Cystic acne is common and difficult to treat. It is easy to improve cystic acne some, but to get it 70% or more better takes a lot of work, for both patient and doctor. Doing this without Accutane is challenging. We see here a pretty young lady with cystic acne. In the 3.5 months prior to this video she has had acne cyst drainage 3 times, a chemical peel and a PDT (photodynamic therapy). The before and after pictures at the video’s end were taken before and after these therapies and before this video of the 4th acne cyst drainage was filmed. Herein I perform her 4th acne cyst drainage and we ask her about her progress. The before and after pics in the last 30 seconds of the video show excellent improvement in just 3.5 months. She will improve further as drainage and PDT therapies are ongoing.