Comedones: symptoms, diagnosis and treatment

Dermatovenereologist (cosmetologist)

Baichorova

Marua Azretovna

21 years of experience

Dermatologist (cosmetologist)

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The constant process of skin renewal can cause blockage of the sebaceous glands and follicles. Getting into microscopic holes, excess sebum and dead cells of the exfoliated epidermis lead to the appearance of blackheads or pimples. Experts have united them under the name “comedones”. The situation is aggravated by the lack of proper skin care, exposure to unfavorable sanitary conditions, as well as the intense production of sebum, the excess of which clogs the ducts and hair follicles.

The vast majority of cases of comedones are observed on oily facial skin: on the nose, forehead and cheeks. According to most medical specialists, such a pathology is true evidence of hormonal imbalances, hidden dermatological problems and malfunctions of the liver and gastrointestinal tract. Therefore, patients who experience discomfort from their appearance are advised not to focus on the cosmetic problem, but to undergo a comprehensive examination to identify possible diseases of the internal organs.

Etiology of the disease

The opinion that comedones appear only in adolescents and young adults is not entirely true. They occur in up to 85% of patients under 25 years of age, after which sebum production decreases and the conditions for blockage of the glands disappear on their own. Also, women often suffer from the disease during pregnancy and at the onset of menopause, when the body experiences a significant hormonal load. The intensive development of the disease can be caused by unsanitary working or living conditions, lack of proper skin care, neglect of hygiene rules and other reasons due to which the adverse effects on the skin of the face acquire such unpleasant consequences. Refusal to treat comedones can cause the formation of scars and age spots at the site of the rash, which can only be eliminated using plastic surgery methods.

Consequences of mechanical cleaning

The disadvantages of getting rid of blackheads include:

A long period of skin renewal and restoration - from three to ten days.
The appearance of scars and cicatrices if the procedure is carried out incorrectly.
Possibility of infection or infection of the wound.
The appearance of itching and rashes after poor cleaning.

Also, significant disadvantages include such a problem as deep-lying fatty tubules in the pores.
How to squeeze out blackheads on the nose if they don't squash? Contact a cosmetologist who will perform deep ultrasonic cleaning and clog the pores, after which they will become less deep, and next time you can cleanse yourself at home. After the procedure, for two to three days it is not recommended to: use decorative cosmetics, drink alcohol, play sports or fitness, visit baths or saunas, wash your face with hot water, sunbathe in the sun or visit a solarium.

Reasons for the formation of comedones

A black dot or raised white spot on the surface of the skin is excess sebum that is stuck in the sebaceous duct or inside the follicle. The resulting plug disrupts the functioning of the glands and forms a closed environment, ideal for the proliferation of pathogenic microorganisms. Their vital activity “enriches” the plug with toxins, which causes a local inflammatory process and its subsequent spread to healthy areas of the skin.

Among the reasons causing the appearance of multiple comedones on the face, ears or back, experts call:

hyperactivity of the sebaceous glands;
use of low-grade cosmetics;
lack of proper facial care, as a result of which excess sebum and epidermal cells remain on the skin;
refusal to remove traces of cosmetics before bedtime;
smoking;
living or working in an environment characterized by the presence of dust and small particles of dirt in the air;
unbalanced diet, dominated by fatty, smoked and spicy foods, sweets and flour products;
deficiency of microelements and vitamins.

A comprehensive examination of the body of a patient complaining of open and closed comedones often reveals hidden pathologies of the following nature:

liver and gastrointestinal diseases;
hypothyroidism, gonadal dysfunction, other hormonal disorders;
genetic predisposition of the skin to inflammation;
intensity of production of certain hormones, their imbalance in the body;
uncontrolled use of hormonal drugs;
frequent stress, sleep disturbances, insomnia.

Complete removal of an external skin defect is only possible if the internal causes listed above are eliminated.

The black dot on the skin is not squeezed out. Why are acne and pimples dangerous?

Many people believe that the problem of acne, pimples and blackheads is not worth attention at all, since these defects go away on their own with age. But thinking like that is a big mistake. As soon as this problem appears, it is necessary to treat it in order to prevent serious complications. You cannot self-medicate and trust remedies that are widely advertised on TV and the Internet. As a rule, these drugs have a lot of contraindications for use. You should not trust devices such as vibrating massagers with a cleansing effect. They are intended for other purposes, but not for removing acne.

