Wednesday, July 15, 2015

What are Blackheads? Why do you have them?

The skin pores sometimes get plugged by keratin squames that pile up and stick together inside them. These keratin squames clump with debris to form a plug inside these pores and forms the blackhead or comado.  A comado may be closed by the skin, forming a whitehead because the air cannot reach the follicle to oxidize melanin, and thus it stays white. Whereas, when the pore opens to the skin surface, the air is allowed to enter, thus blackhead is formed. It can be accompanied by acne.

Blackhead is the first stage of acne, formed before the bacterial invasion of pores. Blackhead can develop into pimples (papules or pustules).  Menstrual cycles, puberty and other hormonal activities may contribute to the formation and worsening of blackheads and acne. During puberty, a rise in androgens (sex hormones) accelerates the growth of follicular cells and production of sebum. This phenomenon is similar to that occurring during pregnancy, where the increased androgen production leads to increased sebum production. This Sebum is intended to keep the hair and skin lubricated. At times, this sebum becomes blocked and bacterial accumulation begins. Sebum contains melanin, a pigment that gives the skin its color. Melanin turns dark (oxidizes) when exposed to air, forming a blackhead; whereas a closed pore would form a whitehead as mentioned above.

Factors other than hormones that can trigger blackheads include overuse of skin products like moisturizers, cosmetics and foundations. Very frequent face washing can also worsen the situation. Also, there is no direct relation between skin hygiene and blackheads because acne occurs beneath the skin. Stress too, does not cause blackheads. However, acne excorie is one of the types of acne in which pimples are scratched by a person in stress. In some cases, the blackhead susceptibility can be attributed to hereditary causes. Greasy foods and chocolates are not found to encourage the formation of acne, but cigarette smoking does.

Topical retinoids are the foundation for the treatment of comedonal acne, as they cause shedding and replacement of follicular epithelial cells and corneocytes at an accelerated rate and thus comedones are extruded. Adapalene is a third-generation retinoid, used to treat mild to moderate acne. In the USA adapalene is available as the brand Differin, in three preparations - 0.1% cream, 0.1% gel, and 0.3% gel. Also, it is available as Teva, (0.1% gel). In Europe only the 0.1% cream and 0.1% gel forms are available. Creams are preferred for dry sensitive skin whereas oily skin is usually treated with gells.

In women, oral contraceptives have often been used for the treatment of blackheads and acne. Another important management factor is cleaning the face regularly with a good cleanser. Most preferred cleansers are the ones for oily skin, such as a salicylic acid cleanser. Face washing should not exceed twice a day. Also hair should be kept away from the face to avoid the spread of infection through them. Moreover, an amazing virus lives on our skin that preys on bacteria responsible for causing blackheads. This virus can be extremely useful for treating this skin condition.

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