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Cystic Acne vs. Hormonal Acne – Know the Difference

Comparison of Cystic Acne vs. Hormonal Acne

Acne, a seemingly common skin concern, can often be far more complex than it appears at first glance. Among the various types of acne, two that often share the spotlight are cystic acne and hormonal acne. While they may share some similarities in appearance, understanding the fundamental differences between these two forms of acne is crucial for effective management. 

In this article, we will dive into the distinct characteristics, causes, and treatment approaches for cystic and hormonal acne, equipping you with the knowledge to navigate these skin challenges confidently.

What is Acne?

Acne is a common skin condition characterised by spots on the skin, most frequently appearing on the face, back, and chest. These spots range from surface-level black and whiteheads to deeper, more painful cysts and nodules. Acne affects individuals of all ages but is most prevalent among teenagers due to hormonal changes. Its impact extends beyond just physical manifestations, often leading to emotional distress and diminished self-esteem due to its effect on physical appearance. 

There is a broad spectrum of acne types, each with unique characteristics and causes. You have mild forms like black and whiteheads at one end, which are typically easy to manage. However, as we move along the spectrum, we encounter more severe and persistent forms, such as cystic acne and hormonal acne. While they share similar features, their underlying causes and treatment approaches significantly differ, which we will explore further in this article.

Cystic vs. Hormonal Acne

Is this cystic acne or hormonal acne

Cystic acne and hormonal acne, both severe forms, are often confused due to their similar manifestations on the skin. This section will delve into the specifics of these two types of acne, distinguishing their characteristics, causes, and appropriate acne treatment options and methods. Understanding these differences is crucial for tailored acne treatment and plans and effectively managing these skin conditions. Let’s explore these forms of acne in depth.


Cystic acne, one of the most severe forms of acne, is predominantly influenced by certain factors. 

  • Genetic predisposition plays a significant role. If your parents had severe acne, you’re more likely to experience it. 

  • Overproduction of sebum can lead to blockages in hair follicles, creating an environment for acne-causing bacteria. Androgen hormones can trigger this overproduction, especially during adolescence or hormonal imbalance. 

  • Inflammation is also critical, as trapped bacteria can lead to painful cysts. 

  • Lifestyle factors like diet and stress can worsen cystic acne. 

As for hormonal acne, hormonal fluctuations are the primary cause. Hormones, particularly androgens, are key in developing and worsening acne. Androgens are hormones that increase during puberty and stimulate skin structure growth, including hair follicles and oil glands. This hormone surge causes the sebaceous glands to enlarge and produce more sebum. 

During life stages like puberty, menstruation, and pregnancy, hormone fluctuations lead to increased sebum production. Puberty brings about various changes, including heightened androgen levels. This hormonal surge causes more sebum production, potentially leading to follicle blockage and acne. 

Similarly, hormonal fluctuations during the menstrual cycle can contribute to breakouts in women. The week before menstruation, increased progesterone levels stimulate sebum production, potentially leading to acne. Additionally, pregnancy can cause elevated androgen levels, resulting in increased sebum production and a higher chance of developing acne. 

While hormonal acne is commonly linked to these life stages, it can also affect adults with hormone imbalances, stress, or certain lifestyle conditions. It’s important to remember that hormones are just one part of a complex interplay of factors contributing to adult acne itself.


cystic vs hormonal acne close up

Cystic acne is a severe type that appears as painful, deep-seated nodules or cysts filled with pus. These cysts are larger than 5mm and often tender, causing significant discomfort. Cystic breakouts are more likely to scar than other acne types due to their depth and inflammation.

While cystic acne primarily affects the face, it can also develop on oil-prone body parts like the back, chest, upper arms, and shoulders. It can persist for weeks or even months, so prompt professional help is recommended to manage it effectively.

Hormonal acne, on the other hand, differs from other types. It typically consists of blackheads, whiteheads, and inflamed spots, focusing on the lower face, particularly the jawline and mouth area.

Hormonal acne breakouts are responsive to hormonal fluctuations, often worsening before menstruation and improving during the period. Its severity varies based on hormone levels and sensitivity.

Hormonal acne is persistent, with spots lingering for weeks and new ones appearing alongside fading ones. Although it is less likely to cause scarring than cystic acne, its chronic nature can be distressing. Seeking appropriate solutions to treat hormonal acne is crucial for the effective management of acne.


Treating cystic acne can be challenging due to its severity and scarring. However, there are various options available. 

  • Lifestyle changes are also important, such as a healthier diet, stress reduction, and a consistent skincare routine. Regular exercise can help regulate hormones and improve skin health. 

