Acne&Cysts: From a Memphis Dermatologist

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by George Woodbury Jr. M.D. (01/06/2022)

Acne and cysts can have really negative effects upon a person’s mood and self-confidence. Fortunately, Dermatologists like myself now have a growing number of promising, new options for acne, cysts, and complexion issues. Let’s take a look at some of these options, having practiced as a Board-certified Dermatologist for the last 30 years, because pimple popping should be a thing of the past, making acne scarring less and less of a problem.

First, let’s be clear about one important aspect of acne: acne is not just a problem for pre-teens and teens. As many of my own patients have realized, it affects peoples in their twenties and thirties, and even beyond. Middle-aged acne is a very real issue for many.

What causes acne and cysts? Dermatologists are increasingly realizing that it’s genetic, meaning that these skin issues tend to run in certain families. Clogging of pores results in a skin inflammation and a skin infection, explaining why antibiotics tend to help.

In fact, traditional therapies for acne include antibiotics like doxycycline and minocycline, with prescription topicals (meaning “on top of the skin”) for blackheads (comedones), papules, or cysts: Tretinoin Cream, differin gel (Adapalene), benzoyl peroxide, azelaic acid, or topical dapsone. Sometimes we consider a five months’ course of an oral medicine called isotretinoin (Accutane), which helps by drying up the oil glands. Accutane is highly effective, but requires strict avoidance of pregnancy while on treatment, and monthly bloodwork. Sometimes Dermatologists also look at hormonal therapies, like spironolactone pills, or even birth control pills.

For cysts, Dermatologists often discuss with patients the options of medical management versus surgical management, which can involve injecting the cyst sac, under a shot of local anesthetic. Dermatologic surgeons like myself sometimes cut out or “excise” cysts, the goal being to cut down the risk of scarring.

In 2022, Dermatologists also have a new oral antibiotic which seems to have a quicker onset of action – Sarecycline – and a newer retinoid gel – Trifarotene®. There is also a variation of acne – called Pityrosporon folliculitis or fungal acne – which can be treated with prescription antifungal medicines.