Pustular, sebum-packed acne: CO2 laser without scarring

Hello. This is Dr. Lee Yumin of MeSOnBom Clinic.

Acne is a source of stress for everyone, but from a doctor's point of view it divides into acne that is awkward to treat and acne whose course is clear and whose results are excellent.

What about the acne of teenage students, whose faces are dotted with sebum and whose skin looks severe at a glance, or the nodular acne set deep in the jaw?

They may look difficult to treat, but for a doctor they are the most rewarding cases, because the process of the skin clearing is so visible.

In today's column I want to set out the importance of the golden window for preventing acne scars, and the CO2 laser extraction and dual laser approach that clears stubborn sebum acne without scarring.

If acne is on your mind, please do read to the end.

The heart of acne treatment is blocking it at the sebum stage, before inflammation forms.

Acne scars do not simply come from accumulated sebum; they form when sebum festers into red, painful inflammatory acne and skin tissue is destroyed.

Sebum, food for acne bacteria: sebum is excellent food for the acne bacteria living on the skin. As they feed and multiply, they provoke a strong inflammatory response.

The warning of porphyrin: photographed with a UV diagnostic device, the skin shows glittering orange points. These are porphyrin, the by-product left as acne bacteria metabolise sebum. Many orange points mean sebum and bacteria are multiplying explosively beneath the surface — a time bomb that can turn into pustular acne at any moment.

So to prevent acne scars, the first task is to remove the sebum behind it completely, before inflammation worsens.

When removing sebum that has already hardened, or acne set deep, ordinary needle extraction has clear limits.

The sebum sits deeper than expected, so forcing it out damages surrounding tissue and readily produces a rebound in which inflammation worsens after extraction.

To prevent that, I prefer extraction using the CO2 laser.

Precise targeting: the CO2 laser makes a fine, deep opening exactly at the pore entrance.

Minimal damage: because a wide, deep channel is secured, even deeply embedded sebum or nodular inflammation comes away gently under light pressure.

Quick recovery: without the wound caused by forcible squeezing, the likelihood of scarring is markedly lower and the inflammatory response afterwards greatly reduced.

Having levelled the ground with the CO2 laser and removed the seed (the sebum), the environment itself must be changed so acne cannot grow back.

Using two lasers in combination gives a very good outcome here.

Apple Laser

Cell Acne Laser

For a final-year male high school student whose whole face was covered with pustular acne and sebum, we followed this systematic schedule.

Laser treatment (every 2 weeks): the Apple Laser and Cell Acne Laser were applied regularly to limit sebum production and bacterial growth.

Focused CO2 extraction (every 4 weeks): at each monthly visit, deeply embedded sebum and nodules were removed precisely one by one with the CO2 laser.

After several months of treatment, the orange porphyrin that had filled the UV images was noticeably reduced, the uneven texture settled and inflammation was clearly lower.

The hard nodular acne that had stayed on the jaw for a month or two at a time was also cleared with CO2 extraction.

If a student or young man has a face full of small bumps or firm inflammation, please do not leave it or squeeze it forcefully at home.

It may look severe, but with accurate laser assessment, proper extraction using the CO2 laser and appropriate care to suppress the sebaceous glands, the process of the skin clearing can be more visible than in almost any other case.

Having acne safely extracted with a doctor's help, before scars form, is the wisest way to protect your skin for life.

Please do come in for an assessment. Thank you for reading to the end.