Frequently Recurring Milia and Pustular Acne — What Are the Treatment Options? [Dr. Kim Hyun-soo Column]

Acne is a common skin condition that occurs when pores beneath the skin become clogged. In dry weather, acne can worsen as thickened dead skin cells block pores and interfere with sebum secretion. Squeezing or touching lesions carelessly can further aggravate acne, so caution is required.

There are various types of acne, the most common being milia and pustular acne. Milia are stagnant acne within the pores — small like seeds, easy to extract, and generally do not leave significant scarring.

Pustular acne, on the other hand, is formed when dead cells accumulate due to inflammation and form pus, accompanied by stagnant turbid blood that gives it a red color. Because the lesion itself is soft, it often ruptures spontaneously. The main concern is its high likelihood of leaving scars and acne marks.

Milia and pustular acne can be difficult to improve with acne injections or simple skincare management alone, and they tend to recur frequently. To address this, it is necessary to eliminate the root causes: overly expanded sebaceous glands and acne bacteria.

The representative treatment is Gold PTT. Gold PTT absorbs nano gold particles using ultrasound, then uses Synergy Laser to destroy only the expanded sebaceous glands. Sebum secretion is suppressed, inhibiting the occurrence and recurrence of acne. Unlike conventional PDT, it has minimal effect on the epidermis and is not affected by UV, allowing immediate return to daily activities.

Agnes Laser is another option that uses micro-insulated needles to individually remove each overly expanded sebaceous gland. It is widely used in dermatology clinics due to its effectiveness in treating high-recurrence acne under the chin, milia, and pustular acne.

Treatment of acne marks left behind is also important. When left untreated with ongoing skin damage, there is a high risk of dark pigmentation (grey or black) or, in severe cases, development into permanent scars. Synergy Focus Therapy using Synergy Laser is helpful for this.

If acne occurs frequently, visiting a dermatology clinic as soon as possible to resolve the underlying cause is essential. Along with treatment, developing healthy daily habits for managing acne is equally important.

(Dr. Kim Hyun-soo, ReYeonK Clinic Apgujeong)