Open comedones (Blackheads)

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hozzy159
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by hozzy159 on Mon Sep 05, 2016 12:11 pm

Open comedones (Blackheads)

Everyone has a few blackheads now and then. I have suffered with dozens on my nose every day since I was a teenager, I'm now 30 and still can't bear to have my face very near another person's. The effect on self-esteem and relationships is understandably significant. What solutions are there for people like me? Removing them one by one seems impossible, and only leaves gaping holes for them to return. Lifelong weekly facials might be another unsatisfactory strategy. I wonder what's the best that medicine has to offer? As a child I was prescribed antibiotics; I'm sure even the GP had little hope for their effectiveness. Have there been developments in treatment since?

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wendygreen
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by wendygreen on Mon Sep 05, 2016 6:38 pm

Re: Open comedones (Blackheads)

Hi,

I think it would be worth visiting your GP again as blackhead treatments have certainly moved on! There are now several topical treatments that help unblock pores and kill bacteria on the skin. These include vitamin A gel or cream, benzoyl peroxide, antibiotic gel or cream and azaleic acid gel or cream.

As well as oral antibiotics there are also hormonal treatments for women if their acne is thought to be linked to certain hormonal conditions such as polycystic ovaries.

It's also worth trying to improve your diet by cutting out refined carbohydrates and sugars (cakes, biscuits, pastries and sweets) and eating plenty of fruit and vegetables to see if it helps improve your skin.

Hope this helps.

Wendy
Wendy Green
Health Expert & Author - BSc (Hons) Health Studies
http://www.talkhealthpartnership.com/on ... _green.php

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Dr Anjali Mahto
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by Dr Anjali Mahto on Tue Sep 06, 2016 7:11 pm

Re: Open comedones (Blackheads)

Thank you so much for your question and I can understand what a nuisance it must be to still be troubled by blackheads. Even if blackheads are removed by a variety of procedural methods, they have a tendency to clinically reform every 20-40 days after extraction so multiple ongoing treatments are required.

Topical retinoid creams containing vitamin A that are prescribed by either a GP or dermatologist (Differin, tretinoin) can be helpful in reducing blackheads. These creams and gels often need to be used ideally for 8-12 weeks before real benefit is apparent, so definitely aren't a quick fix.

It can be helpful to exfoliate the skin on a weekly basis to remove the upper layer of dead skin cells and reduce the formation of blackheads. I wouldn't recommend doing this more than once weekly as you may irritate the skin and make it worse.

Steam extractions can also be of benefit. Steam is used to open the pores then an extractor tool can be used to remove blackheads. This treatment can be carried out by a properly trained medical aesthetician. Its benefits are that it can reduce the number of future inflamed acne spots and immediately creates a sense of "decongestion" or unblocking of the skin. However, it carries a risk of damage to the skin and can make cystic spots worse. It, really, therefore needs to be done by a trained professional. As blackheads reform over time, the procedure will need to be repeated.

Chemical peels can also be used for comedones with good results and there are many types of superficial peels available (e.g. gycolic acid and salicylic acid). These chemicals are applied to the surface of the skin and cause an accelerated type of exfoliation. Again, it is important to see a trained professional as not all peels are suitable for all skin types and certain types of acne may not respond. A dermatologist will be able to guide you.

Comedones can also be treated with heat treatment known as electrodessication. A fine metal electrode heats up the skin and removed the blackheads. This treatment is sometimes used by dermatologists to reduce blackheads before starting someone on stronger acne medication such as isotretinoin (Roaccutane).

If your acne is a mixture of blackheads and other types of acne spots (red bumps known as papules or deeper cysts) then you may require oral medication for control. This can include antibiotics, hormonal treatments such as spironolactone, and isotretinoin.

I hope this answers some of your questions. Female adult acne is a growing problem seen frequently in dermatology clinics. If your acne is affecting your self esteem, then please see your family doctor or dermatologist to discuss options. There are a large number of available treatments and I'm sure you will find the right one for you.
Dr Anjali Mahto
Consultant Dermatologist and British Skin Foundation spokesperson
http://www.talkhealthpartnership.com/on ... _mahto.php

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Dr Walayat Hussain
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by Dr Walayat Hussain on Wed Sep 07, 2016 12:10 pm

Re: Open comedones (Blackheads)

Thanks for getting in touch.

