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Surgical treatment of acne – Does it work?

Introduction and background

Surgery or other procedures can help improve the appearance of skin scarred by acne. Acne surgery involves making an incision into the affected area and draining the clogged matter. The process for blackheads and whiteheads doesn’t actually involve surgery, but is often performed by a nurse, esthetician or dermatologist. A small, pointed blade is used to first open the comedone and then gently work the material out using a comedone extractor.
Following types of surgery are used by cosmetic surgeons or dermatologists to help treat acne or prevent its complications such as scarring:

 

1- Excisional surgery

Severe cysts in acne can be drained and removed by a procedure known as excisional surgery. The procedure should be performed in a sterile environment to reduce the risk of spreading bacterial infection and should only be performed by trained professional. If the cysts are not carefully extracted, they can develop serious infection and create scarring.

 

2- Chemical peeling

Chemical peeling (where a chemical solution is applied to the skin that causes it to blister and eventually peel off) can reduce minor scars

 

3- Dermabrasion

Dermabrasion is a type of surgery that can remove surface scars and reduce the depth of deep scars. (a procedure that uses a rapidly rotating brush to remove the top layers of skin) can help more severe scarring. Laser resurfacing uses pulses of light to remove the top layer of skin and reduce scarring.

 

4- Laser

Acne laser treatment is small-scale laser surgery that is mainly performed either to treat severe forms of acne or to remove permanent acne scars. It focuses on two important goals:

• To target and eliminate the bacteria that grow in acne lesions
• To promote shrinkage of the overly enlarged sebaceous glands seen in acne
While laser treatment techniques for acne have become very popular as the high-tech, non-invasive approach sought by so many patients, they have their own share of weaknesses and limitations such as:

Pain & discomfort: Many patients say each laser pulse feels like the sharp needle burst against the skin, though treatments over active acne may be even more uncomfortable.
One treatment may not work: In many cases, the first treatment is not completely effective. Therefore, subsequent laser procedures are required which not only increase the patient’s discomfort but also become increasingly expensive. Clinical data suggests that most patients find their acne will improve only after the completion of about four treatments, two a week for two weeks.
Plateau phase: While many patients continue to improve in the months following treatment, quite a few good numbers of patients experience a plateau in their improvement. Repeated treatments, therefore, may be necessary to maintain results.
Expensive: Acne laser treatment is one of the most expensive treatment procedures in the cosmetic practice. While the acne laser treatment cost can vary based on the treatment needed, for minor acne scars, the procedure can range from $500 to $600 for each 20-minute session. The cost could be substantially higher for severe case. You should also remember that it may take at least 4 laser treatment to see significant impact on your skin. Also, in most cases, it is not covered by your health insurance provider.

 

Photodynamic therapy

While not exactly a surgical therapy, Photodynamic therapy is a new acne treatment that is often associated with surgical or medical treatments of acne. It begins with light micro¬dermabrasion. This is used to remove dead skin cells on the face’s surface. Then, an acid is put on the skin for 30 to 60 minutes. After this period, the acid is taken off. Lastly, the skin is treated with a laser. This treatment is still being researched and is currently very expensive.

 

Problems with the surgical treatment of acne

Surgical acne procedures have led to a wide variety of poorly documented surgical techniques, with unconvincing results. It is, therefore, widely believed and accepted that acne treatment surgery of any kind is not risk free. While there have been many advances made over the last ten years, there have been also many lawsuits filed over the same.
Following is a summary of some of the major concerns and drawbacks associated with acne treatment surgery:

  • Infection
  • Bleeding
  • Perforation
  • Pain and discomfort
  • Increased hospital stays and time
  • Increased costs not covered by health insurance

Finally, it is always great to discuss all of the complications, risks and factors (such as high costs) that could arise after the surgery. Most skin health experts, therefore, recommend talking to your doctor about surgery strictly as a last resort, and really stress the “only as a last resort” part. There are quite a few good other “natural” options available that, if chosen wisely and carefully, can not only help treat acne but will also prevent its occurrence in the first place.

 

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