Common Acne Surgical Procedures

When turning to surgery is the right choice for your condition

Woman having a chemical peel treatment
Photo: John Burke / Getty Images

The word "surgery" conjures images of being wheeled into a surgical room where an anesthesiologist puts you to sleep and a surgeon performs invasive procedures. As relevant as this may be to certain types of medical conditions, acne surgery generally involves less invasive procedures performed not in a hospital but in an office setting.

The procedures aren't your first line of defense against acne. Rather, they're used to treat stubborn breakouts that aren't improving with other treatments. In most cases, you'll still use an acne treatment medication in addition to your acne surgery procedure.

All of these treatments can be done at your dermatologist's office as well as some medical spas.

Blemish Excision

Some blemishes are extra stubborn and don't want to respond to the medications your doctor has prescribed. In this case, your dermatologist may decide that blemish excision will be helpful. Excision is probably what most people imagine when they think "acne surgery."

Blemish excision is a simple in-office procedure in which a small incision is made on the skin to drain pus and debris from a pimple.

You will be awake throughout the entire time. The doctor may use a numbing agent to help dull the sensations and keep you comfortable.

Ideally, after the pus and comedonal core is cleared, the blemish begins to heal. The procedure itself may cause a slight scar, so you'll have to decide with your doctor if this is the right treatment for you.

Blemish Extractions

Blemish extractions are used to remove non-inflamed blemishes like blackheads and whiteheads (also known as milia). Extractions can also be used to drain pus-filled pockets, called pustules.

Unlike blemish excision, this procedure doesn't have to be done in a medical setting. An esthetician can take care of extractions for you at your local salon or day spa. Extractions are relatively painless, so you don't need any type of numbing agent or anesthetic.

Blemish extractions are often preceded by exfoliation to remove dead skin cells. The esthetician will then squeeze the pimple gently or press it a metal device called a comedone extractor.

Excision and extractions don't stop new breakouts from forming though. They only work on existing blemishes. You'll still need to use an acne treatment medication to get breakouts under control.

These procedures are best left to the medical professionals. Don't ever try to lance and drain any blemish, tiny or not. You open yourself up to infection and could easily scar your skin.

Laser Surgery

There are many different types of laser treatments. They type that is best for you depends on many factors, like your skin type and color, and what your ultimate goal is.

During a laser treatment, a high-intensity pulse of light is directed onto the skin. Depending on the treatment used, a laser can reduce inflammation and acne-causing bacteria, help existing pimples heal, and stimulates the skin to rejuvenate itself.

Lasers are used to treat both acne and acne scars. Some lasers need only one treatment to do the job, while others require a few treatments. Laser treatments are expensive and generally aren't covered by insurance.

Chemical Peels

Chemical peels are just as their name describes, peeling of superficial skin to improve skin quality. These peels gently exfoliate and have no downtime, although your skin may be a bit pink afterward. Superficial peels are best for treating mild acne.

Stronger, medium-depth and deep chemical peels are available at your dermatology office. There are different types of chemical peels, too. Your dermatologist will help you decide which is best for your skin.

Chemical peels involve an agent (such as glycolic acid, salicylic acid, or trichloroacetic acid) that is left on the skin for a period of time to remove the surface layer. This triggers the remodeling process as the skin starts to heal itself.

Over the next several days to weeks, your skin will flake or "peel" off, allowing the renewed skin to come to the surface. Just like laser treatments, chemical peels can be used to treat both acne and scarring.

Intralesional Injections

Intralesional corticosteroid injections, or what most of us simply call cortisone injections, are also often lumped into the acne surgery category. Cortisone injections are used to help shrink down large, inflamed blemishes. It is the same procedure used to treat painful, inflamed joints.

The dermatologist injects a small amount of cortisone directly into a pimple. It sounds worse than it is, the needle used is quite tiny. Over the course of a few hours, the blemish flattens out.

Cortisone injections are not considered a first-line treatment for acne but are rather used when a large pimple fails to respond to standard treatments.

Once completed, you will still need to use a regular acne treatment to get the skin problem cleared up.

A Word From Verywell

These professional acne treatment procedures can be a good jump start or addition to your acne treatment routine. But, in most cases, these procedures should be treated as a complement to your acne treatment, not the sole acne treatment.

Talk with your dermatologist and see if any of these acne surgery options are good additions to your treatment routine if you're interested. Just remember, these are not magic bullets to treating acne, but rather another tool that your dermatologist has in the acne-treatment arsenal.

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