Acne, is Surgery my Only Option? (photo)

I have tried all sorts of prescribed gels, creams and tablets from the dermatologists and it has not worked! I have also tried simple, clinique, Zenmed, Neutragena, clearsil and proactive products but nothing has worked! I have had this problem since I was 14. I do suffer from PCOS and I am wandering if surgery is my only option? I also have chicken pox scars on face and was wandering if theres any treatment available for them?

Doctor Answers 11

Acne surgery and Pox scars

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Yes, surgical excision of your pox scars would do well. You would trade a bad scar that can not be covered with makeup for a better one that can be covered with makeup.

Gainesville Plastic Surgeon
4.9 out of 5 stars 32 reviews

Acne, is Surgery my Only Option?

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It's very difficult to get rid of the scars but they can be improved. Fractora is a radio frequency based treatment I use that can help improve the appearance of acne scarring and help stop active acne as well. The only way to know for sure if this will work is to book a consultation with a board certified plastic surgeon that uses Fractora near you. Best of luck!

Mathew A. Plant, MD, FRCSC
Toronto Plastic Surgeon
4.9 out of 5 stars 40 reviews

You do have acne and this needs to be treated by a board-certified dermatologist

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Thanks for your question and thanks for including the photos as well. You do have acne and this needs to be treated by a board-certified dermatologist to maximize the care you are receiving. Acne medicines work – they must be matched carefully and skillfully to treat all the different types of acne on the face – the white heads and black heads as well as the papules, pustules, and cysts. We also can use lasers or light sources here to improve the skin – such as the Solta Isolaz or the Aerolase Neo.

Once the acne is better, you can treat the scars you have with a variety of energy based systems. Thiswill include the use of fractional lasers.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.

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

2 problems to deal with

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You have 2 completely different problems. 
Firstly, you need your acne treated by a Specialist. Your PCOS may have a contributing role in acne, bottom line- see a Dermatologist for effective treatment. 

Secondly, you have chick pox scars, my suggestion is a filler as there is no downtime, and will not scar. Most chicken pox scars are saucer scars and atrophic, so subscion will not work. Once again, consult either a Derm or Plastics for this. 

Hope this helps

Dr Davin Lim
Laser Dermatologist
Brisbane, Australia

Treating active acne and acne and chicken pox scars

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Thank you for your question.
  • You need to be a Board Certified Dermatologist or Plastic Surgeon interested in acne for a complete evaluation.
  • There is no miracle treatment - you need a long term step-by-step plan.
  • First, control of the PCOS will help.
  • Treating active acne is next - and may take antibiotics as well as other products.
  • Treating sunken scars may take filler and/or surgery.
  • Resurfacing with laser or peels is next - the specific laser or peel depending on your budget, your goals and your skin response.
  • Best wishes.

Acne and Acne Scarring? Is surgery the only treatment

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The lighting in the picture is low and hard to tell if the acne is active or a long standing thing. That would make me approach this differently. Medical treatment would be my choice for active acne and surgery for long standing acne and acne scarring.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Treatment options for acne and acne scarring

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Thank you for your inquiry.  I believe you have 2 separate and related issues.  The first issue is acne which may well be related to your underlying PCOS.  This most likely should be treated medically.  The second issue is your acne scarring.  There are no topical treatments such as creams, lotions, ointments that will make your scarring better. .Without examining you, it is difficult to make firm recommendations for treatment options.  Based on the photographs you supplied, it appears that a combination of laser and subcision may be appropriate.  However, I will emphasize that an actual treatment plan cannot be made without examining you.  Good luck!

Brian Biesman, MD
Nashville Oculoplastic Surgeon
4.8 out of 5 stars 43 reviews

Acne and PCOS

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If you have PCOS there may be hormonal options like Sprinolactone or Birth Control Pills.  The current acne scars can best be treated with lasers, either Fraxel or Ematrix.  If you are type IV or darker complexion I would definitely recommend Ematrix.  If you have a lighter skin type I would have Fraxel performed for the scars.  Be certain to find a board certified dermatologist with experience in cosmetics and medical dermatology for the best results.

Acne Scarring

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Thank you for your question. Fraxel treatment eliminates irregular skin discoloration, and stimulates new collagen production, tightening the skin without prolonged recovery. After a series of 2 to 4 Fraxel treatments, the cumulative cosmetic improvement is near more aggressive lasers, but unlike more aggressive lasers, redness and swelling eliminated within 2 to 4 days after each treatment.
Fraxel is outstanding for fine wrinkles, mild skin laxity, irregular pigmentation, acne scars, surgical scars, enlarged pores, stretch marks, age spots and Rosacea. It can be used safely on the face, neck, hands, arms, and chest. Fraxel is a great first option before resorting to more intensive options.

Acne Scars

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Presently, there are no topical home remedies to remove acne scarring. Acne scarring can be improved by laser resurfacing , surgical dermabrasion and fractional radio-frequency treatments. It is recommended to be evaluated by a plastic surgeon to discuss your options.

Craig Mezrow, MS, MD, FACS
Philadelphia Plastic Surgeon

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.