Comedonal acne are small skin cysts formed due to the accumulation or blockage of the mouths of hair follicles with sebum and exfoliated cells. Disease may look like whitish nodules (whiteheads, closed) or black dots (blackheads, open). They occur more often on oily and porous skin. Diagnosis and elimination of the causes of the formation of comedonal acne is carried out by dermatologists, endocrinologists, gastroenterologists. Competent and regular hygienic skin care, cosmetic procedures (skin cleansing, chemical and mechanical peels, etc.) are important in solving the problem.
Comedonal acne are a symptom of some skin diseases, as well as diseases of the gastrointestinal tract, liver and endocrine disorders. Sebum, dirt and exfoliated cells of the epidermis clog the pores, resulting in the formation of nodules-comedonal acne. Disease are found in all age groups, but in adolescents during puberty and in women, especially with hormonal changes (menstrual disorders, pregnancy, menopause), comedonal acne are more common. Comedonal acne of varying degrees of manifestations occur in 85% of the age group from 12 to 24 years. At a more mature age, due to the natural decrease in fat formation, comedonal acne are diagnosed less often.
The main cause is the accumulation of sebum at the mouth of the hair follicle, which is blocked by a plug of skin cells and dust particles. That is, sebum cannot be evacuated from the follicle on its own and gradually accumulates in it. Toxins that should be excreted through the skin pores interact with sebum, resulting in a thick sticky mass. Externally, the comedone becomes noticeable when sebum mixed with toxins and bacteria partially exits through the narrowed mouth of the follicle and under the influence of oxygen acquires a dark shade.
The main cause is improper skin care of the face and body. The use of fat-based cosmetics, the use of makeup and the habit of going to bed without washing, leads to the accumulation of dead cells, hardened sebum, dust, bacteria and salt crystals (from sweat) on the skin of the face. If the skin of the face is prone to greasiness, then one or more of the above factors are sufficient for the formation of comedonal acne.
Genetic predisposition is also one of the causes of comedonal acne, since women whose close relatives had or have comedonal acne on the skin of the face have a higher incidence rate.
An increased level of testosterone, especially in people prone to acne, stimulates the activity of the sebaceous glands, in addition, the epithelial cells lining the opening of the hair follicle do not fall off in time, which first causes narrowing of the duct, and then its complete blockage, after which comedone is formed. In rare cases, taking some medications as a side effect may be accompanied by the appearance of comedonal acne, which, after the withdrawal of medications, pass on their own.
In stressful situations, the composition of sebum also changes, and during stress, people pay less attention to hygiene and facial care, which indirectly leads to the formation of comedonal acne. After the restoration of a normal lifestyle and with proper skin care, comedonal acne that have arisen for this reason pass on their own. Humid climate and air pollution contribute to the accumulation of dirt microparticles on the skin and provoke the formation of comedonal acne.
The first signs of this disease, when there are no manifestations on the skin yet, are skin coarsening and pore expansion. Oily skin, but prone to peeling, is also a clinical manifestation that precedes comedonal acne. The skin color becomes unhealthy, with a gray, sometimes greenish tinge. Cosmetics hold poorly, as they “drain” from the skin due to its increased fat content. At this stage, therapy is most effective, since there are no comedone nodules yet or they are at the stage when the mouth of the follicle is completely closed. Part of the fat can still be evacuated from the follicle, but some part of it remains inside, because small bumps can be noticed on the skin, which are well felt when stroking areas of the face with a large number of sebaceous glands (T-zone of the face and chin).
In the future, open comedonal acne appear, which outwardly resemble a nodule with a black dot due to the oxidation of the surface part of sebum. Closed comedonal acne are located under the skin, and therefore, not being able to evacuate the contents, they often become inflamed. Externally, they look like pink or red bumps with unchanged or inflamed skin on top.
Self-removal of comedonal acne leads to the formation of scars, the addition of a secondary infection of a purulent nature with the development of pyoderma. Therefore, there are both unopened comedonal acne and pustular rash on the skin of patients, sometimes there are serous and bloody crusts in place of squeezed comedonal acne.
Diagnosis and treatment
The diagnosis is made on the basis of a visual examination and a survey of patients. Almost always there are concomitant diseases of the gastrointestinal tract and endocrine disorders. Therefore, patients with comedonal acne are recommended to consult a gastroenterologist and an endocrinologist.
Treatment of comedonal acne should be comprehensive. It is necessary to carry out therapy, and if it is impossible – correction of the underlying disease. Cosmetic procedures aimed at normalizing the production of fat and peeling dead cells help to heal the skin and return it to its normal state. It is necessary to pay more attention to personal hygiene, wash with detergents no more than 2 times a day, touch the skin of the face with your hands as rarely as possible and do not allow the hair to fall on the face.
Peeling with fruit acids and microdermabrasion removes the top layer of dead cells. After that, it is recommended to apply cosmetic medications with anti-comedogenic properties to the face. Inflamed areas are wiped with salicylic solution and antibacterial gels are applied. It is mandatory to take vitamin complexes and follow a hypoallergenic diet with the exception of fatty and sweet dishes. When a secondary infection is attached, the use of antibacterial drugs is indicated.