Cystic acne is the most severe form of acne. Cystic acne affects deeper skin tissue than the more superficial inflammation from common acne. Since they are severe, so systemic medications are usually required. The treatment consists of topical and oral antibiotics, tretinoin, oral contraceptives in females and Intralesional corticosteroid injections. Very severe cases may need excision and drainage. Also the treatment has to be taken for a long time so that relapses do not occur.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.
Spironolactone. Girls can take it, not boys. That is the key to cystic acne for girls. All hormonal based. I'm 49 and have had them since 17 years old. Still get them, but only once a year. Taking Solodyn 105 mg. with it, too. That's a high dose, but necessary. Spironolactone comes in 25mg pills. One pill a day is not enough! That won't fix anything. I take 100 mg a day to maintain. 50 mg in the morning and 50mg at night. I take more if I need to just to cut the feeding to the androgen glands that produce too much oils that cause the cysts. No fancy face washes. Only Aveeno Daily Complexion face pads. Once in the morning and once at night with the wipes. That's it. My cystic acne was so bad I would get cortisone shots in them to shrink them. Over time that didn't do the trick and I was left with only scars. Found a doctor who finally knew what he was doing. Prescribed the spironolactone (water pill). It is unreal the results.