What should I do for clogged pores and tiny bumps not responding to topical creams?

Doctor's Answer

It sounds like you’ve got closed comedones. In colloquial speak, whiteheads!

Comedones are formed because of increased sebum production, and debris blocking your sebaceous ducts and hair follicles.

You are already doing the right things – BHA and retinol can help with comedones. You need to use them consistently, even when you don’t see any comedones.

Some other things that may work:

  • Use oil-free cosmetics and wash twice daily with a mild soap and water.
  • Choose “comedolytic” topical medications, like the ones you are already using. These should be applied once or twice daily as a thin smear to the entire area affected. Treatment needs to be continued long-term, even if you do not have comedones as it also helps to prevent new ones from forming (by encouraging skin turnover).
  • Another useful topical agent you may want to try is benzoyl peroxide. This is available OTC.
  • You didn’t specify which retinoid you are on, but you could again switch around and try which works well for you. Eg. tretinoin, isotretinoin, adapalene/Differin, Epiduo (I like Epiduo – it has benzoyl peroxide and a retinoid). All retinoids will require a doctor’s prescription in Singapore.

Finally, superficial TCA peels can work quite well for closed comedones, in your case. Speak to your doctor about this option, but make sure you do your own reading about all the other treatments yourself first too (to ensure you don’t go in wanting one treatment, and come out having bought a special 10x whitehead acne treatment “package”).

Cheers

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