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My son has the same problem as you and we have tried everything from Minocycline to Clear Light therapy to name a couple with no great improvement for over a year now. His general doctor and dermatologist have both agreed that it is now time to go with Accutane. My brother had the same cystic acne when he was a teenager and Accutane worked wonders for him; so I'm hoping this will be the same case for my son. The cystic acne has really hampered his Summer because he doesn't want to swim since they are also on his back and chest. Take care
Usually people with cystic acne tend to have small pores that can get clogged easily. When your skin doesn't shed properly, all the dead skin cells can start to accumulate on the skin's surface, clog the pores, and causes things to build under the skin (cysts). The best way to prevent this is by exfoliating. And no, I don't mean by scrubbing your skin, that can irritate the problem. You need to use a gel with alpha hydroxy acid or glycolic acid to help loosen the clogged pores and clear out all the dead skin cells. Look for a product with at least 10% glycolic acid and use twice a day.

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