Acne is a common skin condition that can cause blemishes to appear on the face and other parts of the body. Treatment typically involves medical therapy with topical and oral medications. However, acne surgery may be an additional option to help maximize the effectiveness of acne treatments.

Acne is a common inflammatory skin condition. It affects nearly 90% of adolescents worldwide and can also occur in adults. Typically, treatment will depend on the type and extent of acne but it tends to include topical and oral medications to help relieve symptoms. In some cases, a doctor may suggest surgical options in addition to primary therapy when medications are insufficient or ineffective.

In addition to treating active acne, some people may also receive surgery to treat post-acne scarring. Options can include excision, laser surgery, and injections. While these treatments can help improve skin appearance, they also carry risks and can cause skin irritation.

This article discusses various types of acne surgery and provides tips for acne-prone skin.

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Acne is a common skin condition that occurs when pores in the skin become blocked and inflamed. It typically occurs on the face, chest, and back but can occur in other areas. Usually, a dermatologist will help treat acne.

Acne is the result of several different factors. Often, it occurs due to hormonal changes causing oil-producing sebaceous glands in the skin to become larger and overactive. These glands normally empty the oil they produce onto the surface of the skin through pores. However, these pores can become blocked by keratin, a protein that forms part of the skin.

This combination of debris can trap bacteria that live on the skin and result in skin inflammation, known as acne. There are several different types of acne, including:

Acne surgeries refer to surgical procedures that people can receive alongside other treatments for active acne or to treat post-acne scarring. A dermatologist can use various techniques to help reduce the symptoms of acne and help improve the skin’s appearance.

While more research is still necessary, some evidence suggests that physical modalities, such as surgery, can be an effective acne treatment, particularly for acne resistant to other treatments. However, most dermatologists will typically prescribe topical and oral medication as initial therapy and may consider surgery as an additional treatment.

There are several different types of acne surgery. The type a doctor recommends will depend on what kind of acne a person has, as well as their medical history. A dermatologist can perform many of the procedures in their office.

Acne scarring is a common complication that many people may experience, particularly when delaying treatment for active acne. Evidence suggests that surgical treatments are an effective option to provide satisfactory cosmetic results. A 2020 study adds that while it is difficult to achieve a complete resolution of acne scarring, combining different treatments can produce better outcomes for all people of different skin tones.

Some types of acne surgery include:

Incision and drainage

A dermatologist can perform an incision and drainage procedure to treat a large pimple, painful cyst or nodule. It involves creating a small opening in the blemish with a needle or surgical blade. The dermatologist can then apply a small amount of pressure to drain the contents, reducing pain and swelling.

Blemish extraction

Blemish extraction is a treatment dermatologists perform for blackheads and whiteheads. It may be tempting for some people to squeeze these blemishes themselves, but this can cause more damage. Using sterilized tools, a dermatologist gently applies pressure on the blemishes, pushing their contents out of the follicle.

Laser surgery

Laser surgery works by penetrating layers of the skin and eradicating acne-causing bacteria. The heat from the laser may also cause selective destruction of blood vessels that supply oxygen to the glands that produce oil, lowering oil secretion into the skin.

Some types of laser surgery include:

  • pulsed dye laser
  • intense pulsed light (IPL)
  • infrared laser
  • various wavelengths of visible light such as blue light

In a procedure known as photodynamic therapy, the dermatologist applies a photosensitizer to the skin before the laser treatment. This makes the acne-prone skin more sensitive to light and can increase the effectiveness of the procedure.

A 2016 study on nonantibiotic treatments for acne found that IPL was the most effective at clearing acne, with a 90% decrease in acne, although this took multiple sessions. A 2022 review of laser treatment found that pulsed dye laser surgery, especially procedures that use a longer pulse time, could significantly decrease acne, especially when treatment consisted of four or more sessions.

Results from laser surgery can vary. To help achieve the best results, a person should follow their dermatologist’s instructions.

Injections

Corticosteroid injections, or intralesional steroid injections, can be an effective treatment for reducing the size and inflammation of acne blemishes. A dermatologist may use this for large and painful cysts and nodules that other treatments have failed to treat. The injection will flatten most inflamed acne in 48–72 hours.

Chemical peels

Chemical peeling is a procedure that resurfaces and exfoliates the skin. The procedure may be a superficial, medium, or deep peel. A dermatologist will select the most appropriate peel for a person. The chemical peel treats acne by promoting the shedding of the skin, which can then begin to heal. It also decreases oil production and pore size, as well as reducing inflammation and bacteria in the skin.

Recovery time can vary depending on the depth of the chemical peel, with the skin initially being red, followed by a phase of the skin peeling.

Cryotherapy

Cryotherapy is a procedure that involves the application of a cold liquid, usually liquid nitrogen, or carbon dioxide, to the area of acne. How long the liquid is in contact with the skin will depend on the type and size of acne. The liquid promotes superficial peeling of the skin and can reduce inflammation in blemishes such as papules, pustules, cysts, and nodules.

A 2019 study found that, with an average of three cryotherapy sessions, people experienced a 90% clearance of their active acne.

While many acne surgeries are relatively minor and a doctor can perform them in-office, there are still associated risks. Some potential risks of acne surgery may include:

  • redness, burning, and blistering, although this may be part of the healing process for that surgery
  • infection, especially if a person has an immunocompromised immune system or they do not follow appropriate aftercare
  • pigmentary changes, which is more likely to occur in people with a darker skin tone
  • scarring in the treated area

Each type of surgery may be more associated with certain risks. Individuals may wish to discuss the benefits and risks of a procedure with their dermatologist to find what treatment is right for them. By following their dermatologist’s steps before and after surgery, a person can reduce the chance of adverse effects.

If a person is experiencing ongoing acne, lifestyle changes they can make to help avoid breakouts can include:

  • avoiding touching the face
  • washing the face twice a day and after sweating
  • allowing the skin to heal on its own and avoiding picking or popping any blemishes
  • shampooing the hair regularly if it is particularly oily
  • avoiding the use of too many products, instead trying one product at a time and allowing 4–6 weeks to work

Acne can be difficult to manage and may require a combination of multiple treatments to experience results. Persistent acne can cause significant emotional distress and affect a person’s day-to-day life.

If a person finds it challenging to manage their acne, or if it is painful, leaving scarring, or affecting their mental health, it is advisable to contact a dermatologist for support and treatment.

Acne affects many adolescents but can affect a person of any age. In cases where first-line treatments such as topical and oral medications are not effective, acne surgery may be an effective additional treatment. The results can vary from person to person and people may only notice results after several sessions. A dermatologist can advise what types of surgery may be suitable to treat a person’s acne.