A four-month study by serial photography of the progression of comedones in a 17-year-old white boy with untreated, moderately severe acne vulgaris showed that both open and closed comedones (blackheads and whiteheads) can become inflamed and pustular.
However, having comedones does not necessarily mean you'll get pimples. Other factors (including genetics) also play a role in who gets acne. Comedonal acne can also be caused or made worse by the products you put on your face or skin. This includes oily skin care products or hair pomades.
In fact, whiteheads—which are technically an early stage of acne—aren't even really poppable, Dr. Mariwalla says. If they're left untreated, however, they can progress into the full-blown, angry pimples you know and loathe.
Purging is very common - as many as 25% will experience some degree of purging. If you think about it, that makes sense. You're pushing out clogged up pores in a speeded-up fashion under the influence of your Preventor, so instead of getting those spots over the next 3 months, you get them over the next 3 weeks.
How to Treat Closed Comedones? Resolution is going to take time. This is the first thing to be aware of. Even more importantly, things might look worse before they get better.
Stage 4 – Severe Inflammatory Acne
Severe inflammatory acne is characterized by large, inflamed, and sometimes infected nodules and cysts. This form of acne is most likely to cause scarring and hyperpigmentation. It is also the most likely to impact all areas of the body in addition to the face.
Prevention of Closed Comedones
Drinking enough water is another crucial part of keeping your skin hydrated, which helps regulate oil production. Regular cleaning of makeup brushes and avoiding touching your face at any price is another thing to consider.
Over-the-counter acne creams, gels, and ointments containing benzoyl peroxide, adapalene (0.1 differenc gel) salicylic acid, or glycolic acid can speed up the shedding of dead skin cells and help clear excess sebum from the skin. This can help keep pores from getting clogged.
Appearance. Acne purging and breakouts can look similar at first glance, with increased red bumps and pimples. However, purging tends to cause uniform congestion, affecting the entire area where you applied the new treatment. Breakouts often appear more sporadic in your usual problem spots.
Picking or popping blemishes can make them worse or cause scarring. Touching them can spread bacteria from your fingers and lead to infections.
Grade 4 (severe nodulocystic acne): Numerous large, painful and inflamed pustules and nodules.
Adults with oily skin are more likely to get this type of acne. Additionally, it occurs more frequently in smokers. The following are additional comedonal acne risk factors: Diet categorized with a high dairy intake and lots of fats and sweets.
As closed comedones are caused by a build-up of bacteria and dead skin cells, you can prevent them by cleansing the skin in the morning and evening with a product such as La Roche Posay Effaclar Purifying Cleansing Gel.
While pimple patches are effective on open whiteheads and existing breakouts, they are not very useful on closed lesions or deeper pimples such as blackheads. They work best as spot treatments on active pimples but cannot help prevent breakouts. They are also unable to prevent scarring, sadly.
Extracting closed comedones is best done by a professional to avoid damage and infection. A dermatologist or trained aesthetician can use sterile tools to gently remove the trapped sebum and dead skin cells. Avoid squeezing them yourself, as this can lead to inflammation and scarring.
Over-the-counter topical treatments
Several effective over-the-counter options can help manage comedonal acne: Salicylic acid: this beta-hydroxy acid (BHA) helps exfoliate the skin and unclog pores. Benzoyl peroxide: while primarily known for its antibacterial properties, it can also help reduce comedones.
Benzoyl peroxide attacks the bacteria on your skin. It also helps to unclog pores by removing dead skin to prevent blockages. This treats existing acne and may help prevent new spots. It works best when you use it regularly.
How long will it last? Because purging occurs with a change of skincare regime, it should only take one full skin cycle to get through the worst of it. On average a skin cycle is 5-6 weeks. At the age of 19-21,the process can take 14-21 days compared to a middle-aged adult where it is estimated to be 28 days.
“Skin purging occurs when a product or process speeds up the skin's cell turnover, leading to tiny open or closed comedones that usually manifest as whiteheads on the skin.”
While drinking water alone isn't a cure for acne, it can contribute to clearer skin. Adequate hydration supports your body's natural detoxification processes, helping to flush out toxins that might otherwise contribute to skin issues. Water consumption can also help balance your skin's pH levels.
What causes comedones? Comedones arise when cells lining the sebaceous duct proliferate (cornification), and there is increased sebum production. A comedo is formed by the debris blocking the sebaceous duct and hair follicle. It is now known that comedones also involve inflammation (see causes of acne).
Closed comedones vary in size. They do not itch and spread out with a red or flesh color. On the other hand, fungal acne is uniform in size, appears in clusters, and is pus-filled.
However, ice may have little to no effect on noninflammatory pimples, such as comedones, more commonly known as blackheads and whiteheads. While a cold compress can minimize inflammation and make pimples less noticeable or painful, it will not remove the contents inside a pimple.