Comedones are small bumps (papules) with skin color that are often found on the forehead and chin, mainly in individuals who have acne prone skin. They are differently known by the name: internal spots on the skin / blackheads. The names come from the way comedones look on your skin. They are small bumps that are either the color of the skin or have a dark spot on top. They are usually more common on the forehead, cheeks and chin, but you may also see them on the body, mainly on the back or in the area near the eyes.

Types of comedones

In fact there are 6 different forms of comedones, that appear on the skin of individuals, certainly according to the specifics of each skin type.

• Open comedones (small black dots)
• Closed comedones (spots with skin color), where the follicle is completely blocked
• Large comedones (mainly on the body) look like a type of cyst in which there is a clear opening like a black spot on the skin
• Microcomedones, too small to be seen with the naked eye but with premises to be enlarged if not treated
• Macrocomedones are closed facial comedones larger than 2–3 mm in diameter
• Solar Comedones are found on the cheeks and chin of older people and are thought to be due to sun damage.

Causes

In general, everyone is likely to have comedones, but depending on the skin type and skin care routine. They are created when the cells surrounding the sebaceous duct multiply (framing) and consequently increase fat production. A comedo is formed by impurities that block the sebaceous duct and hair follicle.

Other reasons that lead to the creation of comedones are:

• Smoking  – solar comedone  is more common in smokers than in non-smokers.
• Over hydrating the skin or using unsuitable moisturizers for your skin.
• Diet that consists of many fats and sugars.
• Excessive activity of the male sex hormone 5-testosterone (DHT) within skin cells.
• Contact with certain ingredients including oily ointments, isopropyl myristate, propylene glycol and some dyes in cosmetics.

How are comedones treated?

• Be careful in implementing your routine, by cleansing the skin 2 times a day, treating problems, hydrating and protecting the skin from the sun.
• Let your moisturizer dry before applying sunscreen and make up.
• Clean the face after exercise regardless of the schedule.
• Use masks with charcoal or clay but take care to use them properly and do not irritate or dry the skin. You can also use Tea Tree Oil as well as a tonic with Hamamelis (Witch-hazel)
• Be careful in the food diet, balance the consumption of fats and  added sugars.
• Also do not overdo it with dairy.
• Never sleep with make up, as this can block more fat and dirt in your pores.
• Do not harass your comedones yourself, without the help of a professional.
• Choose products suitable for your skin, preferably “oil-free”.
• Products for local use which fight comedones are advised to have at least one of the following ingredients:\
  • retinoids such as tretinoin, isotretinoin, adapalene (advised to be prescribed by a doctor)
  • – Azelaic Acid
  • – Salicylic acid
  • -Glycolic acid
  • -Benzyl Peroxide

For people who have solar comedones it is recommended:

• Use sunscreen all year round where the sunscreen is “oil-free”
• Cleaning the skin 2 times a day with a suitable cleanser
• Use of retinoids in the area where solar comedones have appeared
• Do not smoke
• Cleaning them by specialists with the right equipment
• In the most developed cases, their elimination with electrosurgery is recommended

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