My colleague, Dr Mahto has given you a really comprehensive reply, so not much to add. I do want to stress however, that this is not something you just 'have to put up with'. There are several very effective treatment options available. Please do make sure you see a GMC registered Consultant Dermatologist to ensure you get the best advice tailored to your personal needs.
Dr Walayat Hussain
Consultant Dermatologist & Specialist Dermatological Surgeon

http://www.talkhealthpartnership.com/on ... ussain.php

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Dr Anton Alexandroff
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by Dr Anton Alexandroff on Mon Sep 12, 2016 10:45 pm

Re: Open comedones (Blackheads)

Thank you very much for your question. I agree with my colleagues.
This is unfortunately is a common and disressing problem not only in teenagers but also in adult women and men.
My favourite treatment for acne is a topical retinoid gel called Epiduo gel (a combination of a retinoid and a bleaching antimicrobial chemical - benzoyl peroxide) which is quite strong so has to be used gently (although other alternatives are also available e.g. Treclin). This can be combined with an oral antibiotic to make it more effective (e.g. lymecycline once daily). If usual antibiotics cause stomach upset, thrush or sun sensitivity, Efracea - a newer and more expensive antibiotic with a slow release submicrobial mode of action can be used. This combination in ladies can be used together with an oral combined contraceptive pill if appropriate (e.g. Dianette). The most effective treatment available is oral isotretinoin (Roacutane) which has to be prescribed and monitored by a dermatologist, because it is so powerful. You can read more about acne and available treatments on this website: www.alexandroff.org.uk

Of note excessive consumption of dairy and/or chocolate may aggravate acne so I hope you are not over indulging in these foods.

I hope this might be of help.

with very best wishes,

Dr Anton Alexandroff CCT(Dermatol) FRCP(UK) FAAD FRSM
Consultant Dermatologist and Senior Lecturer
Member of British Association of Dermatologists
De Montfort University, Leicester Spire Hospital, Leicester Nuffield Health Hospital, Bedford BMI Manor Hospital
www.alexandroff.org.uk
Dr Anton Alexandroff
Consultant Dermatologist, Honorary Senior Lecturer & BSF spokesperson - FRCP, CCT (Derm), PhD, FRSM, FAAD

http://www.talkhealthpartnership.com/on ... ndroff.php

BandyGirl
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by BandyGirl on Tue Sep 13, 2016 12:09 am

Re: Open comedones (Blackheads)

Until a couple of weeks ago, I had suffered with patches of blackheads all over my nose. I am in my very late thirties. However, I can across (by accident) a homemade remedy and thought it wouldn't hurt to give it a try!? WOW! Am I glad tried! I can't believe my nose is mine! It's completely blemish free!


You just need a small amount of honey, add some ground cinnamon and mix until you have a paste consistency. Spread this paste over the area you wish to treat. Then, completely cover with a flat piece of cotton wool and leave for 4-5 mins. When you take away the cotton wool you can see that the paste has separated the blackheads from your skin onto the cotton wool. I can't believe two simple and natural ingredients from my kitchen cupboard achieved what expensive Skincare products had failed to do!

I am not a doctor but I highly recommend trying this remedy!

hozzy159
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by hozzy159 on Mon Sep 26, 2016 10:49 pm

Re: Open comedones (Blackheads)

Thank you so much everyone for all your responses. There are some options here that are new to me, so I feel renewed motivation to seek and explore treatment. Ideally a solution would not involve oral antibiotics as I understand gut health to be fundamental and systemic. I'm especially interested in it's links to mental health via the vagus nerve, so in light of aforementioned low self-esteem and/or depression, topical treatments are preferable. I have enjoyed some good results with salicylic acid gels and creams, however while it makes the rest of my face look fantastic, still won't shift the entrenched little critters! =]

A few years ago I envisaged a lifetime of expensive facials ahead of me; a disheartening thought, I essentially resigned myself to live with this problem. Now I think, well if that's the best option, then at least I know it's the best, so why not. And if through pursuing treatment, something new is even better, then great. At least I'm optimistic and resolute enough to try. I've felt quite alone with this; whilst a number of people must suffer with eczema or similar, I've only ever seen one other chap in my life have such a chronically dotted nose. Thanks again for your attention and help.

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