Skin is made up of a combination of skin cells along with hair follicles embedded in between them. These very fine hair follicles present in our skin induce a very small gap between the skin cells and follicle accommodating sebaceous gland which produces sebum. Sebum is naturally produced in the skin. These sebaceous glands and sebum produced by them is responsible for formation of comedones.
Comedones can be divided into two types:
1. Blackhead
2. Whitehead
When sebum produced by sebaceous glands is blocked due to proliferation of the cells lining them (cornification), it leads to formation of whiteheads. Or even increased production of sebum from these glands can lead to formation of both whiteheads and blackheads. On the other hand when sebum produced by sebaceous glands reaches the skin surface through minute opening between the cells and gets oxidized with air, it leads to formation of blackheads. Moreover, when the bacteria present on the skin surface enters the skin cells and feeds on sebum, it can also lead to formation of pimple or cystic acne.
What factors can lead to increased production of comedones?
All the factors that lead to overproduction of sebum or the ones that increase the gap between the hair follicles and skin cells will be responsible for overproduction of comedones. Some of these factors are:
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Hormonal Changes: Imbalance in hormone can lead to overproduction of sebum and can also increase the size of the opening in skin cells. Hormonal changes are in turn affected by:
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Menstrual cycle: It has been witnessed that in females hormonal changes happen during cycles which are marked by appearance of comedones or pimples.
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Stress: It can also lead to hormonal changes and lead to increase in the size of opening.
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Contraceptives: it can be one of the causes leading to hormonal changes and hence, in turn increases the chances of comedones formation.
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Reduced essential fatty acid in the skin is one of the reasons of formation of whiteheads. This leads to piling up of dead skin cells over the opening due to its inability to exfoliate dead cells and impaired barrier repair function leading to plugging of the gap and blocking the sebum causing formation of whitehead.
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Increased essential fatty acid: This can also be harmful as it increases the size of duct letting bacteria enter the skin cells due to ruptured barrier. These skin bacteria thrive on sebum and also result in an increase in oiliness of the skin as they produce fatty acids themselves.
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Lifestyle mistakes: There are certain lifestyle mistakes that we unknowingly commit which leads to increased production of blackhead and whitehead including :
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Smoking can aggravate comedones production
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Increased consumption of high glycemic index food can increase sebum production and lead to formation of comedones
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Dairy products except curd can also aggravate sebum production and lead to formation of blackhead and whitehead
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Manipulation of hair follicles by squeezing, scrubbing, or popping comedones can rupture the normal skin barrier function and result in its overproduction.
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Humid weather can also be responsible for increased pore clogging and hence, increased chances of comedones formations.
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For these concerns, a dermatologist can always provide a solution and improve the skin health. There are certain products that can help reduce comedones along with treatment options. Various methods are available to prevent and treat these comedones which help by either decreasing the proliferation of bacteria on the skin or by removing the dead cells on the opening of these comedones and hence regulating the cell turnover.
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Alpha-hydroxy acid or Beta-hydroxy Acid
Glycolic acid or salicylic acid based gels and face washes are available. These remove the dead skin cells on the surface of the blocked comedones and hence, help in easy passage of sebum and prevent the formation of new comedones also. -
Benzoyl Peroxide
This works as a great antibacterial agent. It is available in face washes and creams. It works by decreasing the bacterial proliferation and hence, helps in reducing both the open and closed comedones. -
Retinoids
These are available in the form of capsules and gels. Topical retinoids are helpful as they push the sebum from bottom to up and hence, prevent accumulation of sebum in the glands and prevent comedones formation. But retinoids should always be used under supervision of a dermatologist and it should strictly be avoided in lactating and pregnant women. -
Azelaic Acid
It helps in reducing bacterial proliferation and has an anti-comedonal action due to change in keratin production and anti-hormonal effects which corrects the hormonal imbalance. -
Topical antibiotic creams and gels are also helpful as they reduce proliferation of bacteria on the skin surface which is one of the major reasons of comedones formation.
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Hormonal Therapy
It can be beneficial in patients with severe comedones due to hormonal imbalance.
Always consult a qualified dermatologist to start any of the above treatments as they can guide to opt for the best treatment plan as per individual skin condition.
Prevention Tips
There are certain prevention tips that can be followed to reduce or prevent the formation of blackhead and whitehead.
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Use glycolic acid and salicylic acid based face washes. Use them twice a day to avoid bacterial proliferation over skin and maintain cell turnover.
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Opt for salicylic acid and retinoids based creams to reduce formation of comedones.
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Opt for right make up products that suit individual skin type. Choose the right brands and avoid applying make up for longer durations. Avoid doing heavy make up regularly and lastly use the right make up removers. Always remove make up before going to bed. Also clean the make up brushes to avoid any bacterial infection on skin.
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Scrubbing should be avoided as the dead skin cells cannot be removed by scrubbing or rubbing. These in fact damage the skin barrier.
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Self manipulation of comedones should be avoided as it increases the inflammation.
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Face masks can be helpful for short term but cannot be helpful in the long run to prevent formation of these comedones.
Comedones can be really annoying and troublesome but a skin expert will have a solution to this. If someone is frequently facing the problem of comedones they must consult a dermatologist as they can analyze the cause of the problem and ensure a skincare regimen or treatment plan to prevent or reduce the same.
Stay Healthy! Keep Glowing!