  • Topical medications like topical retinoids, benzoyl peroxide, and antibiotics can potentially help reduce inflammation and prevent acne bacteria inflames. 

  • Oral medications may be prescribed for more severe cases. 

  • In stubborn cases, dermatological procedures like laser therapy or chemical peels may be recommended. 

Treating hormonal acne can be effectively managed with hormonal therapies, topical treatments, and lifestyle adjustments. It’s important to consult a dermatologist or healthcare provider for the ideal treatment approach for your specific needs.


Preventing acne completely is challenging, but you can reduce the chances of developing cystic or hormonal acne. Diet and skincare can impact your skin’s health. To manage cystic acne breakouts, limit sugary foods and refined carbohydrates. Instead, incorporate omega-3 fatty acids from fish, and walnuts and antioxidants from fruits, vegetables, and green tea. 

For hormonal acne, focus on foods that help balance hormone levels, like fibre-rich lentils, beans, and whole grains. Flaxseeds and soy products with phytoestrogens can also regulate hormones. Maintain a consistent skincare routine with gentle cleansing, toning, and oil-free moisturising. Use products with salicylic acid, benzoyl peroxide, or retinoids if necessary. 

Protect your skin with sunscreen and exfoliate gently once or twice a week. Avoid touching or meddling your face and picking or squeezing pimples to prevent breakouts and scarring. Remember, a skincare regimen is unique per individual, so patch-test new products and be patient for results.

Understanding acne, especially the differences between cystic and hormonal acne, is crucial for effective treatment. Cystic acne is characterised by deep, painful pimples caused by excess oil and clogged pores (dead skin cells and dirt). It requires acne treatments that reduce inflammation and control or reduce sebum production. Hormonal acne, appearing on the lower face and jawline, is linked to hormonal changes and sensitivity. Regulating hormone levels through therapy and lifestyle adjustments can be helpful. 

Consulting a dermatologist provides personalised solutions for treating acne, which will help promote healthy skin.

Cystic and Hormonal Acne FAQs

Is hormonal acne always cystic?

No, hormonal acne can present in various forms, such as whiteheads, blackheads, or small pimples. Cystic acne is a certain type of acne that appears as deep, painful cysts under the skin’s surface.

Can you have both hormonal and cystic acne?

Yes, it is possible to have both cystic and hormonal acne simultaneously. However, a dermatologist can determine the specific type of acne present and recommend appropriate treatment options.

Does diet play a role in the development of cystic or hormonal acne?

Diet can significantly influence the development and severity of cystic and hormonal acne. A poor diet of consuming foods with a high glycemic index can cause a spike in blood sugar levels, leading to increased sebum production and inflammation, exacerbating cystic acne. Similarly, consuming foods that cause hormonal imbalances, such as those high in sugar or dairy, can trigger hormonal acne. 

When to Seek Professional Help

If home remedies and over-the-counter treatments do not improve your acne, it is time to consult a dermatologist. They can assess the severity of your condition and provide personalised treatment options based on your specific skin type and medical history. Additionally, seek immediate medical attention if you experience severe cystic or hormonal acne with accompanying symptoms such as fever or pain. 

How do you treat scars due to cystic or hormonal acne?

If you’re dealing with persistent acne that is leaving behind unsightly scars, it’s essential to seek acne scar treatment from a dermatologist or doctor. Acne scars, including ice pick, boxcar, and rolling scars, can impact your self-esteem and overall skin appearance. 

Professionals can assess your unique skin condition, recommend tailored treatment options, and help you achieve smoother, more even skin. 

Early intervention is often key to minimising the long-term effects of acne scars, so don’t hesitate to consult with a skincare professional to explore effective solutions for scar reduction and improved skin texture, tailored to your specific needs.


Cystic and hormonal acne are distinct types with their characteristics and treatments. Cystic acne is caused by excess oil production and clogged pores, requiring treatments to reduce inflammation and sebum production. 

Hormonal acne primarily appears on the lower face and jawline, often linked to hormonal imbalance and sensitivity. Management may involve hormonal therapies and lifestyle adjustments. A diet rich in omega-3 fatty acids and antioxidants for cystic acne and fibre-rich foods for hormonal acne can help. Consistent skin care, including cleansing, toning, moisturising, and sun protection, is crucial for both types. 

Remember, skin care is individual, so consult a dermatologist for personalised treatment plans based on your skin type and history. Patience and consistency are key in your skincare journey.


Medical Director

After graduating from the National University of Singapore, Dr Boey’s journey in aesthetics brought him to esteemed institutions such as Harvard Medical School, American Academy of Aesthetic Medicine and Queen Mary University of London in diverse cities like Seoul, London, Boston and New York.