Cystic acne is a form of acne that lodges deep within the skin—the result of a clog of sebum, dead skin cells, and bacteria forming, which is the same as other acne types. Where cystic acne differs is in its severity and resulting appearance. Because the infection is deep, cystic acne appears as large red bumps, often without a visible whitehead, and they are painful when touched. This acne type can be the most frustrating to deal with and cause permanent scarring if you attempt to poke at it. Dermatologists advise getting personalized treatment plans for cystic acne to speed up healing and keep you from wanting to prod at the infection.