. Patients with larger cystic lesions are more prone towards acne scars.
Microcysts are very difficult to diagnose, as they occur in the deeper layers of the skin. Microcystic acne usually occurs on the chin and cheek areas, and usually presents are multiple deep lumps measuring 1 to 2.5 mm in diameter. They are more prominent if the skin’s surface is stretched. Given the depth of the cysts, they do not resolve with creams, microdermabrasion or chemical peels. The good news is that they are easily removed with laser treatment.
Acne cyst treatments will depend on the type of cyst. Cysts can be classified as inflammatory (red, angry and of sudden onset), or microcysts (tiny and persistent acne cysts on the cheeks and chin area).
Intralesional anti-inflammatory injections
This technique is used to treat large inflamed acne cysts. Injections are relatively painless, and most cysts will subside within a day or two. Occasionally this process will need to be repeated. Ideal for large, red, cysts on the face, neck and back areas.
Laser treatment with Erbium Spot
This is our specialist technique for treating smaller deeper cysts. Micro cystic acne or comedomal acne is notoriously difficult to treat. These micro cysts may number in the hundreds, and are frequently located on the cheeks, chin, and forehead areas. They lie deep in the skin, and are more visible if you stretch the skin, or cause pressure from underneath. (For example, push your tongue in your cheek)
An erbium laser is a highly accurate method of cyst removal. Erbium laser drills a very tiny hole in the skin’s surface and targets the cyst wall.
Excision of cyst
This treatment is undertaken by a Plastic Surgeon. As part of the team we enrol the assistance of a plastic surgeon to remove deep, persistent, and hard cysts located in complex areas such as the cheek and chin area.
This can reduce the number of acne cysts. Your Specialist Dermatologist will discuss this technique if you have multiple cysts. Most anti-inflammatory medications will need to be taken over a period of weeks to months.
Our specialists use a highly skilled method of cyst removal using an Erbium laser in drill mode. Using the latest techniques in laser surgery, we focus a one-millimetre spot of erbium laser on the skin’s surface. Two shots of laser are fired into each cyst, destroying the cyst wall. If needed, we manually extract each cyst, as we now have an opening to the skin’s surface.
Each cysts needs to be individually identified, treated and in some cases extracted. Some patients have hundreds of acne microcysts, so it may take more than one appointment to get rid of them all.
Healing time will depend on several factors including the depth of the cysts, the number of acne cysts treated, and individual factors.
As a guide your skin will heal within 2-4 days. Tiny scabs may form for the first 2 days. We will go thru the post laser skin care regime during the laser procedure. In some cases (if lots of acne microcysts are treated) we may give you a short course of antibiotics after treatment.
Most cysts will NOT return after laser. This is because laser permanently destroys the cyst wall. Some patient may have hundred or even thousands of acne micro-cysts and several treatments maybe needed for optimal results.
Preventing acne cyst formation is very important. AHA peels, Vitamin A creams and tablets can help.
Yes…buy- it can also flare up cystic acne. Think of Roaccutane or Oratane as a method to shrink down the oil glands. Oil (sebum) cannot just disappear, it must either be pushed out, or absorbed back. If you have closed cysts, Roaccutane can temporarily worsen, or flare up acne, before improving it.
Our Specialists will provide a tailored regime to minimise the chance for flare -ups. This may involve taking anti-inflammatory medications, or a series of erbium laser drilling, or even a simple (but painless) injection. Treatment will depend on the type of cyst you have.
Cystic acne has a higher incidence of acne scars, especially if the cysts are large. Smaller cysts (microcystic acne) is not usually scarring, however if you pick deep cysts, scarring may ensure.
Large acne cysts are best treated with injections, anti-inflammatory antibiotics and possibly Roaccutane.
Smaller cysts can be extracted with erbium laser. If you suffer from a mixture of acne cysts, scarring and acne lesions, a treatment called RadioFrequency treatment maybe appropriate.
Cost for cyst removal will vary on the number of cysts treated. In some cases, Medicare may partially reimburse acne cyst removal.
As a guide -
- Injections for cysts - $90-110 out of pocket
- Laser treatment for microcysts $198-$298
Laser treatment for microcyst is a very accurate, but time consuming procedure- each cyst will need to be located, drilled, then extracted. This provides the best outcome possible. Laser cyst removal is NOT covered under Medicare.
A referral from your GP would be ideal, as a referral will enable you to claim part of the consultation fees. Additionally some procedures such as injections, surgery and laser for acne scarring can be partially claimed on Medicare. If you do not have a referral, we can arrange one for you.
Call reception on 07 3871 34 37 to discuss the referral process and booking times.