Many cosmetologists answer the question of whether it is possible to crush blackheads on the face that it all depends on the situation. Indeed, if you squeeze out a single point, there will be no harm, of course. BUT this will not solve the problem. Therefore, it is hardly worth spending time and effort on this. It should be borne in mind that constant squeezing of comedones can lead to such consequences as:

The appearance of small scars on the face that remain in place of black spots. When there are many such scars, the face looks like that of a person who has had smallpox;
The formation of microtraumas - cracks and abrasions through which dangerous infections can easily enter the body;
Bleeding and hematomas;
Early formation of wrinkles and blackheads in places where comedones were most often squeezed out. This is due to the fact that injured skin gradually loses its firmness and elasticity.

Clogged pores are dangerous because the skin cannot breathe normally, which can cause its appearance to deteriorate significantly.
Therefore, if comedones begin to appear very often, you need to consult a cosmetologist to select pore care products. Such creams and masks contain substances that dilate pores and improve the “breathing” of the skin. These drugs are classified as medicinal cosmetics, so they can be used strictly for medical reasons. It should be borne in mind that different medications are aimed at women and girls of different ages: what is suitable for a teenager is unlikely to suit a mature woman who has entered menopause.

Varieties and features

The skin is sensitive to lack of care and disruptions in the body. Among the symptoms that precede the appearance of subcutaneous comedones, most patients note:

a sharp increase in skin oiliness;
density and roughness of the skin;
change in natural skin color to an unattractive pale gray-green shade;
dense nodules, indicating blockage of the sebaceous glands and hair follicles.

There are open and closed comedones, which differ in appearance. Black spots on the surface of the cheeks, nose and chin, the so-called T-zone, are an open form of the disease. Noticeable white sebaceous plugs under the skin are a closed type of pathology. They often develop against the background of hidden inflammatory processes due to skin damage by a fungal infection, staphylococcus or pathogenic bacteria. Lack of proper treatment causes plugs of purulent acne to appear at the site, which leave behind scars and scars.

The localization area for closed white comedones on the face is the forehead, nose and chin, as well as the décolleté and upper back. The appearance of formations on the body is often associated with wearing synthetic underwear and clothing, which does not allow air to pass through and causes the skin to secrete sweat. Trying to fight comedones by squeezing in unsanitary conditions only aggravates the problem. The pustular infection spreads to nearby healthy areas of the skin, and the disease progresses rapidly. And in place of the squeezed out formations there remains a serous crust and an inconspicuous scar, indicating damage to the skin.

Open comedones, or blackheads, acquire an unpleasant appearance due to contamination of the sebaceous plug with dust or residues of cosmetics. When exposed to air, the contents of the sebaceous duct oxidize and darken, making it visible on the surface of the skin. Removing such comedones does not bring the expected effect. The empty gland duct soon becomes clogged with fat, and the disease again makes itself felt with an unpleasant cosmetic effect.

Removing blackheads with matches

Before squeezing out blackheads on your nose with matches, you need to prepare your face. Two to three days before the procedure, apply tea tree oil lotion and a green tea mask with honey to the problem area. To prepare the lotion you will need: six drops of tea tree oil, two tablespoons of boiled water. To achieve maximum effect, it is recommended to wipe your face with lotion twice a day; in addition, you can add tea tree oil to water and hold your face over the steam, this manipulation will be no less effective. The same tea tree oil can also be used as a disinfectant.

Green tea mask with honey. To prepare the mask, you need to mix four teaspoons of honey, four tablespoons of sugar, one and a half teaspoons of apple cider vinegar, two tablespoons of green tea. Apply the finished mask to your face for fifteen minutes, then rinse with warm water.

Before cleansing your face, you need to thoroughly steam the area around the nose and disinfect it, then use clean matches from the box to press on the area around the comedone. Using two matches, pressing the match head on the blackhead, you should carefully pull out the sebaceous mass. If the skin is well steamed, there will be no problems during the procedure. After manipulation, it is recommended to lubricate the inflamed areas with salicylic or syntomycin ointment.

When to see a doctor

Experts recommend not delaying a visit to the doctor if symptoms of inflammation and blockage of the sebaceous glands appear. You should not put up with an unpleasant cosmetic effect or try to cope with it using home methods, at the risk of intensifying the pathological process. Moreover, modern medicine has at its disposal many effective methods of combating the disease, depending on the type and general condition of the skin.

