Acne surgery is a term commonly used in the United States to describe various surgical approaches to the treatment of certain acne complications. The simplest form is the application of liquid nitrogen via a roller or swab to the affected areas. This is a very cold liquid which effects a mild burn and peeling results. If there are large, single blocked pores, these may be expressed with a special comedone extractor. If there should be large cysts or scars, these may be injected with steroid preparations which promote shrinkage and healing. If there is residual disturbing scarring after the condition has become quiescent, then dermabrasion may be useful.
Dermabrasion involves planing the skin to a smooth consistency, using a diamond chip disc rotating extremely fast. This is attached to a hand-held electric apparatus like a dental drill. It can be done in a dermatologist’s office, using an appropriate local anaesthetic spray which also freezes the skin to make it firm to work with. This procedure is limited to severe and well-localized scarring, but should not be performed during the active stage of the condition. It does not require hospitalization, and the patient is usually able to return to normal activities within ten to fourteen days.
Superficial X-ray therapy used to be a form of treatment but is not generally recommended nowadays.
Squeezing or picking the ubiquitous pimple is certainly in advisable. Injudicious interference will possibly result in expressing most of the infective material, but some will invariably be pushed deeper, causing continuing problems. Furthermore, as a result, healing is prolonged and scarring a common consequence.
The place of diet in the management of acne is still controversial. This is due mainly to the difficulty of running a well controlled, matched, double-blind trial. However, in practice, many patients derive considerable improvement from avoiding certain derivatives of the cocoa bean, including chocolate, cocoa, cola and also coffee. Similarly, iodized salt and bromides frequently aggravate the condition. Yet there seems to be no evidence to implicate high fat, sugar-containing or milk-based foods.
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