What is a Comedone?
Whether you have acne or not, the comedone is one of those unfortunate blemishes that all girls have likely dealt with at some point in their lives. It is the blemish nightmare. They can be difficult to treat, and harder to cover with makeup especially with their often rough textured appearance. The first step in dealing with it is always understanding what you’re dealing with. We will discuss what types there are, how they are formed, and what causes them.
Types of Comedones
The comedone is a bump on the surface of your skin. If the conditions are just right, the little bump starts under the skin because of a backup of oil and other debris down by the follicles. The comedone has two very basic types. They can be a little skin colored blemish, a white looking lesion commonly called a whitehead, or even blackheads.
When a comedone is first formed, the build-up by the follicle can cause a plug to form. How far it goes towards the surface of the skin determines what sort of comedone it is. Whether it stays at the bottom, or pushes itself up in a big mass out an open pore makes a difference.
The first type of comedone is called the open comedone. If the mixture of oil and debris pushes its way to the surface of the skin, it might happen to find an open pore. When the sebum, as it’s called, hits air it will turn black at the top. From the skin down, the entire pore will be clogged with a plug.
The second type of comedone, the closed comedone, everything stays under the surface of your skin. You will get a build-up of oil and debris down by the follicle, but if it stays down by the follicle it may end up blocking it off entirely. If this is the case, you might only see a skin colored bump on the surface of your skin. If the oil and other debris builds up enough, it can push up through a pore and form a white head on the skin’s surface. This is where some debate comes in. A comedone is thought to be non-inflammatory, however they can become inflamed at this point if the pocket of oil and debris ruptures by the follicle.
There are other subcategories in among the comedones. There is the micro-comedone which is a basic precursor to the two main types. They can’t even be seen by the naked eye, but are known to plug up the pore starting off the build-up of oil.
If you have a comedone that’s larger than 1mm, its called a macro-comedone. These are definitely the ones are the most resistant to treatment among the types of comedones, and usually require a visit to the dermatologist to receive care.
The final type of comedone is actually found on those with skin damage, and so is often seen on the elderly. The solar comedone will display as either a whitehead or a blackhead comedone. The skin in the area will usually appear yellow, and a bit thick from solar elastosis.
How are they formed?
On a very basic level, a comedone is simply a formation of a build-up of oil and skin debris formed by the follicle. You can get them without having acne, and are considered non-inflammatory.
We will get into different causes shortly, but it all starts with a build-up of oil on the skin. Not many people know, but we all have skin flora, or natural bacteria that is on our skin. Its main purpose is to maintain a barrier against outside infections. They protect us for the most part. The problem comes in with the overproduction of oil. They love the stuff. When there is too much oil, they increase more than they probably should.
Now if you’ve got too much oil building up on the skin, it can begin to mix with excess dead skin cells you might have hanging around. Remember those bacteria that are breeding like mad about now? Throw those into the mix and it makes your skin a little unstable. Some of that extra oil, debris, and bacteria can slide into the pores and start mixing up into a sticky paste down by the follicle.
The different types of comedones are formed here. Typically with a closed comedone, the follicle is totally blocked. That sticky paste of your skin’s natural oil, debris, and bacteria forms a pool of sorts that pushes at the surrounding tissues. A bump forms on the surface of the skin. Sometimes, a bit of the oil will push up the pore to the surface and form the tell-tale white head.
The open comedone is formed is a fairly similar manner. The difference here will come down to the pores that mixture found itself in. In this case the oil, debris, and bacteria gather down near the follicle of a pore that happens to be open. The plug that forms has a straight shot to the surface and once it hits open air will form head of black at the very top.
Both types of comedones have similar starts, but they look very different on the skin. Both are equally difficult to remove from the skin. Careful, but often very different treatment methods are required for the two types of comedones.
What causes a comedone?
Technically there isn’t any one singular cause. Typically, and most common especially in teenagers, and women, it’s caused by hormones. Girls and boys have adrenal glands that produce male hormones that stimulate the follicles. They bother us during puberty, and during later periods in life. Any time those male hormones are circulating, you’ll see an increase in oil production on your skin.
For girls, you’ll see it during menstruation as well. Skin tends to be more hydrated during this time period naturally. Many believe that a skin care regimen becomes a factor during these times as any additional moisture to the skin can make the situation worse.
There are also other factors that come into play, such as with skin care products that might clog your pores. Your own body might clog the pore if the hair grows wrong and doesn’t come out right. There has even been evidence that genes may play a part for some people.
Whatever the case may be, understanding the comedone is merely the first step.
