Comedonal acne is an extremely common, yet often misunderstood, form of acne. It is not characterized by inflamed pimples and pustules, characteristic of acne vulgaris (the most common presentation of acne). Instead, comedonal acne causes bumpy skin, blackheads, non-inflamed blemishes, and microcomedones to form on the skin. Microcomedones signal the beginning of an acne lesion and occur when the skin’s sebaceous ducts and pore openings become clogged with excess sebum and dead skin cells. Providing effective, clinical treatments for all stages and types of acne, our dermatologists in Gainesville are committed to helping our patients achieve healthy, beautiful skin.
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What Is A Microcomedone?
A microcomedone signals the primary stage of acne. Several factors contribute to the start of acne lesions. Corneocytes, also known as skin cells, take on a sticky texture as they are shed from the skin’s surface, accumulating within pores instead of dispersing out onto the skin. A greater number of skin cells are shed at the top of the skin’s pores than at the bottom. Thereafter, sebum production increases. During this stage of acne, the pore may appear normal to the naked eye, but there are noticeable changes in the cells that surround the pore.
As shed skin cells, sebum, and bacteria accumulate within the pore, they create a bottleneck that prevents the skin from sloughing off the dead skin cells. The clinical term for this is called a microcomedone. Propionibacterium acnes, or P. acnes, is a bacterium that normally resides inside our pores. This bacterium uses sebum as a nutrient for growth, and as sebum production increases, so too do the number of P. acnes bacteria.
What Is Comedonal Acne?
A common but often misunderstood form of ance, comedonal acne doesn’t feature inflamed pimples, pustules, and lesions, but instead, it causes the skin to become bumpy and develop blackheads and other non-inflamed types of blemishes. The body is covered with hair follicles. Comedonal acne develops when a hair follicle becomes blocked by sebum, a waxy type of skin oil, and dead skin cells, among other types of debris. A single lesion is known as a comedo, while multiple bumps are referred to as comedones. Comedones are small, flesh-colored papules that usually develop on the forehead or chin, though they can occur anywhere. Whiteheads and blackheads are among the most common types of comedonal acne, though other types of comedonal acne may occur as well.
Open comedones, or blackheads, occur when the debris and oil that plug the pore is located near the pore’s opening. They can be grey, black, brown, or another deep color. Blackheads are open-faced. When the melanin pigment found in the sebum produced by oil glands makes contact with the air at the top of the open comedone, the comedone oxidizes and turns dark. This is why blackheads have a dark appearance.
Closed comedones, also called whiteheads, form when a hair follicle becomes completely blocked or clogged. They can range in color from white to flesh-colored. They often appearon the forehead, chin, and cheeks, though they can appear anywhere on the skin. Whiteheads are not usually painful, and unlike blackheads, which can be pushed out, whiteheads are closed within the pore and cannot be pushed out.
A microcomedo cannot be seen with the naked eye and can only be seen under magnification with a microscope. Microcomedones occur with the minor clogging of the hair follicles with sebum, dead skin cells, and other debris. These comedones can develop into acne lesions and are typically treated with topical medications.
Macrocomedones are typically larger than 2 or 3 millimeters in diameter. They appear as white or skin-colored bumps that develop just under the top layer of the skin. You may be able to see them by stretching the skin and observing them using a sidelight. They are either closed or open comedones, but they are often open as they are large enough to push to the opening of a pore.
A giant comedo is a type of blackhead that ranges in size from several millimeters to 2 centimeters in diameter. They usually occur as a single blackhead and primarily affect older adults, though they may occur in people at any age. Also known as an epidermal cyst, or a dilated pore of Winer, giant comedones are exceptionally large blackheads.
A solar comedone, also known as a senile comedo, is a small, skin-colored papule found on the face of individuals who are middle-aged or more mature. These non-inflammatory lesions affect the areas of skin that have been exposed to sunlight for extended perioda. They may be either whiteheads or blackheads, and they don’t typically become inflamed.