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The fastest and most effective way to fight cystic acne is through medical treatment from a dermatologist. Your dermatologist can prescribe the medications or perform non-invasive procedures.  If you don't have a dermatologist, ask your primary care physician for a referral. You can also look up a dermatologist online. Tell your dermatologist if you are pregnant or breastfeeding. In this procedure, your dermatologist will drain the cyst with a sharp needle. This is the fastest way to remove a cyst. When done properly, it can reduce pain, swelling, and scarring as well.  Never try this at home or without the supervision of a licensed professional. Improper lancing may result in scarring or infection. In some cases, your dermatologist may also inject the cyst with medication. Antibiotics work by killing the bacteria that causes acne. Your dermatologist may prescribe you a pill to swallow daily or a cream to apply directly to the acne itself. These require a prescription.  Side-effects of antibiotics include increased sensitivity to the sun, liver damage, and complications with pregnancy. Follow your dermatologist's instructions regarding the use and dosage of antibiotics. Topical retinoids unplug clogged pores, allowing other medications to come in and fight the acne-causing bacteria. Apply the retinoid to your face once a day.  Most retinoids require a prescription. Weak doses are available over the counter, but these may not have as dramatic an effect. Retinoids are usually reserved for moderate to severe acne, when other methods of treatment have not worked. Types if topical retinoids include Adapalene, Tazarotene, and Tretinoin. Topical retinoids may initially make your acne worse before it gets better. It can take a few weeks to see results. Talk to your doctor about possible side-effects. Side effects include increased sensitivity to the sun, dryness, redness, and peeling of skin. If other treatments haven't worked, a retinoid pill, such as isotretinoin (also called Accutane), may be your best option. Take the retinoid by mouth according to your dermatologist's instructions.  Isotretinoin may cause some very serious side effects. These include depression, birth defects, miscarriage, deafness, and bowel disease, among others. Only the worst cases of cystic acne may warrant prescription of this very strong drug. Acne is affected by our body's hormones. A birth control pill or anti-androgen medications may help stem outbreaks. Talk to your doctor about medications that may limit the severity of your cystic acne.  Understand the possible side-effects. Side-effects include irregular menstrual cycle, fatigue, dizziness, and breast tenderness. Women with a high risk or previous history of high blood pressure, stroke, heart disease, blood clots, or breast cancer should not go on hormonal medication. Traditionally used to remove scars, laser therapy may now be used to treat acne itself. Laser therapy burns away the follicle sac, by burning away the sebaceous gland (which produces oil), or by oxygenating the bacteria, and thereby killing them. Moderate to severe cases of cystic acne may require multiple sessions in a 4 week spa, but you may see results after the first treatment.
Make an appointment with your dermatologist. Ask the dermatologist to drain and extract the cyst. Get a prescription for an antibiotic. Get a topical retinoid to apply to your skin. Take a systemic (oral) retinoid for severe cystic acne. Undergo hormonal treatments for women. Zap off cysts with laser therapy.