A majority of the available treatments act by either killing bacteria or by breaking down the debris and oil which causes the development of cystic acne pimples. Some people may also choose to take counseling since the used treatment usually takes a lot of months to be effective. Since these cystic acne lesions do not disappear immediately, many people are known to have issues of body image, lowered self-esteem, and others report that they undergo social isolation as well as limitations of social activity. As a result, some of the effects of such emotional stress seen in many people suffering from cystic acne are heightened levels of anxiety, panic attacks, a lot of anger, depression as well as frustration.