What is the best approach when dealing with cystic acne lesions?

Dealing with cystic acne lesions often requires a more aggressive and targeted approach due to the inflammation and deep-seated nature of these blemishes. Intralesional corticosteroids are particularly effective because they can be injected directly into the cyst itself. This method provides rapid anti-inflammatory action, reduces swelling, and accelerates the healing process.

By directly delivering the medication into the lesion, intralesional corticosteroids can significantly decrease the cyst's size and discomfort more quickly than systemic treatments or topical applications. This is especially important in cases of cystic acne, where lesions can be painful and can leave scarring if not treated effectively.

Other methods, such as topical antibiotics, oral contraceptives, and over-the-counter treatments, may have their uses in managing acne generally, but they do not provide the same immediacy or localized effectiveness for cystic lesions. Topical antibiotics can address bacterial involvement but do not address the inflammation as directly. Oral contraceptives can help regulate hormones that contribute to acne but are not effective in immediately reducing the size or discomfort of cystic lesions. Over-the-counter treatments tend to be less potent and may not have the impact needed for the more severe cystic presentations.