Background: Closed macrocomedones are unsightly lesions that may be resistant to medical treatments and comedone extractors. Light cautery has been used to treat macrocomedones, which are 1 to 3 mm in size; however, its success in larger and chronic lesions is limited.
Objective: To introduce an alternative treatment technique for this neglected problem.
Methods: We treated these lesions by using cautery and standard dissecting forceps. After puncturing the macrocomedones in the center using the sharp-tipped cautery point, we grasped the base of the comedone using standard dissecting forceps and squeezed and pulled out the contents.
Results: Twelve patients were treated with this technique, all of whom tolerated the procedure well and judged the cosmetics results as very good.
Conclusion: We recommend this procedure for patients who have closed macrocomedones larger than 3 mm in size, although it is an effective treatment for macrocomedones of any size.