Topicals
Dr. Ly may prescribe topical creams, gels, or lotions with vitamin A acid-like drugs, benzoyl peroxide, or antibiotics to help unblock the pores and reduce bacteria. These products may cause some drying and peeling. She will advise you about correct usage and how to handle side effects.
Acne Surgery:
This procedure greatly speeds acne clearing and appearance by manually removing blackheads and whiteheads. A round loop extractor is used to apply uniform smooth pressure to dislodge the material. Lesions that offer resistance are loosened by inserting a pointed instrument to carefully expose the contents.
Do not pick, scratch, pop, or squeeze pimples yourself. When the pimples are squeezed, more redness, swelling, inflammation, and scarring may result.
Intralesional Corticosteroid Therapy
If one or several painful acne cysts develop, fast relief is available with this relatively painless procedure. Each cyst is given a single injection of a dilute cortisone solution, using an ultrathin needle.
Accutane Therapy
In 1982 a new oral medication, isotretinoin (Accutane), became available for the treatment of patients with severe acne not responsive to conventional treatments. The duration of treatment is usually 5 months, and one such course is often curative of acne forever. Use of this medication does require a thorough understanding of its side effects and precautions (e.g. the prevention of pregnancy).
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Treatment Of Acne Scarring
Prior to correcting acne scarring, it is generally advisable to wait until acne activity has been low or absent for several months. Scars improve with time as the body softens their appearance. The color contrast is often the most troublesome aspect of resolving large acne blemishes. These lesions may leave a flat or depressed red scar that is so obvious, patients mistake the mark for an active lesion. The color will fade and approach skin tones in 4 to 12 months. Many patients are self-conscious about the pitted and crater-like scars that do not fade. These remain as a permanent record of previous severe acne. Cosmetic Surgeons offer a variety of procedures to remove or revise these marks:
Punch Excision And/Or Grafting
Some narrow pitted scars are too deep to be removed by laser resurfacing. These can be removed with a surgical instrument called a punch. The resulting defect is closed, either primarily or with a tiny skin graft, with gratifying results. Sometimes this procedure is followed by chemical peel or laser resurfacing for patients with a mixed type of scarring.
Collagen Implantation
Patients with a few soft depressed scars with smooth edges respond well to collagen. This natural protein is injected under the lesion to elevate it to the level of the skin.
Soft Tissue Augmentation With An Injectable Filler
Injections with Collagen, Restylane®, and RadiesseTM are good treatments for shallow and deep acne scars. These fillers can be injected into the area of the scar, smoothing depressions. Results are immediately apparent. Patients usually require touch-up treatments every 6 months to 2 years.
Microdermabrasion
Microdermabrasion can be likened to a superficial "skin polishing" using micro-crystals vacuumed over your skin's surface to remove damaged skin cells. These gentle treatments can provide noticeable improvement to acne scars. The treatments are progressive and are applied through a course of weekly sessions.
Non-Ablative Laser
Non-Ablative Laser Treatments do not require anesthesia, as they are not painful and there is no downtime. Most patients receive a series of about 5 treatments. Depending on the type of acne scar, improvement can be dramatic. The improvement is gradual and continues to improve even after the treatment stops.
Laser Resurfacing
More prominent scarring from acne is best treated by this technique. The top several layers of skin are removed with this high energy light. This action evens out the skin to give it a smoother, more pleasing contour.
Laser Resurfacing gives your physician precise control as the procedure gently vaporizes the damaged or acne-scarred skin to reveal the smooth, fresh skin underneath. Scars are removed in a precise, rapid, bloodless fashion achieving excellent results. Laser scar removal can be performed with local anesthesia if limited areas are treated, while full face resurfacing is usually performed with the administration of intravenous sedation by an anesthesiologist. Both procedures may be performed in your doctor's office.
A FINAL WORD
Treatment of acne is a continuing process if the disorder is to be controlled successfully. You must follow your Dr. Ly's instructions, since you are the only one who can accomplish the necessary daily care. If you are willing to spend the time and extend the effort.