Acne Treatment Explained Clearly: Medication, Extraction, Laser, and Inflammation Injections

Hello. I am Lee Sang-ju, a dermatologist with 23 years of experience researching skin.

Acne, once considered a symbol of adolescence, has recently become common among adults due to prolonged mask-wearing and fine dust. Acne is a chronic disease with frequent recurrences, so while temporary treatments like medication, anti-inflammatory injections, and extractions are certainly helpful, many people are seeking more fundamental treatments. Today, we will address various questions related to acne one by one.

There are cases where chin acne is squeezed but no sebum comes out, acne cream doesn't help, and it actually gets bigger. If the sebum in the acne is too deep, it may not extract well. Trying to force it out can worsen inflammation and make it larger, so it is advisable not to forcibly squeeze acne that doesn't come out easily and to visit a clinic for treatment.

Seasonally, some people's acne worsens in summer, while others' worsens in winter; there are individual differences. Some people say that summer UV rays have a positive effect on acne, but seasonal changes vary from person to person, so it's important to manage your skin according to its condition. In particular, dry skin can also be a cause of worsening acne, so applying a small amount of moisturizer to keep the skin hydrated can be helpful.

There are various theories about the relationship between acne and food, and there is no definitive answer yet. Generally, eating spicy food does not cause acne in everyone, so you don't need to worry too much. Parents might tell you not to eat ramen or fried chicken, but that means there's no single right answer.

However, spicy food is not good for facial redness, which causes the face to flush easily. If you have facial redness, it is best to avoid spicy and hot foods.

Many people mistakenly believe that their skin becomes pitted after acne extraction. However, acne extraction itself does not actually cause pitted skin. It's easy to think that it's due to improper extraction when acne is very large, but it's more accurate to see it as severe inflammation leading to scars.

Acne starts in the pores, which are shaped like jars. When extracted, sebum is discharged through that hole, so it does not damage the surrounding dermis. However, if inflammation is severe, the jar-like pore walls may already be damaged. In such cases, it can lead to scars regardless of extraction. In this situation, it is advisable to calm the inflammation with anti-inflammatory injections.

Why do anti-inflammatory injections vary in effectiveness?

Even with the same acne anti-inflammatory injection, the effectiveness can vary depending on the practitioner or the type of acne.

• Acne type: It is effective for large, red, inflamed acne, but for non-inflammatory types like whiteheads, significant effects may not be expected.
• Appropriate treatment: It is not advisable to inject very small acne, or to force an injection when inflammation is too severe to be helped by the injection alone.

Whether extraction is possible after an anti-inflammatory injection is case by case. If the inflammation is too severe and there is pus, aggressive extraction should be avoided, but if the inflammation is not severe, extraction can be done carefully. It should be understood that there are appropriate treatments for each situation: some acne benefits from extraction, some from anti-inflammatory injections, and some from topical medications.

Recently, Gold PTT and Agnes are frequently mentioned as acne treatments at clinics. The main causes of acne are excessive sebum and acne bacteria, and these two treatments can help address these causes.

What is Gold PTT treatment?

Gold PTT involves applying Gold PTT particles to the skin, which then penetrate into the pores. When a laser is then applied, the particles generate heat inside, destroying surrounding acne bacteria and sebaceous glands. By reducing excessive sebum, which is the cause of acne, it is effective in improving acne and can help reduce recurrence through fundamental treatment. It also has the advantage of minimal disruption to daily life. Especially for oily skin with high sebum secretion, Gold PTT treatment can lead to long-lasting sebum reduction and overall complexion improvement.

How does Agnes treatment differ from Gold PTT?

Agnes treatment can be thought of as insulated needle treatment. An insulated needle, similar to a syringe needle, is inserted into the skin, and heat is generated at the tip of the needle to selectively destroy sebaceous glands one by one. Inserting the needle to treat severe inflammatory acne is effective in reducing inflammation. However, it has the disadvantage that it is difficult to treat countless pores across the entire face individually.

On the other hand, when Gold PTT is applied to the face, the particles travel down the pores, making it potentially more effective in overall reduction of not only existing acne but also future acne and sebaceous glands. Therefore, if you are concerned about severe acne in one or two spots, Agnes treatment may be more suitable, while if you want to manage acne and sebaceous glands across the entire face, Gold PTT may be more appropriate.

Many people are stressed by acne constantly appearing in the same spot. There are two main ways to prevent acne recurrence.

• Long-term medication: This method involves long-term use of sebum-suppressing drugs such as isotretinoin. For example, for a person weighing 60kg, consistently taking 6 pills a day for more than 4 months to reach the cumulative dose is known to significantly reduce acne recurrence. While taking high doses for a long period does not guarantee 100% acne prevention, about 9 out of 10 people can expect a significant reduction in the frequency or severity of acne.
• Laser treatment: Continuously reducing sebaceous glands through laser treatments like Gold PTT can greatly suppress recurrence. While this also does not prevent 100% recurrence, it can significantly reduce the number and severity of acne breakouts. If you have struggled with makeup or social interactions due to acne in the past, these treatments can help you lead a more comfortable daily life.

This concludes today's content. If you have any questions related to skin, including acne treatment, please feel free to inquire, and we will answer them with care. This was dermatologist Lee Sang-ju. Thank you.