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Why do you need special care for skin with closed comedones?

According to the international classification of acne, the formation of comedones is the zero or initial stage of acne development.

Impaired evacuation of sebum leads to the development of a retention cyst in the gland itself, which can subsequently lead to inflammation when acne bacteria are activated.

If cleaning is performed incorrectly, for example, with excessive force, the integrity of the sebaceous gland is disrupted, leading to aseptic inflammation.

Summary: treatment for closed comedones is necessary to prevent the development of more severe forms of acne.

Diagnostics

For an experienced dermatologist, an external examination of the patient’s skin is enough to immediately make the correct diagnosis. Specialized laboratory research methods allow us to clarify the mechanism of development of the disease and the presence of pathologies of internal organs: blood tests for hormonal balance and internal infections, tomography of the gastrointestinal tract and liver. It is possible to prescribe additional measures as part of a standard examination if the patient has a history of serious diseases of the internal organs.

Treatment

You can cope with the appearance of a limited number of pimples and comedones of any type with the help of careful skin care. In case of intense shedding, consultation with a dermatologist is required. He will select a remedy for comedones and a suitable list of procedures to free the ducts (so-called extraction) and reduce the volume of sebum production.

In most cases, the following treatment methods are used:

mechanical cleansing of the face - carried out after thorough cleaning and warming of the skin using the fingers, a Uno spoon or a Vidal needle. After cleaning, the skin is treated with alcohol. Provided the contents of the duct are completely removed, the risk of infection is reduced to zero, and there are no signs of hyperemia or inflammation on the face. During the day, it is strictly forbidden to use cosmetics so that its particles do not clog the open duct;
enzymatic peeling using exotic fruit extracts. Loosening the stratum corneum of the skin allows comedones to come out naturally or through brosage - a cleaning procedure with soft brushes. Peeling is contraindicated in the presence of ulcers, exposure to which can cause skin infection;
disincrustation is a hardware technique for removing comedones under the influence of a weak electric current. This method is used relatively rarely due to multiple contraindications;
peelings - chemical, acidic, film or sheet, the effect of which softens the skin and frees the ducts from impurities. At the same time, the substances contained in the peeling preparation relieve the inflammatory process and soothe the skin;
ultrasonic facial cleansing – treatment using ultrasonic waves, the “impact” of which gently “knocks out” plugs. At the same time, the procedure has a pronounced cosmetic effect - it removes wrinkles, refreshes the complexion, tightens the skin;
Vacuum skin cleansing – gentle removal of plugs from the ducts, leaving no noticeable marks. The procedure is contraindicated for patients with rosacea, because there is a risk of injury to small vessels.

Please note: squeezing comedones and using dubious home remedies can worsen your skin condition. It is also not recommended to select medications at the pharmacy on your own, relying on commercials and advice from friends. Treatment should be prescribed only by an experienced specialist who has studied the results of diagnostic studies.

Acne needs to be treated, not crushed.

Squeezing does not cure acne. To get rid of acne, it is necessary to use medications (topical and systemic)18. Clindovit® gel is a topical antibiotic6. The main active ingredient in its composition is clindamycin6. It exhibits antibacterial activity against a large number of strains of propionibacteria6. The foundation also contains auxiliary components to provide a regenerating and anti-inflammatory effect (allantoin), moisturize and soften the skin (emollient)4,5. To reduce the risk of developing antibiotic resistance, it is recommended to use Clindovit® in combination with azelaic acid (for example, Azelik® gel) or benzoyl peroxide28.

How to make an appointment with a dermatologist at JSC “Medicine” (clinic of academician Roitberg) in Moscow

You can make an appointment with the specialists of JSC "Medicine" (clinic of Academician Roitberg) on the website - the interactive form allows you to select a doctor by specialization or search for an employee of any department by name and surname. Each doctor’s schedule contains information about visiting days and hours available for patient visits.

Clinic administrators are ready to accept requests for an appointment or call a doctor at home by calling +7 (495) 775-73-60.

Convenient location on the territory of the central administrative district of Moscow (CAO) - 2nd Tverskoy-Yamskaya lane, building 10 - allows you to quickly reach the clinic from the Mayakovskaya, Novoslobodskaya, Tverskaya, Chekhovskaya and Belorusskaya metro stations .