Topical Treatments for Cystic Acne: OTC

There are many effective homemade natural remedies for cystic acne. You can even try essential oils to treat cystic acne. Meanwhile, consider OTC Topical Treatments for cystic acne. Those are coming with Dermatologist recommendations. Ideally, for a person to person what works best may differ.

You should always a patch test before proceeding with the remedy that works for you. In this article, we are listing the most used over the counter (OTC) topical treatments for cystic acne.

1. Retinol

Do not get confused between retinol and retinoids. Retinol is a specific type of retinoid used to treat cystic acne. It is mild compared to the other types of retinoids. Retinoids are a group of vitamin A derivatives used in anti-aging skincare routines. Says, dermatologist Edidiong Kaminska, MD, Medical Director, and Founder at Kaminska Dermatology. Retinol is the most common type that is found in most OTC products. It is clinically proven to treat acne and wrinkles. The active molecules of retinol have the ability to influence skin structure formation.

To explain further, Retinol is a form of Vitamin A that naturally occurs in plants and animals. Retinoids are a class of medications that are chemically derived from Vitamin A.

Mona Gohara, MD is an Associate Clinical Professor Yale Department of Dermatology. She says that the first defense of cystic acne is the vitamin-A derivatives.

Retinoids speed up and regulate the shedding within your oil glands, kind of like a crossing guard that keeps things moving

Mona Gohara, MD of Associate Clinical Professor Yale Department of Dermatology

Not all retinoid creams work well for cystic acne. Dr. Gohara's recommendation is to start with adapalene. The products like Differin or La-Roche Posay Effaclar have the right prescription strength. It is accordingly formulated adapalene to treat cystic acne. This is a relatively strong topical treatment for acne skin.

You are recommended to use retinaldehyde in case you are new to these creams and have sensitive skin. For example, products like Avene Retinal 0.1 Intensive Cream. This is lower in strength retinoid, less intense, and still effective.

Many other dermatologists also strongly recommend the use of Differin Gel. Here are a few namely:

  • Dr. Joshua Zeichner is a director of cosmetic and clinical research in dermatology at Mount Sinai Hospital. He says prescription-strength retinoid over the counter is ideal for cystic acne treatment.
  • Dr. Samer Jaber is the founder of Washington Square Dermatology. Anyone should choose only Differin as their first choice as topical treatments for cystic acne.
  • Dr. Debra Jaliman an assistant professor of dermatology at Mount Sinai’s Icahn School of Medicine. He recommends Differin and using sun protection factor (SPF) sunscreen. In the morning before you are out in the sunlight. This to give more protection to the sensitive skin.

The topical retinoid adapalene in Differin Gel decreases inflammation. Also prevents new acne breakouts. Further, improves discoloration of the skin.

Listen to Mona Gohara, MD more Insights and How to Use Retinol

2. Salicylic Acid

Salicylic acid is a topical medicine. It is organically derived from the Willow tree. It is a soluble acid and used in the removal of the outer layer of the skin. That is how salicylic acid coming into the picture as one of the topical treatments for cystic acne. It’s well-known for treating acne. It exfoliates the skin and keeps your pores clear. This makes salicylic acid in many cystic acne treatment OTC products.

Salicylic acid comes in many OTC topical forms. Such as creams, cleansers, toners, and liquids to treat skin-related disorders. People do search for salicylic acid products to treat cystic acne as well.

Salicylic acid primarily used for skin routine to fight pimple breakouts. Most commonly found in the overnight solution for getting rid of pimples. Here is what Dr. Robyn Gmyrek (a dermatologist at Union Square Laser Dermatology) got to say. He says cystic acne is caused by hormonal triggers. The salicylic acid alone is not good enough to treat cystic acne. Better to note that according to Dr. Robyn salicylic acid works best to keep pores from clogging. Clogged pores cause redness, whiteheads, and cysts.

You can use salicylic acid in combination with benzoyl peroxide. It is an effective OTC treatment of cystic acne. Please keep reading to understand more.

Caution: Do not use salicylic acid on the damaged skin, open wounds, or any infected skin.

3. Benzoyl peroxide and Salicylic Acid Combination for Cystic Acne

Benzoyl peroxide is a topical antiseptic agent. Whilst salicylic acid provides a skin exfoliation effect. The board-certified dermatologist Joshua Zeichner is a director of cosmetic and clinical research at Mount Sinai Medical Center in New York City. He goes into detailing further:

Zeichner says these two ingredients compliments each other when used together to treat cystic acne. Topical treatments for cystic acne package. He recommends systematically using the package that includes:

  • Salicylic acid cleanser
  • Oil-free moisturizer
  • Benzoyl peroxide

How to Apply the Three Ingredients?

Application of Salicylic Acid Cleanser - Start with a salicylic acid cleanser. It works like a short-contact therapy. Using high concentrations of salicylic acid, (a beta-hydroxy acid (BHA)) cleanser shrinks cystic pimples. It removes excess oils. Gently peels off dead skins and dry them off.

Those who have cystic acne should opt for a cleanser with a 1.5 to 2 percent concentration of salicylic acid. Some such products over the counter are:

  • La Roche-Posay Effaclar Medicated Acne Face Wash
  • Murad Clarifying Cleanser

In case your skin is sensitive to acne then opt for 0.5 to 1 percent to avoid over-drying. Some of the recommended products are:

  • Aveeno's Clear Complexion Foaming Cleanser
  • Burt's Bees Natural Acne Solutions Purifying Gel Cleanser

Here is what dermatologist Zeichner suggests. After application of cleanser let the cleanser sit on the skin for about a couple of minutes. This is to allow active ingredients to take effect on the skin.

