Retinoids in comedones treatment

Retinoids are derivatives of retinoic acid, syntetic analogs of vitamin A. Being a components of comedonal acne (also called comedones, clogged pores etc.) treating products, they regulate sebaceous secretion and skin cells keratinization processes. The fact that retinoids accumulating in the sebaceous glands reduce inflammation and treat acne is very valuable.

Retinoids possess following effects:

- remove hyperkeratosis;
- lighten the skin;
- improve skin firmness and elasticity;
- diminish wrinkles;
- reduce inflammations;
- speed up healing processes;

Types of retinoids used for acne treatments:

There are several groups of retinoids (generations).

First generation includes retinoic acid derivatives. This group includes retinol, retinal, tretinoin, isotretinoin, alitretinoin. These substances are widely used for acne treatments. They are especially effective in comedonal acne (whiteheads and blackheads comedones) therapy.

The scale of retinoids activity can be presented in the following way (form left to right):

Retinyl palmitate => Retinol (Retinol) => Retinaldehyde (retinal) => Retinoic acid (retinoic acid)

Retinoid called tretinoin reduces sebum production and accelerates skin cells regeneration, inhibits micro comedones formation and promotes closed comedones (whiteheads) into open comedones (blackheads) transformation.

Retinoid isotretinoin inhibits sebum production, prevent microcomedones and blocked pores formation, posess antibacterial and anti-iflammatory effects.

Retinol derivatives are a medication, so their usage cosmetic products is limited while retinol and retinilpalmitat are more common. This is because of that fact the cosmetics, unlike medications, is usually used for a long time and without any medical control.

Retinoids properties:

1. Comedolytic. The application prevents comedonal acne formation and promote closed comedones (whiteheads) into open comedones (blackheads) transformation making them more accessible of other medications penetration.

2. Sebostatic. Reduce sebum production preventing congested pores formation.

3. Normalize cells differentiation. Decreases hyperproliferation of sebaceous gland epithelium and decreases cell adhesion promoting drainage of clogged pores.

4. Anti-inflammatory. Reduces the inflammation around the sebaceous glands.

5. Do not cause toxic reactions.

How to use for comedones treatment:

- apply in a very thin layer only on a dry and clean skin;
- apply a small amount;
- gradually increase concentrations;
- at the beginning of the treatment apply 2-3 times a week, after 2 weeks apply every night or day and night if skin is not exposed to the sun;
- use at least 2-4 month for the best results, as a maintenance therapy use 2-3 time a week for a several month;
- depending on the skin type choose gel ( for oily skin type), cream (for dry skin) or lotion emulsion (oily to combination skin) form;

Contraindications for retinoids usage:

If you want the therapy effects increase, retinoid containing products should be used constantly, it doesn’t cause addiction. However they have some contraindications: sensitive and allergic skin, inflamed skin areas.

Retinoids should not be used by:

- pregnant women;
- those who are taking medications which increase photosensitivity (skin sensitivity to the sun);
- those who take vitamin A;

Retinoids increase skin sensitivity to the sun radiation so the sunscreen should be used. Avoid skin peels and other irritating products including alcoholic solutions and scrubs.

Comedonal acne

Comedonal acne is one of the non-inflamed acne forms. Depending of the nature of comedones manifestations, comedonal acne can be mild, moderate or severe. The form is determined with the help of visual inspection including the number and structure of acne elements evaluation, sebum secretion, keratinization and keratosis processes level evaluation. In most cases, the appearance of comedonal acne does not involve the inflammatory process or pathogenic microflora development.

Causes

The main morphological elements are single comedones. Comedones can be open and closed depending on their formation. Open comedones appear in the case when sebum, dead skin cells and dirt accumulate in the pore at skin surface. As a result of sebum oxidization these clogs become darker and form a blackhead. Closed comedones are the small light-yellow nodules slightly protruding above the skin surface.

Closed comedo (or whitehead) forms due to the sebum and keratosis products accumulation deep into the hair follicle. As a result, sebum oxidization becomes impossible but favorable conditions for anaerobic pathogenic bacteria growth appear. This causes the development of inflammation and suppuration processes. As a rule, comedonal acne appears in people suffering seborrhea and various acne forms. Comedonal acne can also occur as a result of sun exposure and other physical factors.

As atrophy of sebaceous glands takes place, comedones transform into dense blackheads and cysts, resulting in hair follicles expansion. The skin thickens and becomes rough due to the elastic fibers amount decrease. A correct diagnosis is very important to determine an adequate treatment. Therapeutic methods used for papules, pustular and nodular-cystic formations are inappropriate for comedonal acne treatment.

Open and closed comedones

Micro-comedones are primary microscopic clusters of sebaceous glands secretion formed due to the hair follicle partial blockage. The blockage is caused by corneocytes (surface skin cells that constantly shed). Micro comedones are hardly visible on the surface of the skin.

Closed comedones (whiteheads) form due to the further sebum accumulation and its pressure on the clogged follicle. The main feature of closed comedo formation is nodules formation beneath the skin surface. Inflammatory processes are not very active, however favorable for anaerobic propionibacterium conditions cause superficial skin layers inflammations. Therefore, closed comedones are often called “time bomb”.

Open comedones (blackheads) form due to the continuous accumulation of sebum and corneocytes in the sebaceous gland leading to the hair follicle atrophy. The sebum becomes thick and over-saturated by korneocytes and can not be moved to the skin surface forming a dark plug. This plug is made of densely packed corneocytes (dead ckin cells), sebum (skin oil), propionic bacteria and staphylococcus.

