Refractory cystic acne is caused by follicular inflammation, abnormal keratinization, and hyperproliferation of Cutibacterium acnes, manifesting as deep cysts, pain and scars. Existing treatments (such as isotretinoin, antibiotics, etc.) have limited efficacy in some patients, with issues of drug resistance or adverse reactions. Topical medications, due to insufficient permeability, are difficult to penetrate deep into the lesion, affecting treatment effect. As a potent glucocorticoid, triamcinolone acetonide has shown unique value in the interventional treatment of refractory cystic acne in recent years, owing to its antiinflammatory, immunosuppressive and anti-proliferative properties. Through intralesional injection, triamcinolone acetonide can rapidly inhibit the release of inflammatory mediators, reduce tissue edema, promote cyst regression, and simultaneously reduce the risk of scar formation. This paper reviews the application progress of triamcinolone acetonide in the cosmetic treatment of refractory cystic acne, aiming to provide an evidence-based basis for clinical practice.