Ways to Remove a Comedone
Removing a comedone can be a frustrating process for many. Understanding what a comedone is may be the first step, but learning how to treat it can sometimes be a leap. As we have previously covered blackheads in another article, we will feature treatments for closed comedones this time. While the basic skincare regimen for healthy skin is the same for any blemish prone skin, some of treatment options will vary greatly when you have a completely blocked follicle.
Clean & Exfoliated
When you’re trying to remove a comedone you need to first address what’s causing it. Due to the tendency for comedones to form when there’s a build-up for oil on the skin’s surface, it helps to be sure the skin is clean. Wash your face twice a day to make sure the day’s build-up of oil and debris is removed. If you’ve been wearing makeup, be sure to remove it so that there’s nothing extra to clog up the pores. It’s not necessary to use anything too harsh. If you wash your face too often, or use a cleanser that’s overly drying, you can actually cause your skin to want to produce even more oil to hydrate itself. So don’t do it! That’s the first mistake many people make, and one I myself made when I was much younger. The routine I use now is to wash twice a day with a gentle daily cleanser that suits my sensitive skin needs.
A comedone also has excess skin debris in it, so you need to be sure you’re exfoliating your skin once or twice a week to be sure there isn’t anything there for future comedones to grab onto. Don’t do it more than that, and never use anything too harsh on your skin. The closed comedones are actually pretty fragile. You don’t want to do anything that could possible cause the comedone to rupture, so always be gentle.
I know you’re probably wondering if you read that right, but you did. If you’re trying to remove a comedone, letting your skin dry out is a good way to make the situation worse. Believe me, I’ve been there. It’s an endless cycle sometimes of thinking that if you dry out the oil on your face, you’ll somehow make the blemish disappear. But it never quite works that way. If you wash with a harsh cleanser, then immediately apply a topical comedolytic medication of some sort (like benzoyl peroxide) you’ll end up with dry, red skin. Your skin’s response to this is to try and rehydrate itself by making yet more oil. A treatment like benzoyl peroxide is very drying on its own, which would cause even more dry skin cells to collect on the surface of your skin. As you can imagine, it can sometimes make the situation worse, even with the medications.
Your skin really does need a bit of balance. On the one hand, you’re producing too much oil which you’re helping to take care of by washing twice a day. But you also need to balance it out to make sure there’s no extra dry skin cells and debris. Exfoliation helps, but using an oil-free moisturizer on a daily basis will do wonders.
When treating closed comedones, you’re likely to come across some very harsh treatments. I myself am very sensitive to quite a few of them. The most basic treatments would usually consist of things like benzoyl peroxide, azelaic acid, glycolic acid, or salicylic acid. Many of them are easily found over the counter. If you’re like me though, you might have trouble using them. Some people are able to use azelaic acid as it’s a wheat based acid and tends to be milder on the skin for some. Not everyone tolerates it well though.
As an alternative to benzoyl peroxide, studies have shown that thyme (and oregano which is in the same plant family) show promising results when use topically. Typically, it’s used in the form of a tincture. It’s very similar to a toner, but it’s a longer process to make. You would need to sterilize a jar. You can either run it through a dishwasher, or boil it for ten minutes. Once you do that add 1 tablespoon dried thyme to 4 tablespoons of witch hazel and shake it well. It will turn color in about 20 minutes, but it really needs to be kept for a few days in a cool dry place. After it has sat a few days, you’ll strain it through a coffee filter. You’ll need to have another sterilized bottle on hand to store it in. It’ll keep for a month like this so long as it’s kept in a dry, cool environment.
Another alternative, if you remember from our articles on blackheads was the alternative to salicylic acid. Apple cider vinegar is excellent at controlling oil, and works wonderfully as an astringent. Typically, you would use 1 part vinegar to 3 parts water. To add in the component for salicylic acid, it’ll vary the recipe. You’ll need to adjust the strength that works for your skin. The recipe that works well for us is 3 tablespoons mint, 2 ounces vinegar, and 8 ounces water.
For a spot treatment, I’ve found the best treat is actually garlic. It smells awful, so it’s best to do it at night. You can either cut a clove in half and rub it on the whitehead, and leave it there overnight. You would then wash it off the next morning as part of your regular routine. Some people have found that too harsh for their skin, and have found it better to dilute a solution of 3 cloves and add it to 1 cup water. You would let that steep for 10 minutes, and then add cotton pads to the solution and let the soak a few minutes. You would then apply those to the skin and leave them for five minutes before removing and rinsing.
Is there more?
There really is much more out there to be found on the topic of treating comedones naturally, but these are the best treatments I’ve found. I encourage you to explore and see what you can find, and see what works for you. Everyone’s skin is different, and not every treatment will work the same for each person. Hopefully with time, you too can successfully clear your skin.