Is Acne surgery a good choice for severe acne? What options do I have to severe acne?

Acne surgery (Dr Young of Bellevue, Washington) typically means when a physician or assitant opens up an active flare of acne to express inflammatory fluid to prevent further infection and damage.  This is used to when the acne has already reached the infective stage.  The key is preventing this progression.

A couple ideas could help.  You can take a food diary and find out what foods are causing the outbreak.  The way to do this is to try to eliminate all of your foods for a week or so by just consuming protein non allergenic drinks.  Then once all of the food allergens are out of your system you can introduce one food at a time that you normally eat and then record sensations like tingling to your face or more breakouts that seem to correlate.  I have found many foods to correlate with acne.  Then avoidance is the next step.

You should definitely be on a cleaning regime with salicylic acid cleansers and toners.  Also at home glycolic peels could help as well with this.  A retinoid is always recommended and a 3rd generation retinoid like adapalene could be less irritating, can decrease the inflammation, is keratolytic and has some mild antimicrobial activity.  When you want more antimicrobial activity, topical and oral antibiotics can really help.  And for the other category of sebosuppressive you will need to add an oral retinoid, accutane, or oral contraceptives.

I usually always suggest a salicylic acid cleanser and toner, I add a retinoid and usually adapalene.  If they are resistant to this then I consider topical antibiotics like clindagel for breakouts. For more severe breakouts I will do oral clindamycin, or one of the tetracyclines.  If after three months of not responding to also oral and topical antibiotics I then consider oral accutane.

Other choices include oral contraceptives, and testosterone binding medications like spironolactone, flutamide, cyproterone and testosterone enzyme blockers like 5 alpha reductase.

From a procedural standpoint, serial chemical peels can help but it could also worsen the acne.  The only way to determine whether they will work is to see how they individual affect your acne.  Choices include tricholoroacetic acid, jessner’s, and glycolic peels.

Here is a live demonstration video of an Acne Treatment Procedure.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

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