Dr Sandra Lee Blackhead Removal (5)

Comedones are associated with the pilosebaceous unit, which includes a hair follicle and sebaceous gland. These units are mostly on the face, neck, upper chest, shoulders and back.[2] Excess keratin combined with sebum can plug the opening of the follicle.[2][8] This small plug is called a microcomedo.[8] Androgens increase sebum (oil) production.[2] If sebum continues to build up behind the plug, it can enlarge and form a visible comedo.[8]

A comedo may be open to the air (“blackhead”) or closed by skin (“whitehead”).[1] Being open to the air causes oxidization, which turns it black.[1] Propionibacterium acnes is the suspected infectious agent in acne.[2] It can proliferate in sebum and cause inflamed pustules (pimples) characteristic of acne.[2] Nodules are inflamed, painful deep bumps under the skin.

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