Comedones

Comedones are one form of acne associated with the dysfunction of sebaceous glands and skin renewal processes. Their formation is based on a combination of increased sebum production, slowed shedding of dead skin cells, and changes in the microbial balance of the skin. As a result, the opening of the hair follicle becomes clogged, forming characteristic elements.

Most often, comedones are localized in areas with a high density of sebaceous glands – on the face (forehead, nose, chin), back, and upper chest, but they can also appear on the shoulders or neck.

Types of Comedones

There are two main types of comedones that differ in their formation mechanism and appearance:

• open comedones – form when the follicle opening partially expands, allowing sebum and keratinous masses to contact the air and darken due to oxidation;
• closed comedones – occur when the follicle outlet is completely blocked, causing the contents to remain under the skin and appear as dense whitish bumps.

Mechanism of Formation

The key factor is hyperkeratosis – the slowed renewal of epidermal cells. Dead cells do not get removed in time and mix with sebum, forming a dense plug.

Additionally, the situation is exacerbated by changes in the composition of sebum. In comedonal acne, changes in the lipid composition of sebum are often observed, related to the disruption of metabolism and transport of linoleic acid in the skin. As a result, sebum becomes denser, which facilitates the clogging of follicles and the formation of comedones.

Causes of Comedones

Factors contributing to the development of comedones affect both external care and the internal state of the body:

1. excessive activity of sebaceous glands, often related to hormonal fluctuations;
2. improperly selected care, including aggressive cleansing agents and comedogenic cosmetics;
3. hormonal changes during adolescence, pregnancy, and the premenstrual period;
4. diet high in simple carbohydrates, trans fats, and lacking protein and micronutrients;
5. chronic stress, sleep disturbances, and elevated cortisol levels;
6. deficiencies in zinc, vitamin A, B vitamins, and omega-3 fatty acids.

Prevention

Prevention of comedones aims to normalize skin function and eliminate provoking factors:

• gentle but regular skin cleansing without over-drying;
• using products labeled as non-comedogenic;
• maintaining adequate skin hydration to prevent compensatory sebum production;
• correcting diet with an emphasis on protein, vegetables, sources of zinc, and fat-soluble vitamins;
• normalizing sleep patterns and reducing stress levels.

Treatment Approaches

The treatment strategy depends on the severity of the condition and skin type.

In mild cases, proper care and regular exfoliation are sufficient. More pronounced cases require a comprehensive approach:

• professional skin cleansing with adherence to aseptic techniques;
• chemical peels with acids that promote normalization of keratinization;
• products containing salicylic acid, azelaic acid, or retinoids;
• addressing internal factors, including diet and hormonal balance;
• consultation with a dermatologist in cases prone to inflammatory forms of acne.

Conclusion

Comedones reflect not only the condition of the skin but also the overall metabolic and hormonal background of the body.

Eliminating only external manifestations without addressing the underlying causes often provides only a temporary effect. A comprehensive approach that combines proper care, nutrition, and lifestyle can significantly reduce the tendency for their formation and improve skin quality in the long term.