Comedones (blackheads and whiteheads)

Come­do­nes are clog­ged hair fol­lic­les, known as black­heads and whit­eheads. They are the basic lesi­on of acne and appear main­ly on the face, chest and back. Open and clo­sed come­do­nes are distinguished.

Cau­ses

Increased sebum pro­duc­tion and abnor­mal kera­ti­ni­sa­ti­on at the fol­lic­le ope­ning cau­se oil and dead skin cells to block the pore. Hor­mo­nes, gene­tics, greasy cos­me­tics and mecha­ni­cal irri­ta­ti­on all play a part.

Sym­ptoms

Open come­do­nes appear as black dots; the colour comes from oxi­dised sebum and mela­nin, not from dirt. Clo­sed come­do­nes are small white or skin-colou­red bumps that can deve­lop into infla­med spots. They should be distin­gu­is­hed from milia, which have no ope­ning to the skin surface.

Tre­at­ment

Topi­cal reti­no­ids, sali­cy­lic acid or azelaic acid are effec­ti­ve, as they nor­ma­li­se kera­ti­ni­sa­ti­on. Pro­fes­sio­nal extra­c­tions and peels can help in addi­ti­on. Squeezing them yours­elf can pro­mo­te inflamm­a­ti­on and scar­ri­ng. Non-come­do­ge­nic skin­ca­re helps pre­vent new black­heads. Initi­al impro­ve­ment usual­ly takes a few weeks of con­sis­tent use.

Matching tre­at­ment at Swiss Der­ma Cli­nic: Acne Assess­ment and Treatment