Name of the Procedure:

Acne Surgery (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)

Summary

Acne surgery is a dermatological procedure used to treat and manage severe acne by physically removing acne lesions such as milia, comedones (blackheads or whiteheads), cysts, and pustules. It involves cleaning out blocked pores and may include techniques such as marsupialization, which creates a permanent open pocket for drainage.

Purpose

This procedure aims to treat severe or persistent acne that does not respond to conventional treatments like topical or oral medications. By removing the lesions, the procedure can reduce inflammation, prevent further scarring, and promote clearer skin.

Indications

• Presence of severe or cystic acne
• Failure to respond to other acne treatments
• Large, painful cysts or nodules
• Repeated formation of milia and comedones causing discomfort or aesthetic concerns

Preparation

• Patients may be advised to avoid certain medications such as blood thinners.
• They should clean their face thoroughly before the procedure.
• A topical or oral antibiotic may be prescribed to prevent infection.
• No fasting is generally required.

Procedure Description

1. The area to be treated is sterilized.
2. For marsupialization, a small incision is made, and the cyst is drained, creating an open pocket to allow for continuous drainage.
3. For the removal of milia, comedones, or pustules, a sterile needle or surgical blade is used to carefully open the lesion.
4. The contents of the lesion are then extracted using gentle pressure or special extraction tools.
5. The treated area is cleaned and may be dressed with an antibiotic ointment to prevent infection.

Duration

The procedure typically takes around 30 minutes to an hour, depending on the number of lesions being treated.

Setting

Acne surgery is commonly performed in an outpatient dermatology clinic or a medical office.

Personnel

• Dermatologist or trained healthcare professional
• Nurses or medical assistants for support

Risks and Complications

• Infection at the site of the procedure
• Scarring or changes in skin texture
• Temporary redness or swelling
• Pain or discomfort during and after the procedure

Benefits

• Reduction in acne severity and prevention of further breakouts
• Immediate relief from large or painful cysts
• Reduced risk of acne scarring when compared to untreated severe acne
• Clearer skin and improved appearance

Recovery

• Patients may experience mild discomfort or swelling for a few days.
• Aftercare includes keeping the treated area clean and avoiding picking at the skin.
• Patients may be prescribed topical or oral antibiotics to prevent infection.
• Follow-up appointments may be necessary to assess healing and overall skin condition.
• Most patients can return to normal activities immediately but should avoid strenuous activities that may cause sweating for a day or two.

Alternatives

• Topical treatments such as retinoids or benzoyl peroxide
• Oral medications including antibiotics or isotretinoin
• Non-invasive procedures like chemical peels or laser therapy
• Each alternative has its pros and cons; for instance, medications may take longer to show results but involve less immediate discomfort.

Patient Experience

During the procedure, patients might feel slight pressure or discomfort, especially if the lesions are deep. Local anesthesia may be used to minimize pain. Post-procedure, mild pain or tenderness could be present, but it can be managed with over-the-counter pain relievers. The treated area may look red or swollen briefly but will improve in a few days, leading to clearer skin and relief from painful acne lesions.