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Dermatovenereologist (cosmetologist)

Baichorova

Marua Azretovna

21 years of experience

Dermatologist (cosmetologist)

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The constant process of skin renewal can cause blockage of the sebaceous glands and follicles. Getting into microscopic holes, excess sebum and dead cells of the exfoliated epidermis lead to the appearance of blackheads or pimples. Experts have united them under the name “comedones”. The situation is aggravated by the lack of proper skin care, exposure to unfavorable sanitary conditions, as well as the intense production of sebum, the excess of which clogs the ducts and hair follicles.

The vast majority of cases of comedones are observed on oily facial skin: on the nose, forehead and cheeks. According to most medical specialists, such a pathology is true evidence of hormonal imbalances, hidden dermatological problems and malfunctions of the liver and gastrointestinal tract. Therefore, patients who experience discomfort from their appearance are advised not to focus on the cosmetic problem, but to undergo a comprehensive examination to identify possible diseases of the internal organs.

Etiology of the disease

The opinion that comedones appear only in adolescents and young adults is not entirely true. They occur in up to 85% of patients under 25 years of age, after which sebum production decreases and the conditions for blockage of the glands disappear on their own. Also, women often suffer from the disease during pregnancy and at the onset of menopause, when the body experiences a significant hormonal load. The intensive development of the disease can be caused by unsanitary working or living conditions, lack of proper skin care, neglect of hygiene rules and other reasons due to which the adverse effects on the skin of the face acquire such unpleasant consequences. Refusal to treat comedones can cause the formation of scars and age spots at the site of the rash, which can only be eliminated using plastic surgery methods.

Possible consequences of mechanical removal of comedones

You can squeeze out a blackhead without the risk of complications if you follow the rules. The main danger of removal is pustules that appear as a result of infection. After examination by a dermatologist, treatment methods are determined.

It is difficult to squeeze out a closed comedon on your own: the surface above the formation is dense and requires a lot of mechanical force. After manipulation, skin damage may remain with the formation of scars; it is recommended to get rid of pimples with exfoliants - peeling rolls, scrubs, masks with fruit acids.

Violating the integrity of the attribute can damage small blood vessels and provoke skin hyperemia, which can be removed with an ice compress.

Reasons for the formation of comedones

A black dot or raised white spot on the surface of the skin is excess sebum that is stuck in the sebaceous duct or inside the follicle. The resulting plug disrupts the functioning of the glands and forms a closed environment, ideal for the proliferation of pathogenic microorganisms. Their vital activity “enriches” the plug with toxins, which causes a local inflammatory process and its subsequent spread to healthy areas of the skin.

Among the reasons causing the appearance of multiple comedones on the face, ears or back, experts call:

• hyperactivity of the sebaceous glands;
• use of low-grade cosmetics;
• lack of proper facial care, as a result of which excess sebum and epidermal cells remain on the skin;
• refusal to remove traces of cosmetics before bedtime;
• smoking;
• living or working in an environment characterized by the presence of dust and small particles of dirt in the air;
• unbalanced diet, dominated by fatty, smoked and spicy foods, sweets and flour products;
• deficiency of microelements and vitamins.

A comprehensive examination of the body of a patient complaining of open and closed comedones often reveals hidden pathologies of the following nature:

• liver and gastrointestinal diseases;
• hypothyroidism, gonadal dysfunction, other hormonal disorders;
• genetic predisposition of the skin to inflammation;
• intensity of production of certain hormones, their imbalance in the body;
• uncontrolled use of hormonal drugs;
• frequent stress, sleep disturbances, insomnia.

Complete removal of an external skin defect is only possible if the internal causes listed above are eliminated.

How are closed comedones formed?

The mechanism of formation of white comedones involves 2 disorders:

• Hyperkeratosis - a violation of the exfoliation of keratinized cells inside the ducts of the sebaceous glands, scales accumulate and block the duct;
• Changes in the composition of sebum - it becomes thicker and denser, gluing the scales together, making it even more difficult for skin secretions to come out.

Closed comedones are formed in the presence of both disorders, as well as due to the narrowness of the excretory duct , i.e. pores. The release of the contents of the pores becomes impossible and a blockage forms (the initial stage of acne).

Varieties and features

The skin is sensitive to lack of care and disruptions in the body. Among the symptoms that precede the appearance of subcutaneous comedones, most patients note:

• a sharp increase in skin oiliness;
• density and roughness of the skin;
• change in natural skin color to an unattractive pale gray-green shade;
• dense nodules, indicating blockage of the sebaceous glands and hair follicles.

There are open and closed comedones, which differ in appearance. Black spots on the surface of the cheeks, nose and chin, the so-called T-zone, are an open form of the disease. Noticeable white sebaceous plugs under the skin are a closed type of pathology. They often develop against the background of hidden inflammatory processes due to skin damage by a fungal infection, staphylococcus or pathogenic bacteria. Lack of proper treatment causes plugs of purulent acne to appear at the site, which leave behind scars and scars.

The localization area for closed white comedones on the face is the forehead, nose and chin, as well as the décolleté and upper back. The appearance of formations on the body is often associated with wearing synthetic underwear and clothing, which does not allow air to pass through and causes the skin to secrete sweat. Trying to fight comedones by squeezing in unsanitary conditions only aggravates the problem. The pustular infection spreads to nearby healthy areas of the skin, and the disease progresses rapidly. And in place of the squeezed out formations there remains a serous crust and an inconspicuous scar, indicating damage to the skin.

