Ask a Dermatologist: What Happens if Cystic Acne is Left Untreated?

Dr. Courtney Rubin, our Chief Medical Officer, weighs in on your most pressing skincare questions.

A few different things can happen if cystic acne is left untreated. One possibility is that the deep inflammation eventually rises to the surface, leading to a "whitehead," or a pimple with purulent discharge in the center, that eventually drains or resolves on its own. Another possibility is that the inflammation associated with the cystic pimple remains deep in the skin, and eventually simmers down and resolves. Both of these options can leave behind PIH (post-inflammatory pigmentation), which is a dark spot or pink spot left behind after a pimple resolves.

Contrary to the name, cystic acne does not usually grow and grow because it is not actually associated with a true cyst under the skin. It is called “cystic” because it feels deep within the skin, but what you are really feeling is deep inflammation associated with a clogged pore.