How can I prevent persistent closed comedones that keep recurring?

Doctor's Answer

Photo of Dr Joanna Chan
Dr Joanna Chan

Aesthetic, General Practitioner

It is great that you are using non-comedogenic products! Do take note, though, that no product is 100% safe, so the key is also not to apply makeup/cosmetics/skin care products excessively.

Comedones form when our skin cells lining the sebaceous ducts proliferate abnormally. Combined with the increased sebum production that is common in acne-prone skin and some skin debris such as cosmetic residue, these debris can block the sebaceous duct and result in a comedo.

In terms of controlling comedones, and acne, in the long-term, I would suggest the use of topical medical-grade creams as a cost-effective way to promote our skin’s normal shedding of dead skin cells so that they do not clog up the pores. In this way, they help to "exfoliate" the skin without excessive mechanical trauma/irritation.

Suitable agents include benzoyl peroxide and topical retinoids 0.025% or 0.05% such as adapalene 0.1% (differin) and treitinoin. Topical chemical peels containing glycolic and salicylic acid of the appropriate concentrations are frequently useful too. In severe cases oral medications such as isotreitinoin may be used.

If your problem is persistent, you could be experiencing a subtype of acne known as acne cosmetica, where multiple small skin-colored bumps and comedones form as a result of unsuitable/excessive use of facial products. As excessive sebum is also a factor in the formation of comedones as it increases the chance our dead skin cells lining the pores "stick" together, your doctor may also consider medications to target excessive sebum production such as spironolactone and oral contraceptive pills for some patients.

Do seek a consult with a trusted doctor for a more in-depth solution to your concerns. Hope this helps!

Best Regards,

Dr. Joanna Chan

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