White Points

What are White Points

Technically known as closed comedones, whiteheads represent a type of non-inflammatory acne which, although it can ideally affect any area of ​​the skin, tends to occur on the face, neck, back and forearm.

Attention

Closed comedones should not be confused with millet grains: although apparently similar, the two types of whiteheads differ in their triggering causes and in the necessary treatment. In this article we will focus exclusively on closed comedones.

Features

Closed comedones are small infarctions rich in keratin, sebum and bacteria that accumulate inside the hair follicles forming small (and unsightly) white, swollen and soft balls. The characteristic nickname with which this imperfection is identified derives precisely from their particular "white dome" appearance.

Symptoms

In addition to representing an evident aesthetic damage for the individuals who manifest them, in principle, the white points do not cause particular disturbances. However, in some cases, they could cause itching or pain.

Evolution

Evolution and degeneration of the White Points

In a certain sense, whiteheads are progenitors of acne: it is in fact not uncommon that, over time, the secretion contained within the sebaceous follicle pours inside, triggering an inflammatory reaction characterized precisely by papules and pustules ( pus-filled boils).
Before transforming into the so-called pimple or furuncle, the white point must however pass into the intermediate stage of black point: when the white point opens, the oxidation of lipids and the migration of cells rich in melanin and sebum favor the formation of a typical dark head (hence the term blackhead or open comedone).

Curiosity

After the white point has transformed into a black point, it is not certain that the pimple will inevitably form: once popped, the open comedones (blackheads) can in fact regress, remain so or degenerate into inflammatory acne, papules and pustules .

Causes

The origin of closed comedones is closely related to an overactivity of the sebaceous glands, the tiny anatomical structures used for the production of sebum. Any possible increase in the size of the sebaceous glands, as well as an overproduction of sebaceous secretion, can heavily influence the onset of white spots.
Closed comedones are also related to hormonal alterations: it is no coincidence that white spots are often observed during puberty and among young adults, as well as in women affected by polycystic ovary syndrome. In fact, during the phase preceding the puberty, androgens - produced by the adrenal glands (testosterone, dihydrotestosterone, dehydroepiandrosterone, androstenedione, etc.) and by the testicles in the male - undergo a physiological increase: consequently, the activity of the sebaceous glands is stimulated to the point of favoring the appearance of open, closed comedones and acne.
In addition to the causes listed above, it seems that the appearance of white spots is also linked to other factors:

• Presence of infected scratches on the skin or other forms of skin irritation.
• Excessive accumulation of sebum on the skin.
• Poor facial cleansing.
• Use of aggressive detergents or cosmetics.
• Presence of scars.
• Stress.
• Hereditary factors.
• Other forms of hormonal alteration (eg menstruation, pregnancy).
• Constant exposure to UV rays from the sun or to artificial lamps (especially in the absence of "adequate sun protection).
• Incorrect feeding.

Treatments and Remedies

Let's start immediately by saying that whiteheads must not be crushed: the treatment of blackheads, whether open or closed, cannot be separated from a specialist dermatological control.
By squeezing the white spot with your fingers or, worse still, with your nails, you risk infecting the area, promoting the appearance of scars and spreading dirt and bacteria to nearby areas. For this reason, it is recommended to resist the temptation to squeeze the white spots, relying exclusively on the care of an expert.

Behavioral precautions

When not instigated, whiteheads tend to regress spontaneously through the correction of some imperfect behaviors: it is in fact sufficient to optimize the facial cleansing method and always choose quality cosmetics, suitable for your skin type, to favor the spontaneous regression of blackheads. closed.
It is also recommended to use astringent lotions for the treatment of oily skin in moderation and common sense. By excessively drying the skin, these substances stimulate the sebaceous glands which, reacting to the insult, increase the production of sebum and predispose to the formation of white spots.

Pharmacological and aesthetic treatment

In the past, for the treatment of white spots, it was customary to prescribe a treatment based on retinoids to patients; considering the risks and side effects derived from these drugs (eg teratogenic effect), today doctors recommend chemical peeling sessions based on alpha- and beta-hydroxy acids (in particular, tartaric acid, glycolic acid and salicylic acid). By smoothing the skin and removing superficial dead cells, these exfoliating treatments stimulate both cell renewal and the synthesis of collagen and elastin in the dermis.
Furthermore, on the market there are several drugs without prescription to be used topically based on active ingredients with antibacterial, comedolytic and exfoliating action. As a rule, these drugs are used mainly for the treatment of acneic manifestations, but they can prove to be very useful even in case of whiteheads not related to acne.The classic example of an active principle of this type is given by benzoyl peroxide (Benzac®).
The topical application of antibiotic drugs, on the other hand, is reserved for severe cases of acne, characterized by the simultaneous presence of open comedones, closed comedones, papules and inflamed pustules.

Dermo-aesthetic medicine interventions

When local drug treatments are not sufficient to eradicate the disorder, whiteheads can be removed by minimally invasive interventions. Sessions of micro-dermabrasion with salicylic acid, laser therapy or surgical enucleation (a practice that involves the "expulsion of the infarction of the white point using a special surgical instrument)" are generally sufficient to completely eliminate the closed comedones from the skin, avoiding a possible " reappeared.

Useful tips

Despite what you might think, whitehead skin needs care and treatments just like dry or sensitive skin. To do this and to prevent, or at least limit, the appearance of white spots, it may be useful to adopt some precautions:

• For face cleansing, use non-oily and, above all, delicate products. In fact, the use of aggressive detergents - similarly to the excessive use of astringent products for oily skin - would stimulate the sebaceous glands, thus accentuating the problem of white spots.
• Avoid excessive washing.
• Reduce direct exposure to UV rays and use adequate sunscreens.
• Use quality make-up products.
• Ensure a good degree of skin hydration by using products suitable for your skin type.
• Adopt a balanced diet free of excesses.