The Right Way To Treat Cystic Acne

I'll do anything to clear up my cystic acne. I've Supermarket Sweep-ed the florescent lit isles of Duane Reade for extra strength OXY-10, transferred rent money from my savings account for an emergency cortisone shot and gotten excruciating facials that involve metal lancets, extractions and estheticians who shame me for picking at my blemishes. Most recently, I sought out Lucky’s executive beauty director, Jean Godfrey June, who recommended I speak to top New York dermatologist Dr. Amy Wechsler and New York/Miami dermatologist Dr. Fredric Brant.

A cure-all doesn’t exist. While both doctors provided sound advice that’s worked for many patients, their two treatment philosophies differ on several points. For instance, although Wechsler doesn’t believe topical agents can help cystic acne, Brant does. So there’s no single, absolute prescription for clear skin; rather, I got many of them:

You probably aren’t doing anything wrong.

This is what Dr. Amy Wechsler told me when we talked on the phone. "The reason most women get cystic acne is a hormonal imbalance. There's nothing you can apply topically to fix it, you really need to seek the help of a dermatologist." She explained that the first thing she does for patients afflicted with nodule-like blemishes, especially around the jawline and lower face, is check for poly-cystic ovarian syndrome, or PCOS, which causes an increase in testosterone. Other ways to detect PCOS: extra hair growth in areas it shouldn't be growing, weight gain, irregular periods and trouble conceiving. Still, even if PCOS isn't the cause, it's something happening internally, brought on by anything from genetics to stress to poor sleeping habits.

WWD/Kyle Ericksen