Should I wait for more healing after an acne cyst or should I do it now so that I can help remodel the scar? (Photos)

Question

I am currently healing from a large acne cyst on my cheek that got infected. It has been empty and healing for the last week, but has left me with raised scarring with a pit in the middle. However, I have seen a lot of improvement in just a week and have been using a silicone sheet almost 24/7. There are no longer any signs of infection or inflammation, just looking for how to minimize scarring.

Nelson Lee Novick, MD · Answer

From the photos, it is difficult to be sure whether what you were calling a large acne cyst was indeed an acne cyst or an inflamed or infected epidermoid (sometimes referred to as a "sebaceous" cyst), which can be confused with an ordinary acne cyst. It would be wise to have the site evaluated by a dermatologist. If an epidermoid cyst, the cyst wall is likely to still be inside, meaning that recurrence and further tissue damage is possible. And if this is healing from a large acne cyst, it has been shown that early intervention may minimize scar formation or even eliminate it entirely, especially if done between weeks eight and twelve following the cessation of active inflammation. Best of luck

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

YES this should be treated now I would remove this surgically but If you are unwiling, vbeam laser would be a good start twith at home cosmelan peel and dermarolling.  other lasers can be combined for your antiaging benfit like halo or clear and brilliant, but if the cyst remains it can always actup.  see link to emeragecosmetics.com.  Best, Dr. Emer.

Should I wait for more healing after an acne cyst or should I do it now so that I can help remodel the scar? (Photos)

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Should I wait for more healing after an acne cyst or should I do it now so that I can help remodel the scar? (Photos)

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