Closed Comedones: Treatment and Skincare Concerns - Dermatology

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Understanding closed comedones, commonly known as closed pores or whiteheads, is essential for effective skincare and treatment. Closed comedones occur when hair follicles become clogged with sebum (oil), dead skin cells, and bacteria, leading to the formation of small, flesh-colored bumps on the skin. These can be particularly frustrating as they are often resistant to topical treatments and can lead to further acne issues if not addressed properly.

From your description, it seems you have been using a topical retinoid, specifically "痘膚潤" (which contains Adapalene), for about a month. It's not uncommon to experience initial peeling or dryness when starting retinoids, as they work by increasing cell turnover and promoting the shedding of dead skin cells. The fact that you experienced peeling initially but have since transitioned to using a moisturizer without further peeling is a positive sign that your skin is adjusting to the treatment.

However, the increase in oiliness you mentioned could be a normal response as your skin adapts to the new regimen. Retinoids can initially cause dryness, but as your skin becomes more accustomed to the treatment, oil production may normalize. It's essential to use a non-comedogenic moisturizer to avoid exacerbating the issue of closed comedones.

Regarding your concern about the size of the closed comedones, it is indeed possible for larger comedones to become trapped within the pore, making them more challenging to treat with topical agents alone. In such cases, professional treatments like chemical peels, which often utilize alpha hydroxy acids (AHAs) like glycolic acid, can help exfoliate the skin more deeply and promote the extraction of these stubborn comedones. Chemical peels can effectively remove the upper layer of dead skin cells and help unclog pores, potentially leading to clearer skin over time.

It's understandable to feel skeptical about recommendations for procedures like chemical peels, especially if you suspect they may be motivated by financial incentives. However, if your dermatologist has assessed your skin and believes that a chemical peel could benefit you, it may be worth considering. Just ensure that you discuss your concerns openly with your dermatologist and ask for a clear explanation of how the treatment could specifically help your condition.

In addition to professional treatments, maintaining a consistent skincare routine is crucial. Here are some tips to manage closed comedones effectively:
1. Gentle Cleansing: Use a mild, non-comedogenic cleanser to avoid stripping your skin of its natural oils while still keeping it clean.

2. Exfoliation: Incorporate gentle exfoliation into your routine, either through chemical exfoliants (like AHAs or BHAs) or physical exfoliants, but be cautious not to over-exfoliate, as this can irritate the skin.

3. Non-Comedogenic Products: Ensure that all skincare and makeup products are labeled non-comedogenic to prevent further clogging of pores.

4. Sun Protection: Use a broad-spectrum sunscreen daily, as some treatments can increase your skin's sensitivity to the sun.

5. Patience and Consistency: Treatments for closed comedones often require time to see significant results. Consistency in your skincare routine is key.

If you continue to experience issues or have concerns about the treatments suggested, consider seeking a second opinion from another dermatologist. They can provide additional insights and alternative treatment options tailored to your specific skin type and concerns. Remember, effective management of closed comedones often requires a multifaceted approach, combining both at-home care and professional treatments.