Cystic acne is a severe form of acne, manifesting as large, painful bumps deep beneath the skin’s surface. These lesions are inflamed and feel tender to the touch. Cystic pimples are challenging to manage due to their significant depth and size. They can affect various parts of the body, including the face, back, chest, and shoulders.
The Contents of a Cystic Pimple
A cystic pimple contains a complex mixture of substances. Within these deep lesions, excess sebum, the skin’s natural oil, is a primary component. Dead skin cells that have shed from the follicle lining also become trapped, contributing to the blockage.
Cutibacterium acnes bacteria thrive in this clogged, oxygen-deprived environment. The body’s immune system responds to this bacterial proliferation and trapped material by sending inflammatory cells to the site. These white blood cells contribute to the inflammation and pain associated with cystic pimples. The deep inflammation can also lead to the rupture of small blood vessels, resulting in blood and cellular debris from damaged skin tissue within the cyst.
How Cystic Pimples Form
The formation of a cystic pimple begins when a hair follicle becomes blocked. This blockage occurs due to an accumulation of excess sebum and dead skin cells. As the follicle clogs, it creates an anaerobic environment that allows Cutibacterium acnes bacteria to multiply rapidly.
The presence of these bacteria and trapped debris triggers a strong inflammatory response. This inflammation and increasing pressure within the follicle can cause its wall to rupture deep within the dermis. When the follicle wall breaks, its contents—sebum, dead cells, bacteria, and inflammatory cells—spill into the surrounding skin tissue. This spillage leads to a widespread and intense inflammatory reaction, forming a large, painful, sac-like structure characteristic of a cystic pimple.
What Makes a Cystic Pimple Different
Cystic pimples stand apart from common acne types like blackheads, whiteheads, or typical papules and pustules due to several distinct characteristics. A primary difference is their depth; cystic lesions form much deeper within the skin’s layers. They are typically larger than other pimples, sometimes reaching the size of a pea or even a dime.
These deeper, larger lesions are also more painful and tender to the touch because they are closer to nerve endings. Unlike many other pimples, cystic pimples often do not develop a visible “head” that comes to the skin’s surface. They carry an elevated risk of leaving behind permanent scars, such as pitted or raised marks, due to the extensive tissue damage and inflammation they cause.
The Dangers of Popping a Cystic Pimple
Attempting to pop or squeeze a cystic pimple can lead to several negative outcomes. Manual manipulation can force the infected contents deeper into the skin or spread them to surrounding healthy tissue, potentially leading to more breakouts. This action also aggravates the existing inflammation, causing increased pain and swelling.
Popping a cystic pimple significantly raises the likelihood and severity of permanent scarring, as it intensifies damage to deep skin tissues. Additionally, introducing new bacteria from hands or tools can result in a secondary infection, making the lesion more severe. Interfering with a cystic pimple can prolong its healing time and worsen its overall appearance.