About Comedone

Cause of "Comedone"

Comedone appears due to a plug of sebaceous and dead skin material stuck in the opening of a hair follicle. The follicle may be open (blackhead) or almost closed (whitehead). The closed comedones are likely to turn to be "acne" when infection occurs.

Closed comedones (Whiteheads):

They are follicles which filled with plugs of sebum and sloughed-off cells, but have only a microscopic opening to the skin surface. Since the air cannot reach the follicle, the material is not oxidized, and remains white.

Open comedones (Blackheads):

They are follicles that have a wider than normal opening. They are filled with the same material as whiteheads and have undergone a chemical reaction resulting in the oxidation of melanin. This gives the material in the follicle the typical black color.

1. What is comedone? Are they toxic substance produced inside the body?
   There are two main causes of comedones. One is due to hyperkeratosis and excessive production of oil which leads to the blockage of hair follicle. When comedones occur, the acne bacteria (Propionibacterium Acnes) will further worsen the skin condition. Comedones are the bi-product or called metabolite of our body but not toxic substance.
   There are 2 types of comedones: whitehead and blackhead. Whiteheads are comedones with smaller opening whereas blackhead are comedones with wider opening and you can obviously see the black spots on the surface of opening.
   
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2. Should we clear the comedone every day in order to prevent the outbreak of acne?
   Comedone always appears before an actual acne is formed. Logically, Iif there is no comedone, the chance of getting acne will be lower.
   We suggest the acne prone patient to follow a better skin care regime to prevent acnes. For instance, they could use those with AHA or BHA ingredients, which target to eliminate dead skin and induce formation of new skin cells. For more severe case, some prescribed medication with Retinoid is suggested, in order to control the growth of acnes.
   There are various types of skin care product for acne prone skin but they are not suggested to be used too frequently, once every 1-2weeks is more appropriate. There are many factors that induce the growth of acnes. It would not be enough by merely clearing the comedones but not changing the unhealthy living styles like staying up late at night and using wrong skin care product.
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3. Are those "Deep cleansing product" effective to wash away all the comedones?
   According to Dr Anthony Chui, those deep cleansing product are claimed to be effective to clear the dirt inside the pores. Indeed the substance used is extremely strong that can dissolve the dirt and dead skin on the skin surface but still cannot remove the comedone which grows underneath the deeper skin layer. Some deep cleansing products like facial scrub may even damage the pores if we rub it too hard over the skin. For people with combination skin types, they should not use these kind of products too frequently because the locally dry skin would become even more dry if all of the oil is removed. As a result even more acnes might appear because the skin would giving a wrong signal to produce more oil to protect the skin.
   
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4. Can exfoliation help to eliminate the comedones on the arms?
   Dr Chang explained that the comedones appear on the arms are the very common phenomenon called Hyperkeratosis. In fact, it is an inherent skin problem. They usually appear in upper arms, outer area of upper legs, back, hip area or area below the cheeks. They are rough, tiny and bulging spots in dark red color. They are more common in females in puberty to 40's. It is not suggested to use with the scrubbing product because it will stimulate the skin surface and cause irritation. As long as there is no allergy history, it is better to apply AHA/BHA lotion or medicated topical prescribed by doctor. Be aware that topical treatment always takes longer time to see the result, so if you want to treat this problem, you must be patient in order to see the effect.