The causes of cystic acne are the same as those of the more common type. It is just that the inflammation affects deeper skin tissues.

The cysts or boils commonly form on the buttocks, groin or under the armpits, although they can appear anywhere. They are more common in the regions where sweat tends to collect in the hair follicles and perspiration ducts.

Almost 90% of all teenagers develop acne as they pass through puberty, which is why hormonal activity and production were initially suspected to be the causes. Hormones are still believed to play a role, but not simply the increased hormone production that accompanies puberty.

In men, increased production of testosterone and dihydrotestosterone during the onset of puberty stimulates the growth of facial hair. The hormones activate the pilosebaceous unit, which includes the sebaceous gland and the hair-producing follicles.

The sebaceous glands become larger and sebum production increases. Sebum is the oily substance produced to moisturize and lubricate the skin. Efforts to “dry up” or reduce sebum production have been recommended in the past, but that can backfire. The drying effects may cause the glands to produce even more sebum. What we really want is a balance.

Sebum can combine with keratin (a structural protein that makes up the skin’s outer layers) to form a plug. Referred to by dermatologists as a microcomedo, we usually call them blackheads or white heads.

The plug clogs the hair-producing follicle, preventing sebum from being released or the hair from growing. The follicle can become swollen with excessive sebum and bacteria can grow in the follicle, causing inflammation and a minor infection.

Sometimes the inflammation and/or infection occur beneath the follicle, around the base of the pilosebaceous unit. We can see the swelling and the area is painful to the touch. We call them cysts or boils. We might say that there is no “head”, so the pressure cannot be relieved by squeezing.

Why some people are prone to have cysts and others are not is believed to be mostly due to genetics. But, that doesn’t mean that we can do nothing to reduce the inflammation or keep the bacteria under control.

The first order of business is to treat the skin gently. When a cyst or boil does appear, use cold compresses to reduce the swelling and relieve the pain. Never try to cut through the skin. See a doctor if the boil does not resolve on its own within a week.

A lack of nutrients in the diet may be the cause or at least a contributing factor. Low levels of vitamins A and E are known to accompany acne. People without acne have higher levels of the vitamins circulating in their bloodstreams.

Low blood levels of the vitamins A and E indicate that the diet is low in fruits and vegetables. So, the natural cure for cystic acne might be to eat more fruits and vegetables.