Effective Strategies to Treat Closed Comedones and Acne - Dermatology

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How to improve acne?


Since last summer, I have developed many closed comedones on my forehead and cheeks.
They don't seem to come out on their own unless I extract them, but when I do, they might not be completely cleared, leading to acne.
I have been continuously seeing a doctor, and while the comedones on my forehead have disappeared, I still occasionally get acne.
The comedones on my cheeks persist, and applying medication doesn't seem to have much effect.
Can I use extraction methods to improve this? Do all hospitals have this type of equipment, and will my skin be red after the extraction?

Xiao Qiong, 20~29 year old female. Ask Date: 2004/08/29

Dr. Jiang Zheen reply Dermatology


Clearing acne is possible, but it is only temporary, as it will return after a while.
The fundamental approach is to use topical retinoids, or to incorporate regular chemical peels with alpha hydroxy acids, both of which can achieve effective results.
Wishing you well.

Reply Date: 2004/08/29

More Info


Closed comedones, commonly known as whiteheads, are a type of acne that occurs when hair follicles become clogged with oil, dead skin cells, and bacteria. Treating closed comedones effectively requires a multifaceted approach that includes both topical treatments and professional interventions. Here are some effective strategies to consider:

1. Topical Treatments
- Retinoids: Topical retinoids, such as tretinoin or adapalene, are highly effective in promoting cell turnover and preventing clogged pores. They help to exfoliate the skin and can reduce the formation of closed comedones.

- Benzoyl Peroxide: This ingredient has antibacterial properties and can help to reduce inflammation and prevent the formation of new acne lesions. It’s often used in conjunction with other treatments.

- Salicylic Acid: A beta hydroxy acid (BHA) that penetrates deep into the pores, salicylic acid helps to exfoliate the skin and clear out clogged pores. It’s particularly effective for treating acne and preventing future breakouts.

- Alpha Hydroxy Acids (AHAs): Ingredients like glycolic acid can help exfoliate the surface of the skin, promoting the shedding of dead skin cells and preventing clogged pores.


2. Professional Treatments
- Chemical Peels: Dermatologists can perform chemical peels using stronger concentrations of AHAs or BHAs to exfoliate the skin more deeply. This can help to clear out closed comedones and improve overall skin texture.

- Extraction: Professional extraction by a licensed esthetician or dermatologist can safely remove closed comedones. This procedure involves using specialized tools to gently extract the clogged material from the pores. It’s important to have this done by a professional to minimize the risk of scarring or infection.

- Laser Therapy: Certain laser treatments can target acne and reduce inflammation, helping to clear up existing lesions and prevent new ones from forming.


3. Skincare Routine
- Gentle Cleansing: Use a mild, non-comedogenic cleanser to avoid further irritation. Avoid harsh scrubs that can aggravate the skin.

- Moisturizing: Even oily skin needs hydration. Use a lightweight, oil-free moisturizer to maintain skin balance without clogging pores.

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


4. Lifestyle Modifications
- Diet: Some studies suggest that a diet high in refined sugars and dairy may exacerbate acne. Consider a balanced diet rich in fruits, vegetables, and whole grains.

- Hydration: Drink plenty of water to keep your skin hydrated from the inside out.

- Avoid Picking: Resist the urge to pick or squeeze closed comedones, as this can lead to scarring and further inflammation.


5. Consultation with a Dermatologist
Since you mentioned that you have been seeing a doctor but still experience issues, it may be beneficial to discuss your treatment plan further. A dermatologist can provide personalized recommendations based on your skin type and condition. They can also determine if you need a stronger prescription treatment or a different approach altogether.


Conclusion
While closed comedones can be persistent, a combination of topical treatments, professional interventions, and a consistent skincare routine can lead to significant improvement. It’s essential to be patient and give treatments time to work, as results may not be immediate. If you’re considering extraction or any professional treatment, ensure that the facility is reputable and that the staff is qualified to perform these procedures. After extraction, it’s normal for the skin to appear red or slightly irritated, but this should subside within a few hours to a couple of days. Always follow up with your dermatologist for ongoing care and adjustments to your treatment plan as needed.

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