Oil-free moisturizer - Use the facial oil-free moisturizer regularly. This helps to hydrate and maintain healthy skin. Non-comedogenic moisturizer product called "Dr. Dennis Gross Stress Repair Face Cream" would be ideal to use.

Because it is oil-free and has ceramides, niacinamide, or hyaluronic acid. These ingredients as the ability to reduce redness and inflammation. Restores the skin’s protective barrier as well.

Benzoyl Peroxide - Final step. Complete the routine with medicated spot treatment with benzoyl peroxide. It will kill the bacteria. Note this has to be a spot treatment only on the cystic acne.

Dermatologist Zeichner recommends acne spot treatments with 2.5 percent benzoyl peroxide concentration. Such OTC products are:

  • Neutrogena Rapid Clear Stubborn Acne Daily Leave-On Mask
  • Paula's Choice Clear Daily Skin Clearing Treatment

Hydrocortisone Cream Cocktail - In case of painful cystic acne (as a next step) top off with a hydrocortisone cream cocktail. It will help further to reduce redness and calm inflammation. Some of the OTC products are:

  • Aveeno's 1% Hydrocortisone Anti-Itch Cream
  • Cortizone 10 Maximum Strength Cream

4. Proactiv Topical Treatments for Cystic Acne

Proactiv is a popular acne treatment or acne preventive product. It has been advertised even with celebrities vouching for the effectiveness. It presents are felt through social media platforms and TV endorsements.

The question is does it work for cystic acne. No, it is not. Proactiv is not meant for treating cystic, nodular acne, or any severe acne. The Proactiv product label itself suggests seeking a dermatologist to treat cystic acne.

Proactiv acne treatment products contain many acne-fighting compounds including. The compounds are including:

  • Benzoyl peroxide
  • Salicylic acid
  • Adapalene
  • Glycolic acid
  • Sulfur

Unlike other acne products, Proactiv is a multi-step skincare regimen. As said earlier it is many products combined together to fight against acne. Simply you can call it combination therapy. The main objective of this therapy is to prevent the occurrence of acne and have healthy skin.

Take care of your skin and stop chasing pimples: You brush all of your teeth every day, not just the ones that have cavities, so why not treat your entire face instead of the pimples that you can actually see

how Proactiv Works

So, the final word here is Proactiv for cystic acne does not work. For moderate acne and if could be treated with benzoyl peroxide then Proactiv is a good option. Otherwise, look for other options including cystic acne.

5. Sulfur for Cystic Acne

If you check the labels of many acne products you find sulfur is present in them. Sulfur can be bought. Sulfur has been used for ages for various skin conditions including acne. The main reason is its antimicrobial properties.

The sulfur effectiveness on acne is similar to benzoyl peroxide and salicylic acid. Therefore, one could say that if sulfur does not work on cystic acne then benzoyl peroxide and salicylic acid also will not work. Also, wise versa.

Sulfur works on your cystic acne by drying out the skin surface and absorbing the excess sebum oil. Further, drying out dead skin helps to unclog skin pores and is good for healing acne.

Given the nature of cystic acne, sulfur may not work for everyone. The side effects may the irritations on sensitive skin and excessive dryness.

6. Hydrocortisone Cream for Cystic Acne

Acne experts say that Hydrocortisone Cream works best along with Benzoyl Peroxide.

The hydrocortisone cream works to calm redness and to reduce inflammation. Meanwhile, benzoyl peroxide doing its part in killing the acne-causing bacteria. Then drying the acne skin surface. The hydrocortisone and benzoyl peroxide together helps to reduce irritation on the skin.

Having said that, the same experts say hydrocortisone with benzoyl peroxide treatment is not a permanent fix. It is a cosmetic fix only. It is because of the nature of the formation of cystic acne which more related to hormonal imbalance. Meaning, application heals acne on the skin. But at the same time, you need to address the hormonal imbalance issue for a permanent fix.

Before applying the hydrocortisone cream, do a facial cleansing. You may use a mild salicylic acid cleanser for this purpose. Then do the spot treatment with hydrocortisone cream on the cystic acne. Allow the hydrocortisone cream to get absorbed by the skin completely. Then you may apply some oil-free moisturizer to soothe skin. You may do this skin routine in the morning and in the evening.

Consider stopping applying hydrocortisone cream if you experience side effects. Side effects such as rash, pain, itching, worsening acne, and so on.

Before you go here is the

Take away

As you know cystic acne is a more severe form of acne. The main trigger to cause cystic acne breakouts is the hormonal imbalance in your system.

Dermatologists do recommend topical treatments for cystic acne using over the counter (OTC) products. Yet more focus is needed to understand the cause of the hormonal imbalance. Then take medication accordingly to contain further cystic acne breakouts.

The best way forward is to identify the cause of cystic acne and take the necessary medication. Discussing with your doctor or dermatologist available treatment options is more advisable.

1. What’s the Difference Between Retinol and Retinoids? by Reader's Digest -
2. Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments -,7,37473,0,1.html
3. How to Treat Cystic Acne at Home and With a Dermatologist by Cosmopolitan -,Gohara.
4. Is Salicylic Acid the Answer to All Your Acne Problems by ELLE -
5. How to Get Rid of Cystic Acne, According to Dermatologists - by Allure -
6. Nodular Acne and Cystic Acne by Proactive -
7. Proactiv - Does It Work and Is It the Right Acne Treatment for you?- Healthline -
8. What types of acne does it work for? - Healthline -
9. The Correct Way to Treat Under-the-Skin Pimples - Hydrocortisone - Kaplan MD, Beverly Hills -

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