Cystic Acne Treatment in Singapore — How We Stop Cysts Coming Back
Written and medically reviewed by the doctors of The Clifford Clinic. Last medically reviewed 6 November 2026.
In short, cystic acne is acne at its most severe — deep, painful lumps under the skin that last for weeks, return in the same places and leave scars. Creams cannot reach it, and antibiotics only hold it while you take them. What stops it is treating the cause, the overactive oil glands feeding the cysts. At The Clifford Clinic that means AGNES RF to shut down the individual glands that keep refilling, AviClear laser to shrink the glands across a whole area, and isotretinoin where the acne is severe or scarring. A painful cyst can be calmed in days while the course is under way.
Can cystic acne be cured?
Cystic acne can be treated at the root cause, which is the overactive sebaceous glands. Every cyst starts in an oil gland. The pore blocks, oil and bacteria build up behind it, and the follicle wall bursts into the surrounding skin — which is why a cyst hurts, lasts weeks and scars. Treatments that only clean the surface or kill bacteria leave the gland producing, so the cysts return when the treatment stops. Treatments that act on the gland — AGNES RF, AviClear and isotretinoin — are the ones that change the course of the condition.
AGNES and AviClear are the two device treatments with published trials for the gland itself, and the clinic uses them for patients who cannot take isotretinoin, have relapsed after it, or want to avoid medication.1
The three cystic acne treatments that act on the oil glands
AGNES RF — CYSTS THAT COME BACK IN THE SAME SPOT
Radiofrequency through an insulated micro-needle destroys the oil gland under the recurring pore, so it stops producing. Two to three sessions. $800–$1,500 a session. AGNES acne treatment →
AVICLEAR — WIDESPREAD CYSTIC ACNE
A 1726 nm laser that shrinks the oil glands across the whole area in three sessions, no medication, no downtime. FDA-cleared for mild to severe acne. $1,800 a session, $3,000 for two. AviClear →
ISOTRETINOIN — SEVERE OR SCARRING CYSTIC ACNE
Shrinks every oil gland at once and is the guideline’s first choice for severe or scarring acne. Monthly review and blood tests. Not in pregnancy. Prescribed and monitored by our doctors. Isotretinoin in Singapore →
Which cystic acne treatment for which pattern
| Your cystic acne | What stops it |
|---|---|
| The same two or three spots, every month | AGNES RF on those pores |
| Cysts across the jaw, cheeks or back | AviClear course |
| Severe, many nodules, scarring already | Isotretinoin |
| Jawline and chin, flaring with the cycle | Hormonal treatment + AGNES or AviClear |
| Cannot take isotretinoin, or relapsed after it | AviClear (widespread) or AGNES (localised) |
| Pregnant or planning | AGNES and AviClear are not used. Selected topicals and injection only |
Getting the present cysts down while the course works
Gland treatment takes weeks to show. In the meantime the cysts that are there are brought down in three ways. A short oral antibiotic course (doxycycline or minocycline, three to four months at most, always with a topical) for inflamed nodules.1 A topical retinoid with benzoyl peroxide to keep pores from re-blocking and hold the result afterwards.1 7 And for a cyst that is throbbing or large enough to scar, a dilute steroid injection into it, which flattens it in days rather than weeks.1
The injection treats that cyst only — it is the gland treatment that stops the next one. The single-lesion procedure is described on the pimple treatment page.
What cystic acne is — and why creams and facials do not clear it
Acne is graded by its lesions. Blackheads and whiteheads are mild, red bumps and pus spots moderate, nodules and cysts severe. A nodule is a firm, painful lump deep in the skin. A cyst is the same lump once it has filled with pus and broken down inside. Cystic acne — nodulocystic acne — means the skin keeps producing them. It runs in families, it is driven by androgen hormones acting on the oil glands, and it peaks in the late teens and twenties, though it affects adults in their thirties and forties too, particularly women along the jawline.
One deep lump on its own is a cystic pimple, not cystic acne. The pimple treatment page covers that. This page is for acne that keeps producing them.
Over-the-counter products act on the surface. A cyst sits in the dermis, below the reach of a wash or a spot gel, and the inflammation inside it is under way before it is visible. Squeezing forces the contents deeper and widens the rupture — a larger, longer-lasting lesion and a higher chance of a depressed scar. Facials and extraction do not treat the oil gland either. The reason cystic acne “comes back after every treatment” is that the treatment never reached the gland.
Jawline, chin and back. Jawline and chin cysts in women are hormonal until proven otherwise and are treated with hormonal therapy alongside the gland treatments. Cysts on the back and chest — truncal acne — are managed the same way as the face, with AviClear preferred over AGNES because the area is large. See the back acne treatment page.
Preventing scars while the cysts are active. Nodules and cysts are the lesions that leave depressed scars, and scarring is not reliably prevented even by isotretinoin, so the protection is speed. Treat the glands before they have ruptured for the fifth time, bring down the cysts that are present, and do not squeeze.1 8 Scars that remain once the acne is controlled are treated separately — see acne scar treatment.
Cystic acne treatment cost in Singapore
| Item | Price (before GST) |
|---|---|
| Doctor consultation | $100 |
| AGNES RF | $800–$1,500 per session |
| AviClear | $1,800 per session, $3,000 for two |
| Gold PTT (oily, congested skin with active acne) | $1,000 per session, $2,500 for three |
| Isotretinoin, oral antibiotics, hormonal treatment, prescription topicals | Quoted at consultation. Isotretinoin includes monthly review |
| Steroid injection for a cyst | $150 per session |
The doctor gives you the full price before anything is done. All of the clinic’s acne treatments are compared in cost on the acne treatment price list.