Comedonal acne treatment

In the case of comedonal acne dermatologist usually recommend to remove cosmetics properly, stop using comedogenic skin care products and use comedolytic treatments like retinoids or Alpha and Beta Hydroxy Acids. The recommendations and algorithm of various acne forms treatment commonly include following medications: in the case of mild acne – topical retinoids, topical antibiotics, in case of moderate acne – topical retinoids and/or benzoyl peroxide. As an alternative means different products containing azelaic acid, AHAs and BHAs, benzoyl peroxide and hormonal therapy can be used.

Cosmetic Acne and Pores Clogging

How cosmetics clog pores?

Cosmetic acne can strike everyone, even people who are resistant to acne manifestations. Cosmetics cause clogged pores (comedones). Most make up is usually removed during the day by clothes and rubbing, but some stays in the skin pores, builds up and provokes blocked pores, which inevitably leads to acne. Acne forms in a few weeks. Those who have sensitive skin or allergic reactions to any cosmetics ingredients are likely to get more severe acne in shorter time.

Cosmetic acne peculiarities

You can tell cosmetic acne by numerous small whiteheads on cheeks, chin and rarely forehead. Normally, it doesn’t leave scars, but it can be hard to get rid of cosmetic acne.

Cosmetic acne considerably differs from common acne by the cause of appearance. The latter is triggered by accumulation of oil, dead cells and bacteria while the former is caused by the impact of pore clogging products.

Many cosmetics are claimed to be anti-comedogenic. Stick to them if you suffer from cosmetic comedonal acne or susceptible to sensitive skin problems. This, combined with daily skin care regimen may help to reduce or even remove cosmetic acne and blocked pores.

Everybody can develop cosmetic acne. Since it takes time to appear, most women do not connect appearance of clogged pores to repeated application of particular acne-provoking products. They get into vicious cycle: the more whiteheads appear, the more make-up is applied to conceal acne manifestations. This only causes new breakouts.

Test one new product at a time

Sometimes temptation to try many new products at a time is irresistible. Though, it’s a bad practice. You won’t be able to track back efficiency of each cosmetic product. Good advice is to test new product alone, avoiding application of any other new health-and-beauty aids.

Introduce one new product to your beauty regimen at a time. If you notice any acne manifestations within a few days after application stop using the product and see whether your breakouts will go off. If they vanish, product is likely to be comedogenic and cause clogged pores. You may repeat application to reassure yourself that this health-and-beauty aid leads to blocked pores.

Precautions

Don’t use cosmetics that contain lanolin derivatives, isopropyl myristate or its substitutes, laureth-4 and D&C red dyes. Examine product labels to provide that cosmetic formula is safe and hasn’t been altered lately.

Choose natural products that prevent acne, cleanse debris and open pores without irritation or any other consequences. The one that regenerates damaged tissues will be perfect.

Follow these recommendations to prevent clogged pores and cosmetic acne.

Acne and Clogged Pores

Acne develops from clogged pores (comedones). Although it can emerge virtually anywhere on the body acne is mostly found on the face. Many forms of acne can be differed. It varies by strength from mild to severe. Mild acne is the most common form. It is usually self-treated and easy to handle. More severe acne breakouts require professional supervision.

Although pimples are the most widespread form there are other forms of acne. They can be divided into two groups, namely, non-inflammatory and inflammatory acne.

Non-inflammatory acne:

Two types of non-inflammatory acne (aka clogged pores or comedones) can be specified: fully clogged pores (closed comedones, whiteheads) and partly clogged pores (open comedones, blackheads).

Closed comedones or whiteheads appear when hair follicle is blocked underneath the skin. This acne eruption looks like tiny whitish bumps right under the skin.

Open comedones or blackheads appear when the clog enlarges itself and breaks through the skin surface. Such blocked pores are dark by color due to melanin build up. Amazingly, blackish appearance has nothing in common with debris or dirt.

Inflammatory acne

Most skin conditions are triggered by accumulation of sebum and dead cells near the hair follicle, leading to pore blocking. Clogged pore inflammation can be caused either by bacteria infection or irritation from squeezing. You can tell inflammation by reddening, swelling and pain. Four types of inflamed acne can be specified:

1. Papule is the mildest form of inflamed acne. It looks like a small solid pinkish bump and is frequently gentle by touch. Papules are considered an intermediary between inflammatory and non-inflammatory acne.

2. Nodules are big aching lesions. Acne of this type is filled with fuss and sits deep in one’s skin. It occurs when comedo expands further to skin, which activates the immune defense producing pus.

3. Pustules are tiny round lesions resembling papules. Though, they are often inflamed to a large extent and fester. In this case inflammation is caused by chemical irritation from sebum components (e.g. fatty acids) but not by bacteria.

4. Cysts are extremely large and inflamed acne. Indeed, they are referred to as the most severe form of acne. Cysts can be depicted as tender by touch, fluid-filled bumps under the dermis surface. They are really painful. Initially, cysts develop similarly to nodules: they stem from the deep break in the follicle wall. Subsequently, a membrane forms around the infection that has affected the skin. Then cyst starts its way to the surface injuring wholesome skin cells and destroying the follicle. This inevitably leads to scarring.

Clogged pores are initial forms of inflammatory and non-inflammatory acne that require proper treatment.