Same Spot, Same Problem: Why You Have Recurring Cystic Pimples

If you have a recurring pimple in the same spot, it could be cystic acne thanks to hormonal breakouts and using pore-clogging products.

Do you always have that one blemish in the same spot just staring back at you? Cystic acne is a particularly painful type of acne, characterized by deep blemishes that can linger under the skin for weeks — or even months.

If you’ve tried everything to make that stubborn, deep pimple go away, there’s a good chance you’re dealing with cystic acne. So what’s the deal? Here’s why you might be getting recurring pimples and cysts in the same spot. Plus, how to treat those stubborn zits.

It’s a recurring cyst

Cystic acne is a type of acne that’s characterized by deep, swollen, inflamed pustules — or cysts. You can find cystic acne anywhere on your face or body, but it tends to favor the chest, lower face/jawline, and upper back.

Cysts form when your pores become clogged with dead skin cells, dirt, and bacteria. The area then swells and ruptures underneath the skin, causing a tender, red bump to appear on the surface. Sometimes multiple cysts fuse to form one giant spot.

Cystic acne is notorious for appearing in the same spot because they’re deep in the skin. Cysts can also form a lining or sac under the skin where the cyst initially forms. So any hormonal changes or flares of acne tend to make the same cyst become inflamed again. Even when you calm the inflammation, the bump often sticks around under the skin for weeks or months. To treat a cyst that won’t go away, see a dermatologist for treatment to help you avoid scarring. Your derm may recommend:

  • Corticosteroids: If you have a few inflamed cysts, your doc may inject them with a corticosteroid. This helps shrink the cyst and reduce inflammation quickly. Steroid injections are the most common treatment for cysts and can also help treat cysts early on.
  • Isotretinoin: If you’re concerned about scarring, this treatment is your best option. This potent medication tackles bacteria, clogged pores, excess oil, and inflammation. Around 8 in 10 peeps see permanent clearing after just one course of treatment. But, it’s not without serious side effects and isn’t an option if you’re pregnant or planning to become pregnant.
  • Antibiotics: If you’re already dealing with cystic acne scarring, oral antibiotics are often paired with topical medications like benzoyl peroxide with clindamycin and a retinoid. These meds help kill nasty bacteria and ease inflammation and redness.

Changing hormones

Owning a vagina means dealing with a regular hormone roller coaster. These fluctuations, particularly around your period, can wreak havoc on your skin, causing inflammation and pimples. Pregnancy is another time when hormones go into overdrive, which can lead to breakouts. Hormonal zits tend to show up on your lower cheeks, chin, jawline, and neck.

But folks with a penis can also experience hormonal breakouts. Stress, for example, increases levels of the hormone cortisol, which in turn can make you more prone to pimples.

Your hormones can also worsen or trigger a breakout if you already have cystic acne. Picking or squeezing can smear the bacteria into the surrounding tissues, causing the area to flare up again and again.

If you think your recurring cyst is linked to hormones, see your derm. They may recommend these additional treatments:

  • Birth control pill: If you get cystic acne monthly before your period, hormonal contraceptives can help prevent cystic acne caused by hormonal changes. Your derm may recommend them along with an antibiotic or spironolactone.
  • Spironolactone: Another one for folks with ovaries, this medication reduces excess oil and may help banish cysts. Spironolactone can also help folks with PCOS (polycystic ovary syndrome) who tend to develop dark hairs along the jawline, irregular periods, and acne along the jawline and upper neck.
  • Retinoids: These vitamin A derivatives helps to unplug pores and prevent them from clogging up in the first place.

Popping zits 

It can be hard to resist, right? But, squeezing and picking pimples only makes things worse in the long term. Trying to pop cysts and zits spreads the bacteria and can increase inflammation and irritation, which can lead to scarring.

Plus, if you don’t squeeze zit just right, you won’t remove the entire blockage. When you leave goo behind, it’s the perfect breeding ground for — drumroll — pimples, lesions, spots, cysts, whatever you want to call them. So, just don’t do it!

Instead, apply a warm compress to any spots or cysts to ease inflammation. Then slap a hydrocolloid patch over it to stop yourself from picking, popping, or playing with it. That said, sometimes, these patches allow bacteria to multiply and make pimples worse, so you’ll need to see if it works for you.

Touching your face

No matter how clean you think they are, your hands are full of bacteria and microscopic dirt particles. So, when you touch your face, these can end up in your pores and cause blemishes.

Even if you don’t think you touch your face that much, you probably do it without realizing it. Plus, resting your phone against your face transfers bacteria to the same places on your skin, potentially causing pimples. Sleeping on dirty pillowcases also doesn’t do you any favors. So swap them out several times a week if you keep getting breakouts.

Try to be more aware of when you touch your face, and keep your hands, nails, and phone clean and relatively germ-free. If you know you’ve been touching your skin, wash your face with a gentle cleanser as soon as possible. And follow up with a light moisturizer to soothe any irritation.

Choosing the wrong products

If you’re dealing with a reoccurring cyst or pimple, the products you’re using on your face may be clogging your pores or putting oil production into overdrive.

Some skin care products may be too harsh or drying, which can strip away the natural oil your skin needs to protect itself. This can make your sebaceous glands overcompensate and produce even more oil. Some cleansers, makeup, moisturizers, and sunscreens can also clog pores and cause breakouts. Besides zits, using pore-clogging products can make your skin appear congested, resulting in a rough and bumpy texture with multiple enlarged pores.

To treat congested skin, try using an alpha hydroxy acid (AHA) or beta hydroxy acid (BHA) product to gently exfoliate the skin and unclog pores. Then make sure you’re only using products that are non-comedogenic (aka won’t clog pores). Build these goodies into a regular skin care routine, use them as directed, and you should see an improvement in your skin’s texture and recurring breakouts.

Psssst. Don’t forget to wash your makeup brushes, too! These bad boys can also harbor tons of bacteria and gunk.

Takeaway

Dealing with a recurring cystic pimple can be frustrating, but knowing the underlying cause can help you get it under control.

If you have a cyst that just won’t budge, chat with a dermatologist to help you find the best treatment option. Depending on the cause, antibiotics, steroids, or retinoids may help clear it up.

In the meantime, try to keep your hands off your face, wash your face with a gentle cleanser, and use products that won’t clog your pores. And if a spot or cyst does show up, leave it TF alone.

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