Most cystic acne is caused by hormonal imbalances and stress, (helps to know age range ) Your issue might have to be addressed from that angle, alot of GYN's or NP's offer that service a blood draw is required to get accurate levels. Consider using digestive enzymes and probiotics to help keep your acidity levels down as this can contribute to cystic breakouts as well. Laser Acne treatments do work very effectively and can help address the discoloration. A less pricey option is spot treating with high frequency, and or LED blue lite stay away from abrasive type treatments. Salicylic acid helps to keep oils at bay but does not have an effect on cystic acne try spot treating with a betonite clay based mask leave on overnight will help form a head, and draw out impurities. In Good Health!View Thread