How comedones form
At the mouth of the hair follicle, cells are constantly exfoliated and sebum is secreted. If the cells stick together and do not move away, and more sebum is produced than normal, a dense plug is formed. An open comedone has access to the surface, where the contents oxidize and darken due to melanin and oxygen - this is how a black dot appears. A closed comedone remains under a thin layer of skin in the form of a white tubercle. It is closed comedones that become inflamed more often: bacteria multiply in a confined space, and the element turns into a papule or pustule.
- Excessive sebum production
- Impaired exfoliation at the mouth of the follicle
- Open comedon - blackhead
- A closed comedon is a white bump under the skin.
- Reproduction of bacteria and transition to inflammation
Why do they appear
The main factor is hormonal: androgens enhance the work of the sebaceous glands, so comedones are typical during adolescence, and in women they often intensify before menstruation. Heredity plays a role: skin type and tendency to acne are largely determined genetically. External causes are also significant - thick foundations and oils that clog pores, friction from a mask, helmet or phone, a humid hot climate. The influence of diet is being studied: the connection with foods with a high glycemic index and large amounts of milk is discussed, but there is no universal diet for comedones.
- Increased androgen activity
- Adolescence and hormonal fluctuations
- Hereditary tendency to oily skin
- Comedogenic cosmetics and heavy foundations
- Friction and pressure on the skin
- Hot humid climate
- Certain medications, including hormonal medications
What not to do
The most common mistake is extrusion. When pressed, the contents partially go deep, causing inflammation, and skin trauma results in dark spots and scars. Equally useless and harmful are aggressive washing several times a day, alcohol lotions and harsh scrubs: they damage the skin barrier, and the sebaceous glands work even more actively. Strip patches remove only the top of the plug, while the pores remain, and the spots return after a few days. Homemade masks with baking soda, lemon and toothpaste irritate the skin and do not affect the cause.
- Do not squeeze out comedones with your nails
- Do not wash your face more than twice a day
- Avoid alcohol lotions and harsh scrubs
- Don't Rely on Nasal Strips
- Do not use soda, lemon and toothpaste
- Do not dry the skin until it feels tight
What really helps
The basis is external retinoids: they normalize exfoliation at the mouth of the follicle and prevent the formation of new plugs. Start with a low concentration and low frequency, gradually increasing, since the first weeks may cause dryness and flaking. Acids work well: salicylic acid penetrates the pores and dissolves the contents, azelaic acid additionally evens out the tone. Gentle cleansing twice a day, non-comedogenic moisturizer and sun protection are required, especially against the background of retinoids and acids. The effect is assessed no earlier than after 8–12 weeks of regular use.
- Topical retinoids with gradual introduction
- Products with salicylic or azelaic acid
- Gentle cleansing twice daily
- Non-comedogenic hydration
- Daily sun protection
- Evaluation of results after 8–12 weeks
- Maintenance therapy after improvement
When do you need a doctor and procedures?
If comedones are accompanied by inflammatory elements, nodules, scars, or cannot be properly cared for within 3 months, you should consult a dermatologist: he will select stronger external remedies, and in severe forms, systemic therapy, which is prescribed strictly by a doctor. In women with irregular cycles, excess hair growth and sudden onset of acne in adulthood, hormonal testing is appropriate. Professional cleaning and gentle peelings provide a quick cosmetic effect, but without home care, comedones return, so procedures are considered as an addition, not a replacement for treatment.
- Consult a doctor for inflammation, nodes and scars
- Hormonal examination according to indications in women
- Professional cleaning as an addition to care
- Gentle peelings in a course as prescribed
- Systemic treatment only as prescribed by a dermatologist
- Review cosmetics for comedogenicity
