This kind of cystic acne is really damaging.
First the pore gets plugged. Then an infection develops behind the plug.
As the infection grows and the area swells, it breaks the capillaries (tiny blood vessels) around the pore causing blood to pool.
Ideally, the plug is removed before the blood begins pooling, but at this point, it just looks a deep pink and is tender to touch.
If there are multiple infected pores near each other, and each has a pool of blood, the pools will join up and blood has a larger pocket to fill. When there is a lot of blood collecting, the skin looks purple.
Adding to the problem – anytime blood is outside a blood vessel, the body rejects it as an irritant. Blood outside a blood vessel causes irritation and swelling. So these pools of blood cause more pressure so more capillaries break and more blood pools.
If you look at this fellow, on his left cheek, he has a bulge of purple near his jaw line. Gravity is pulling the blood from other parts of his face to pool at the bottom.
To heal this, first, the plugs need to be removed so the infection can be drained from the pores.
The pores need to be squeezed so the infection comes out. The pocket around the pore that is full of blood has to be squeezed too to drain off all the blood that is irritating and causing swelling. All of this has to happen so the capillaries can heal. Drainage has to happen over and over so the pockets dry up and the bleeding stops. At the same time new plugs have to be cleared out and infections have to be drained.
At home treatments could include a warm wet cloth dipped in salty water (water with salt, but not so salty that you can taste the salt) to draw out the infection). Lay the cloth over the face. The heat will open the pores. The damp will soften the skin, and the damp with salt will draw the infection by osmosis.
Then pat the skin dry. Never use hydrogen peroxide or rubbing alcohol on any open wound! Closed skin only when you are going to cut into the skin. Apply a topical antibiotic, or sweet almond oil with a drop of tea tree (melaluca) oil in it. One or the other, both of these will kill bacteria and prevent infection on all of the areas that were bleeding.
Daily cleaning with a gentle cleanser (not soap, no antibacterial soap or cleaning wipes) each morning and a daily check to remove new plugs (very clean hands or gloves and clean tools) and drain new infection and blood making each pocket as flat as possible followed by warm, damp cloth and antibacterial treatment.
Also a B vitamin supplement will be helpful with all of the blood loss.