I've noticed that with comedonal acne, the plugs have to be manually removed. I have tried AHAs, BHAs, etc. and they don't dissolve the gunk inside. With Tazorac (using for 8 weeks), the plugs are pushed up to the surface and then with a squeeze they finally come out or sometimes they get inflamed first. I know squeezing is bad and can leave scarring so is there anyway to remove the plugs without doing so? Very rarely will they come off by themselves with dead skin as I wash my face.
How Can I Get Rid of Comedonal Acne Without Squeezing?
Doctor Answers 6
Getting rid of comedonal acne
Yes, even on topical retinoids, some comedonal acne lesions are hard to get rid of. Physically removing them (aka acne surgery or extraction) can be very effective--but you may want to have a professional such as your dermatologist or a licensed esthetician remove them for you rather than squeezing them yourself. Once removed, continued use of retinoids will prevent formation of these stubborn lesions.
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Retinoid medications (Retin-A, Tazorac and Differin) combined with chemical peels that are able to penetrate the pores (SAHA) are the best way to deal with this frustrating problem. All treatments are likely long term, however, because there is no cure for comedonal acne (unless it goes away on it's own!)
Comedonal acne (blackheads/whiteheads) treatment
Comedonal acne can be treated with topical creams - retinoids work best. There are many new creams that combine a retinoid with another agent that helps with acne, such as benzoyl peroxide or clindamycin. Acne surgery also works well. Ask you dermatologists, since acne surgery usually isn't covered by your insurance.
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Keep up with the Tazorac
Retinoids are your answer. Also, the use of the Claisonic PoreBaby will help clean the pores better but gently. Also a microdermabrasion with water (JETPEEL) will help nicely. Every other week a mild chemical peel (Jessner's solution) can be used to expedite the entire process. DO NOT pick!
Getting rid of comedonal acne
Comedonal acne is a relatively mild form of acne that involves little or no inflammation. Comedones are usually classified as either blackheads or whiteheads, and they should never, ever be picked! I might suggest you see about getting a Clarisonic. Some of my comedonal acne patients have found that using this device (and they have a head specifically targeting acne!) helps clear their pores and they don't pick at their faces as much. Plus, products are actually driven deeper with these devices and you use less product. If the Tazorac isn't strong enough, your dermatologist might suggest another prescription be used in conjunction with it. But please don't pick your face anymore!
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.