What a cystic acne consultation involves
The doctor grades the acne, maps the recurring pores, asks about the cycle, family history, past treatments and pregnancy plans, and sets out the plan on the day. Which gland treatment, what holds the result, and what brings the present cysts down in the meantime. Progress is reviewed at four to six weeks.
Cystic acne treatment FAQ
It can be treated at the root cause — the overactive sebaceous glands. AGNES RF destroys the individual glands behind recurring cysts, AviClear shrinks the glands across an area, and isotretinoin shrinks all of them. Treatments that act only on the surface or on bacteria hold the acne while they are used. The gland treatments change its course. Whether there is a permanent cure for acne and what AGNES can and cannot do is covered on our AGNES guide.
It depends on the pattern. AGNES RF for cysts that return in the same spots. AviClear for cysts across the jaw, cheeks or back. Isotretinoin for severe or scarring acne. The doctor matches the treatment to the pattern at the consultation.
A follicle that has ruptured repeatedly forms a pocket that refills. Medication cannot close it. AGNES RF ablates that follicle’s oil gland so it stops producing.
Yes. In the main AviClear trial, most patients with moderate to severe acne had at least half of their inflamed spots cleared by six months, and the result held at one year, without medication. AGNES treats localised recurring cysts without medication. Neither has been compared head-to-head with isotretinoin.
Not always. It is recommended for severe nodulocystic acne, acne that is scarring, or acne that has not cleared after three months of other treatment. Localised recurring cysts are treated with AGNES, widespread cysts with AviClear.
A dilute steroid injection into it flattens it within days. It treats that lump only. The gland treatments stop the next one.
Nodules and cysts are the lesions most likely to, and even isotretinoin does not reliably prevent it, so early gland treatment is the protection. Scars that remain are treated once the acne is controlled.
Consultation $100. AGNES RF $800–$1,500 per session. AviClear $1,800 per session or $3,000 for two. Medication quoted at consultation.
The Clifford Clinic, 50 Raffles Place #01-01, Singapore Land Tower, Singapore 048623 (Raffles Place MRT, Exit B). Tel +65 6532 2400, WhatsApp +65 8318 6332.
- Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2024, 90(5), 1006.e1–30. doi.org/10.1016/j.jaad.2023.12.017
- Lee JW, Kim BJ, Kim MN, et al. Selective sebaceous gland electrothermolysis as a treatment for acne — a prospective pilot study. Int J Dermatol 2012, 51(3), 339–344. doi.org/10.1111/j.1365-4632.2011.05226.x
- Alexiades M, Kothare A, Goldberg D, Dierickx C. Novel 1726 nm laser demonstrates durable therapeutic outcomes and tolerability for moderate to severe acne across skin types. J Am Acad Dermatol 2023, 89(4), 703–710. doi.org/10.1016/j.jaad.2023.05.085
- Goldberg D, et al. 1726 nm sebum-selective laser — one-year data from a prospective multicenter study. J Am Acad Dermatol 2026, 94(2), 517–524. doi.org/10.1016/j.jaad.2025.09.077
- Zaenglein AL. Acne vulgaris. N Engl J Med 2018, 379(14), 1343–1352. doi.org/10.1056/NEJMcp1702493
- Lai J, Barbieri JS. Acne relapse and isotretinoin retrial in patients with acne. JAMA Dermatol 2025, 161(4), 367–374. doi.org/10.1001/jamadermatol.2024.5416
- Mavranezouli I, Daly CH, Welton NJ, et al. A systematic review and network meta-analysis of topical, oral, physical and combined treatments for acne vulgaris. Br J Dermatol 2022, 187(5), 639–649. doi.org/10.1111/bjd.21739
- Layton AM, Ravenscroft J. Adolescent acne vulgaris — current and emerging treatments. Lancet Child Adolesc Health 2023, 7(2), 136–144. doi.org/10.1016/S2352-4642(22)00314-5
Our acne doctors
Every acne plan at The Clifford Clinic is set and reviewed by one of our doctors. You see the same doctor at each review.
Dr Gerard Ee
Managing Director · MBBS (St George’s) · MRCS (Edin) · PG Dip Dermatology (Cardiff)
Trained at SGH, NUH and Mount Sinai Hospital, New York. Accredited in lasers, light therapies, fillers and Botox. Has published in medical journals on surgical and aesthetic topics.
Dr Chow Yuen Ho
Medical Director · MBBS (NUS)
More than 10 years in clinical practice with a special interest in aesthetic dermatology procedures and lasers. Formerly founding Director of Medical Informatics at SGH.
Dr Law Zhi Wei
Partner · MBBS (NUS) · MRCS (Edin) · PG Dip Practical Dermatology (Cardiff)
Surgical training across KKH, SGH and CGH. Accredited in lasers, radiofrequency, ultrasound therapies, Botox and fillers, with a focus on acne care.
Dr Bernard Ong
MBBS (NUS)
Aesthetic and wellness medicine. Former national-level badminton player who represented Singapore at the Youth Olympic Games.
Book your cystic acne consultation
To have your cystic acne assessed and the treatment that fits its pattern set out on the day, message us on WhatsApp or call the clinic.
Mon–Fri 10am–8pm · Sat 10am–5pm · 50 Raffles Place #01-01 Singapore Land Tower