Open comedones, or blackheads, acquire an unpleasant appearance due to contamination of the sebaceous plug with dust or residues of cosmetics. When exposed to air, the contents of the sebaceous duct oxidize and darken, making it visible on the surface of the skin. Removing such comedones does not bring the expected effect. The empty gland duct soon becomes clogged with fat, and the disease again makes itself felt with an unpleasant cosmetic effect.

When to see a doctor

Experts recommend not delaying a visit to the doctor if symptoms of inflammation and blockage of the sebaceous glands appear. You should not put up with an unpleasant cosmetic effect or try to cope with it using home methods, at the risk of intensifying the pathological process. Moreover, modern medicine has at its disposal many effective methods of combating the disease, depending on the type and general condition of the skin.

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Squeezing out blackheads does not prevent acne

Before squeezing out blackheads on the nose and other areas, even if you do it in a cosmetologist’s office, you need to consult a specialist. He must explain that comedone extraction is a cosmetic, not a therapeutic procedure. Treatment of acne should be medicinal; drugs are selected by a dermatologist individually, based on the severity of acne and the causes of its occurrence9.

The patient should treat acne as a disease, and not just as an aesthetic defect, and prepare for the fact that treatment may take several months, and getting rid of acne is not a guarantee that it will not return.

Azelik® gel is a medicinal product based on azelaic acid, used to combat mild to moderate acne5. The drug helps reduce free fatty acids on the skin, normalize keratinization processes, reduce the colonization of propionibacteria due to the manifestation of antimicrobial activity against propionibacteria and epidermal staphylococcus5. Its anti-inflammatory effect is explained by a decrease in neutrophil metabolism and the production of free radical oxygen species5.

Diagnostics

For an experienced dermatologist, an external examination of the patient’s skin is enough to immediately make the correct diagnosis. Specialized laboratory research methods allow us to clarify the mechanism of development of the disease and the presence of pathologies of internal organs: blood tests for hormonal balance and internal infections, tomography of the gastrointestinal tract and liver. It is possible to prescribe additional measures as part of a standard examination if the patient has a history of serious diseases of the internal organs.

Treatment

You can cope with the appearance of a limited number of pimples and comedones of any type with the help of careful skin care. In case of intense shedding, consultation with a dermatologist is required. He will select a remedy for comedones and a suitable list of procedures to free the ducts (so-called extraction) and reduce the volume of sebum production.

In most cases, the following treatment methods are used:

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• mechanical cleansing of the face - carried out after thorough cleaning and warming of the skin using the fingers, a Uno spoon or a Vidal needle. After cleaning, the skin is treated with alcohol. Provided the contents of the duct are completely removed, the risk of infection is reduced to zero, and there are no signs of hyperemia or inflammation on the face. During the day, it is strictly forbidden to use cosmetics so that its particles do not clog the open duct;
• enzymatic peeling using exotic fruit extracts. Loosening the stratum corneum of the skin allows comedones to come out naturally or through brosage - a cleaning procedure with soft brushes. Peeling is contraindicated in the presence of ulcers, exposure to which can cause skin infection;
• disincrustation is a hardware technique for removing comedones under the influence of a weak electric current. This method is used relatively rarely due to multiple contraindications;
• peelings - chemical, acidic, film or sheet, the effect of which softens the skin and frees the ducts from impurities. At the same time, the substances contained in the peeling preparation relieve the inflammatory process and soothe the skin;
• ultrasonic facial cleansing – treatment using ultrasonic waves, the “impact” of which gently “knocks out” plugs. At the same time, the procedure has a pronounced cosmetic effect - it removes wrinkles, refreshes the complexion, tightens the skin;
• Vacuum skin cleansing – gentle removal of plugs from the ducts, leaving no noticeable marks. The procedure is contraindicated for patients with rosacea, because there is a risk of injury to small vessels.

Please note: squeezing comedones and using dubious home remedies can worsen your skin condition. It is also not recommended to select medications at the pharmacy on your own, relying on commercials and advice from friends. Treatment should be prescribed only by an experienced specialist who has studied the results of diagnostic studies.

Professional cleaning of comedones

There are cosmetic procedures for grinding, peeling, and mechanically squeezing out pimples with a deep core. Diagnosis of pathology and determination of the degree of damage by comedones is carried out using a microscope.

When removing a formation, a specialist can use a Uno spoon, a metal cosmetology needle, or a Vidal loop - a stick with an elongated eye at the end. Before squeezing, the patient’s face is steamed, softened, and dirt is removed from the pores by pressing on the area with the comedone.

Types of hardware cleaning:

• vacuum: the plug is sucked out from the skin with a device;
• ultrasonic: short waves penetrate the epidermis, massaging the tissue, pushing out comedones;
• galvanic: low voltage currents soften sebaceous plugs, squeezing the substance out of them.

You can remove the top layers of skin by extracting the formation using chemical peels: Jessner, salicylic, trichloroacetic, fruit, glycolic. The procedures help eliminate wrinkles, scars, tighten the oval of the face, and remove pigmentation.

How to make an appointment with a dermatologist at JSC “Medicine” (clinic of academician Roitberg) in Moscow

You can make an appointment with the specialists of JSC "Medicine" (clinic of Academician Roitberg) on ​​the website - the interactive form allows you to select a doctor by specialization or search for an employee of any department by name and surname. Each doctor’s schedule contains information about visiting days and hours available for patient visits.

Clinic administrators are ready to accept requests for an appointment or call a doctor at home by calling +7 (495) 775-73-60.

Convenient location on the territory of the central administrative district of Moscow (CAO) - 2nd Tverskoy-Yamskaya lane, building 10 - allows you to quickly reach the clinic from the Mayakovskaya, Novoslobodskaya, Tverskaya, Chekhovskaya and Belorusskaya metro stations .