[Acne] How do you know when you should get a returning acne cyst removed VS left alone?

I posted about my acne cyst in this sub a few days ago & got SO many helpful suggestions, but my post was taken down :/ Anyways, I have a MASSIVE acne cyst on my cheek that has been there for over a month now. Got it injected twice and it’s still very much there.

I am going to go to the derm again anyway, so he will give me a course of action, but what are the signs a cyst should be removed vs left alone or injected?

Many people say a cyst will keep returning if the sac is not removed — but why do so many people have cysts successfully injected, making them go away in a matter of days? I have had hormonal / cystic pimples and they all eventually go away on their own. Why isn’t this one? And why isn’t my cyst responding well to injections?

I will say the second round of injections flattened it a lot, but I am afraid it won’t go away because its still a bit inflamed and i can still very much feel it under my skin.

I’ve also been on spiro 75 mg for 10 weeks now and my purge seems to be clearing, except for this cyst!