Cystic acne is treated in much the same way as “regular” acne, although it may benefit from Aczone (topical dapsone 5%) to relieve inflammation. Since cystic acne is more common in women and is influenced by hormonal fluctuations, combination birth control pills may be an option for those who want to use them for contraception. Aldactone (spironolactone) is often used in women who don’t respond to oral antibiotics. Isotretinoin or local steroid injections may be appropriate for severe cases.