Comedones: blackheads and whiteheads

Comedones

Comedones are the starting point of acne. Acne begins with blocked pores, which may then lead to inflammation, marks and scars. They occur in all sexes and age groups, most often in adolescents and young adults. Common sites include the face, neck and trunk, especially the back, where there are many sebaceous glands.

What comedones look like

They include black open comedones and white closed comedones. Running a hand over affected skin can reveal small bumps containing accumulated keratin within follicles. Squeezing or repeatedly rubbing them can cause inflammation. Inappropriate treatment may worsen inflammation and leave more marks.

Causes of comedones

1. Sebaceous glands produce too much oil. Higher levels of androgens such as testosterone, which regulate gland growth and sebum production, may contribute. Blockage of the channel that carries oil to the skin surface can lead to comedones.
2. Abnormal shedding of cells inside the follicular lumen can cause blockage.
3. Acne cosmetica may follow the use of certain cosmetics and reactions to them.
4. Steroid-related acne can occur with steroid-containing creams used for skin reactions or regular oral prednisolone, for example in people with nephrotic syndrome or SLE.
5. Stress.
6. Hormonal changes, such as those around menstruation or menopause.

Treatment of comedones

Read about acne treatment and consulting a physician