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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Acne Cyst On Face

Hello,

My daughter is struggling with acne. She has an acne cyst on her face that is quite painful & fluid filled. Last week we determined that she had an allergic reaction to the antibiotic that her dermatologist prescribed so we gave her Benadryl for 2 days. The cyst seemed to be getting better and we assumed that it was the due to the Benadryl. She has not taken the Benadryl now for a week as the dermatologist said that this is probably not the case, however now the cyst is bad again. Have you ever heard of Benadryl helping an acne cyst? What can we do for the cyst?
Tue, 24 Mar 2015
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Dermatologist 's  Response
Hello. Thank you for writing to us at healthcaremagic

Your dermatologist is right; an Acne cyst is not due to an allergic reaction and therefore should not respond to antihistamines (benadryl).
If I was the treating doctor I would have started on her Oral Retinoids; Oral retinoids (Isotretinoin) are the drugs of choice for severe nodulocystic acne.
Nodulocystic acne is the worst type of acne and retinoids are the only drugs effective for these.
Apart from Oral retinoids Individuals cysts can also be made to improve with an intralesional depot injection of triamcinolone acetonide. With these injections the cyst usually flattens in 36-48 hours.
Topical treatment of severe nodulocystic acne is same as inflammatory acne i.e benzoyl peroxide gel twice daily.
Oral antibiotics e.g Azithromycin may also be started for the first 4-6 weeks to control the inflammation and pain of cystic acne.
You may discuss in more detail about these with your dermatologist.

Regards
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Dermatologist Dr. Ilyas Patel's  Response
Hi,

You said your daughter suffers from acne cystica..a type of acne.. She has taken long term treatment with improvement...but got reaction to antibiotics,so stopped.... Acne is a multifactorial disease. There may be different form of acne like comedones,papules,pustules or cystic lesions. It is a relapsing condition. Sometime cysts might get infected.

Stress, anxiety, sleeplessness,drugs like steroids,oil food,dandruff..etc might exacerbate the disease.

She has to take treatment for long time to have good response...under observation of dermatologist.

You consult dermatologist...have perfect treatment. If there is reaction,he might replace the drug.

He might give antibiotic like minocycline 50 mg daily in morning and isotretinoin cap in low dose of 5 mg daily at night .

And he might advise to apply clindamycine gel in morning and adapalene gel at night. And to cleanse the face with antiseptic like acmed face wash. If there is a need,he might give intralesional steroid injection in a cyst.

Have pateince for the result. It may take few months for the good result. I hope you got my answer.

Thanks..

Dr. Ilyas Patel MD
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Suggest Treatment For Acne Cyst On Face

Hello. Thank you for writing to us at healthcaremagic Your dermatologist is right; an Acne cyst is not due to an allergic reaction and therefore should not respond to antihistamines (benadryl). If I was the treating doctor I would have started on her Oral Retinoids; Oral retinoids (Isotretinoin) are the drugs of choice for severe nodulocystic acne. Nodulocystic acne is the worst type of acne and retinoids are the only drugs effective for these. Apart from Oral retinoids Individuals cysts can also be made to improve with an intralesional depot injection of triamcinolone acetonide. With these injections the cyst usually flattens in 36-48 hours. Topical treatment of severe nodulocystic acne is same as inflammatory acne i.e benzoyl peroxide gel twice daily. Oral antibiotics e.g Azithromycin may also be started for the first 4-6 weeks to control the inflammation and pain of cystic acne. You may discuss in more detail about these with your dermatologist. Regards