Acne Surgery for Brown Skin

I have acne scars (kind of bulges) all over my nose and on my chin. I got the pimples when I was in my teenage and they stayed for ever on my nose leaving as bulges. It is making me looking worse. What kind of surgery helps me to remove these bulges and have a clean nose. I an 25 years old Female Asian origin. Will laser surgery help me to remove the acne scars or bulges. Your response is greatly appreciated.

Doctor Answers 13

Acne and acne scar treatments

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It is unclear from your photo whether these are scars or still active acne on your nose.  So we will approach the question in two parts:  In both parts, I am presuming you have no health conditions that would prevent you from getting these treatments and that you are not pregnant or trying to become pregnant.  To determine whether these are scars or still active acne, I recommend you see a board-certified dermatologist for an evaluation.

1. Cystic acne treatments:

  • Stop all milk and dairy products.  Milk and milk products, regardless whether organic or not, contain hormones, like growth hormone, anabolic steroids, androgens, etc, all of which will contribute to cystic acne.
  • Tell your doctor about your family history of acne and your personal history of menstrual irregularities or other health problems.
  • Medications that may improve cystic acne are oral antibiotics, anti-androgens, like spironolactone, and isotretinoin (Accutane). 

2. Acne scar treatments: 

  • Atrophic acne scars can be treated with fractional laser resurfacing with excellent improvement.  Usually that is done after the active acne is under control. 
  • If a person takes Accutane to treat acne, fractional laser resurfacing of acne scars should be done no earlier than 24 months after Accutane treatment is completed, as Accutane may contribute to excessive scarring within the first 24 months after treatment.
  • Usually a fading cream and broad-spectrum sunscreen need to be used for one month before and one month after the procedure to minimize hyperpigmentation after the procedure.
  • Strict sun avoidance and sun protection must be practiced daily.
  • For individual depressed acne scars, dermal fillers may be used for correction.
  • For hypertrophic or keloidal acne scars, injections of intralesional Kenalog (a corticosteroid anti inflammatory medication) can help smooth out the scars.


Short Hills Dermatologic Surgeon

Melarase creams and Ematrix for acne scars

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My office has many options for acne scar treatment without laser including Ematrix. Ematrix is ideal for acne scars without the added risk of pigmentation. In any case, I would suggest using Melarase creams before your procedures. 

Dr. Karamanoukian 
Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

The non-ablative fractional lasers will help here

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Thanks for the question and the photo. You need to have your skin evaluated by a board-certified dermatologist or plastic surgeon to first diagnose what we are dealing with now with your skin. If these bulges have been persistent for some time, laser surgery will most likely be the treatment of choice. The lasers we would choose would be of the fractional type.The non-ablative fractional lasers will help here, and will require a series of treatments, with minimal downtime to give some very nice results. Four to six treatments over 4-6 months is usually required and many of the scars will improve. The ablative fractional lasers work faster, but have more downtime. Sometimes more than one treatment is needed with your kind of scarring. There are many kinds of ablative fractional lasers – we use mainly the Lumenis UltraPulse or AcuPulse, the Ellman Cortex, and the Syneron Core. We also have the sublative RF fractional devices, the Syneron eMatrix and the Venus Viva that has shown great results in treating acne scars. We did a lot of the FDA work with the eMatrix and use it regularly in our clinic. The new Venus Viva is showing similar results. And now there are RF microneedling devices, such as the EndyMed Intensif, and this also works well with these kinds of scars.

Having said this, the evaluation of your skin is most important to determine if your bulges are scars or something else. And don’t be concerned about your skin color – most lasers and light sources of today are fully tested in Asia as they represent a bigger and bigger part of the laser sales around the world – so they have to work and be safe in darker skin types. Your physician will pre-treat and post-treat you with an appropriate skin care routine to minimize any potential pigmentary concerns post procedure.

Michael Gold, MD
Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Laser can help... read more.

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This is a very common condition that we come across, the lumps and bumps are soft right? This is due to a lack of collagen in the area and leads to hernation of the skin- causing bulges. Conditions like acne and granulomatous rosacea can lead to this. 

Laser resurfacing can help. I would consider CO2 Fractional at max settings BUT conservative coverage. You will need at least 4-5 sessions. This should improve things by 50-70%, depending on how much collagen we can stimulate. 


Dr Davin Lim 
Laser and cosmetic dermatologist
BRISBANE, Australia

Treatment of acne scars on brown skin

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If you truly have acne scars, the treatments options would mostly likely include chemical or laser peels (based on your photo).  Make sure that you have gotten your acne under control so that you don't start getting new scars.  The best option is to find a board-certified dermatologist.

Dina D. Strachan, MD
New York Dermatologist

Treating Acne on Brown Skin

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I would suggest the Elos Laser Acne treatment for your acne. This treatment works by combining Bi-Polar Radiofrequency and Blue Light energies to penetrate the skin to precisely target and destroy active acne-causing bacteria, while simultaneously slowing excessive sebaceous oil production. Treatments help to reduce active acne and speeds up healing time. Elos Laser Acne treatment is effective in all skin types and the number of treatments depends upon the severity of acne. Treatments are made comfortable by the placement of topical numbing creme, with further comfort provided by cooling the skin surface. There is no associated down time with treatments, and normal activities can be started immediately the procedure is performed.

The picture looks like active acne still!

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The bumps on the nose appear like active acne papules / rosacea. LASER would be a good choice, as also ablative radiofrequency. You can also consider a TCA peel. A course of Isotretinoin may also be considered if you keep getting these bumps. Make sure to use a non comedogenic sunscreen, and a salicylic acid based facewash would be helpful. If you have dandruff, that needs to be treated as well. 

Treating Acne Scars on Darker Skin Types

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Without a picture it is difficult to know exactly what you mean by "bulges" related to prior acne.  Typically acne scarring comes in the form of depressions in the skin, not bulges; however, you can occasionally get hypertrophic (raised, thickened) scarring from acne.  There are many excellent treatments for acne scarring which include injectable fillers, chemical peeling, laser resurfacing, punch excision, punch grafting, and/or light electrosurgery.  The treatments selected depends on the nature of the scars and the skin type and color.  But it is very possible to safely and effectively treat acne scarring in darker skin types. I recommend you consult with a board-certified dermatologist experienced in treating acne scars. Click on the link below to look at before and after photos of patients with acne scars treated with injectable fillers and some resurfacing with light electrosurgery.

Channing R. Barnett, MD
Boca Raton Dermatologist
4.1 out of 5 stars 8 reviews

Scars, acne, acne scars, acne scars in brown skin

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This is a real tough question. Without a high quality picture, it is impossible to tell which treatment is best

Lasers are often the best answer

Barry Lycka, MD - Account Suspended
Edmonton Dermatologic Surgeon

Acne surgery for brown skin

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I agree that laser surgery, chemical peels, and dermabrasion may all be of benefit to you.  But I think you should know that while acne surgery will help a lot, the goal of treatment would be improvement, not a perfect, “clean” nose.  But don’t despair.  Certainly, there is help for your condition.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.