Yes --- this is a nodule or a very inflamed cyst. I used to get cysts like this. It looks like you have other cysts happening, as well as common acne, and oily skin. You should see a derm to properly treat your acne before it causes too much damage to your skin. It will be well worth your money to do this. If for some reason you don't want to see a derm then you need to use some serious acne medication and diet changes to get clear.

Nicam only reduces redness. It does nothing to open pores nor does it kill acne bacteria --- both of which you must do to stop cystic acne. Have you tried Dan's regime? His regime will lessen surface oil, unclog pores and kill acne bacteria. These are the 3 things you have to do. You can try your own version of his regime by applying 5% benzoyl peroxide morning and night, washing with a mild noncomedogenic cleanser (no rubbing) and applying a lotion made for sensitive acne skin (like DML lotion). Some people like to use a salicylic acid cleanser to help open pores. However this may be too much for sensitive skin. With this regime you may have more breaking out to start but this is because all the deep plugs and infection are coming to the surface. Stick with it.

The other thing to do is to avoid all dairy products (cheese, milk, etc.). Dairy has hormones that make acne worse. Also eat fresh whole foods...no junk...no fried foods. Become a natural foods person. You skin will look sooooo much better. Also avoiding all added oils (salad dressings, oily foods, fried foods, etc.) will dry up your oily skin.

Please try the above. It will help. You can send me a message if you want. I have dealt with acne for a very long time, tried everything and have a pretty good grasp of what works and what doesn't for various acne types.

to me, who has suffered from cystic acne for years, that doesn't look like a cyst to me...cysts are deep under the skin and rarely come to a head...I can almost see the white coming to the surface here

but no matter, it's big and it stinks, for sure to have to deal with....have you tried retin a or tazorac? those things help clear out pores, you have a lot of clogged pores, it would help....there is a break in period, but once you get over that it does work

and try ditching dairy too for a month, I totally agree with the other poster on that!

good luck, keep us posted- look at the icing method here on the site, search for it, you may get some relief

Yes --- this is a nodule or a very inflamed cyst. I used to get cysts like this. It looks like you have other cysts happening, as well as common acne, and oily skin. You should see a derm to properly treat your acne before it causes too much damage to your skin. It will be well worth your money to do this. If for some reason you don't want to see a derm then you need to use some serious acne medication and diet changes to get clear.

Nicam only reduces redness. It does nothing to open pores nor does it kill acne bacteria --- both of which you must do to stop cystic acne. Have you tried Dan's regime? His regime will lessen surface oil, unclog pores and kill acne bacteria. These are the 3 things you have to do. You can try your own version of his regime by applying 5% benzoyl peroxide morning and night, washing with a mild noncomedogenic cleanser (no rubbing) and applying a lotion made for sensitive acne skin (like DML lotion). Some people like to use a salicylic acid cleanser to help open pores. However this may be too much for sensitive skin. With this regime you may have more breaking out to start but this is because all the deep plugs and infection are coming to the surface. Stick with it.

The other thing to do is to avoid all dairy products (cheese, milk, etc.). Dairy has hormones that make acne worse. Also eat fresh whole foods...no junk...no fried foods. Become a natural foods person. You skin will look sooooo much better. Also avoiding all added oils (salad dressings, oily foods, fried foods, etc.) will dry up your oily skin.

Please try the above. It will help. You can send me a message if you want. I have dealt with acne for a very long time, tried everything and have a pretty good grasp of what works and what doesn't for various acne types.

Thanks very much for the honest input and the helpful advice.

I have tried using BP once in the past, but I found out the hard way that my skin is sensitive to the chemical, even at the lowest concentration (2.5%). I can tolerate SA, but it seems to be effective only on non-inflamed pimples.

I have just started making big changes to my diet. Now I eat lots of vegetables, low-glycemic fruits, salmon, sardines, and oats, in addition to cutting off dairy, caffeine, chocolate, and anything high-glycemic in general.

Also, could stress be the main cause of my acne outbreak? I'm in grad school and running against time to get my thesis in before September.

I appreciate your help.

to me, who has suffered from cystic acne for years, that doesn't look like a cyst to me...cysts are deep under the skin and rarely come to a head...I can almost see the white coming to the surface here

but no matter, it's big and it stinks, for sure to have to deal with....have you tried retin a or tazorac? those things help clear out pores, you have a lot of clogged pores, it would help....there is a break in period, but once you get over that it does work

and try ditching dairy too for a month, I totally agree with the other poster on that!

good luck, keep us posted- look at the icing method here on the site, search for it, you may get some relief

I have had *true* cysts in the past (the really big ones where several inflamed pimples merge and take months to heal) - if my definition of "cyst" is right. But this one that I am having right now in particular is big, round, and red. It's probably just a very large nodule bordering on cyst.

I have read about how icing can help in reducing the swelling and redness, but I have also heard about it slowing down the healing process at the same time.

Thank you (and the other poster) for suggesting that I have a derm look at my condition.

My acne looked like yours and my derms diagnosed it as cystic acne. Nodules typically are so deep they don't come to a head but cysts can come to a head...although it can take a long time. Although I had cysts that were so inflamed that mine could come to a head within a couple of days. Size and degree of inflammation and infection determines whether it is a typical pimple or a cyst.

I too have extremely sensitive skin and topical BP was always too harsh. I was very surprised when my derm had me do a BP cleanser (Panoxyl 4%)...in fact he had to actively talk me into trying it. It's great for sensitive skin, formulated to kill acne bacteria eventhough it's only a cleanser and rinsed off before irritating skin. Panoxyl 4% can be bought over the counter now. What really makes it effective is when it is paired with Cleocin-T, a topical antibiotic. There have been studies on the pairing of BP cleansers with topical antibiotics for being gentle but really good at controlling acne. You have to see a derm for topical antibiotics.

On your diet you should also avoid nuts, including peanut butter. Chinese and holistic medicine both recommend it. I avoided this advice until several years ago but wish I hadn't. When I finally avoided nuts the degree of facial oil went down. Nuts are great for non-acne prone people but if you get acne nuts can cause oily skin and clog pores. Same with processed oils (olive, canola, etc.). I know the arguments for oils but at least for me avoiding them did the trick as far as reducing facial oil and unclogging pores.

Stress can also be a cause due to an increase in stress hormones (cortisol) and then androgens which cause acne. However if stress is the cause you can still do things topically that will help keep the pores open, kill acne bacteria and stop the breakouts. Breaking out from stress just means that you are prone to clogged up pores and the extra oil and inflammation caused by an increase in hormones makes it a perfect environment for serious acne. I'd say that if you are breaking out like this because of stress that you most likely will continue to break out when the major stress is over...although less. You'll want to develop a regime to help your skin cope...one you can do regularly when under stress and not. Keeping up a good regime keeps the pores open so that you are ahead of the curve next time you are under lots of stress.

I know how you feel...i had a recurring cyst exactly like that in between my eyebrows! I looked like a unicorn...

I used to do hot compresses as opposed to cold in order to speed up the life cycle of the cyst, so to say. It would also throb al ot and i could feel the puss pushing...

I used to put Differin on them as well, it was given to me by the University Doctor where I study and is mainly used to prevent outbreaks but I found that, as an anti-inflammatory it would help with my cysts.

I have in the past drained cysts as well, not the same as picking, but as it is on your cheek i would not recommend this for you, as many people seem to scar easily on the cheeks.

It doesnt look like it has fully 'ripened' to me, I mean the head has not fully developed.

I hope it goes relatively soon and leaves no scarring.

sorry I couldnt help, I just wanted you to know that you are not alone

Ming-Ju