Learn how to treat cystic acne from a real doctor. 1 Painful cystic acne must be treated from within, topical solutions don't work. 2 If you have cystic acne you can consult your doctor and get a prescription for oral antibiotics. A two - three week course of oral antibiotics should help. 3 If that does not work ask your doctor for Accutane to help cure your cystic acne.