Acne - is Laser Surgery the Answer?

Everyone knows what acne is. Zits. Pimples. An odd disorder that strikes when you are a young teenager and socially most vulnerable. It seems to sense when you're preparing for an important date, job interview, or meeting your girlfriend's parents - that's when it strikes.

I suffered from acne as a teenage girl and was left with scars - pits in the skin. It's 45 years later, and I still get an occasional breakout. As a girl, I tried everything I could get my hands on: strong soap, constant scrubbing - I didn't have a dead skin cell anywhere between my ears. Someone told my mother, "Try carbolic acid." For six months I applied carbolic acid. It burned. The acne sneered and continued to ravage my face. Someone else told my mother, "Have her wash her face in her own urine." For three months or more, I washed in my own urine. Nothing helped.

Acne is truly a scourge. More than the facial scars, it's the unwelcome attention it brings you that hurts deep down where you live. Every negative comment, every time you catch someone staring at you ("Oh, that poor girl") another wound is piled on.

We didn't know anything about retinoids, dermabrasion, the "pilosebaceous unit," or lipids in those days. Today there are about as many treatments for acne as there are spots on your face at any one time - the newest and most promising (according to some sources) is laser surgery. But does it work?

First let's look at what happens to produce acne. Acne is inflammation, pure and simple, of something called "the pilosebaceous unit." What that means is that the tubes in the skin that bring oil (sebum) to the outside have become blocked and infected, either because their cells are abnormal or due to the action of bacteria. The infection causes scarring on the top layers of the skin or deeper down. Abnormal cells in the gland and tube (duct) can be caused by hormones, overproduction of oil, and toxins produced by the body or by the bacteria. The aim of treatment is to unblock the tube, destroy bacteria, and bring the level of oil production to a manageable level.