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Pimple Blackheads: Unmasking the Culprits of Skin Woes
Introduction

What is a Cyst?

A cyst is a benign, encapsulated lesion that consists of a fluid sac which contains liquid, or semi-fluid material. It can vary in shape, size and location. The most common types of cysts are reviewed here.

Acne, acne cysts, and sebaceous cysts are benign skin lesions and are one of the most common reasons which patients consult with dermatologists like Dr. Michele Green in Manhattan.  Sebaceous cysts are the most common type of cyst, and are slow-growing noncancerous bumps on the skin. However, if sebaceous cysts are left untreated, they tend to enlarge, get infected, and cause cosmetic scarring. Dr. Michele Green treats these sebaceous cysts in her Upper East Side NYC office each day. Through her minimally invasive techniques, she treats these cysts in a cosmetically elegant way, and avoids any unnecessary scarring.

What is a Sebaceous Cyst?

A Sebaceous cyst is like a large pimple. Similar to acne, sebaceous cysts form within or near hair follicles. Sebaceous cysts are benign, firm or palpable growths, which can present as a small lump under the dermis. These cysts are formed from dirt, or excess oil, or a build-up of dead skin and sebum which gets trapped due to clogged hair follicles. Sebaceous cysts can grow rapidly, enlarging over the course of days or weeks.

These cysts most commonly present on the face, back and chest, where the majority of sebaceous glands exist. They do not occur on the palms of the hand or soles of the feet. Sebaceous cysts form a lump under the skin and initially looks like a small bump. The overlying skin is usually flesh colored or yellow in appearance due to the build up of sebum, pus, and keratin. These cysts grow slowly and can also be formed from trauma. Sebaceous cysts may initially be painless, although as large cysts develop, they often become painful. Most sebaceous cyst are not life-threatening, and they can often resolve on their own. However, some sebaceous cysts  do not resolve and need further treatment. Depending on the location of the cyst, the amount of discomfort, the possibility of infection and scarring, and the cosmetic ramifications, these cysts will need to be treated and removed by Dr. Green in her NYC office.

Ear comedones, or ear blackheads, are clogged pores in the skin of your ear, often in or around the ear canal or on the outer ear. They’re similar to regular blackheads on your face or body but are often harder to manage due to the shape and sensitivity of the ear.

1. Cleanse the Area:

Start by washing your ears with a gentle cleanser. This removes dirt, oil, and bacteria that could cause further clogging or irritation.

2. Exfoliate:

Use a gentle exfoliating scrub or a chemical exfoliant (like salicylic acid) on the outer ear. This helps to loosen dead skin cells and keep your pores clear.

3. Steam:

If the comedones are stubborn, steam your face (and ears) for a few minutes. You can do this by placing your head over a bowl of hot water with a towel over your head to trap the steam. This helps to open up the pores and makes extractions easier.

4. Extraction:

Use a clean comedone extractor tool or your fingers (with clean hands and nails) to gently press around the comedones to extract them. Be careful not to apply too much pressure, as the skin around your ears is sensitive.

5. Apply a Treatment:

After extraction, apply a toner with salicylic acid or a gentle acne treatment to prevent new breakouts.

6. Moisturize:

Finish with a lightweight moisturizer to hydrate the skin without clogging the pores.

7. Repeat Regularly:

Regular cleaning and gentle exfoliation can help prevent ear comedones from forming.

Important tips:

• Avoid picking at the comedones too roughly, as this can lead to irritation or infection.
• Be mindful of not over-exfoliating, as the skin around the ear can be sensitive.

Certainly! Here’s a more detailed guide to treating and removing ear comedones (blackheads), with references to methods and ingredients that are commonly recommended by dermatologists:

1. Cleansing the Area

Proper cleansing is the first step to remove excess oil, dirt, and bacteria that may contribute to clogged pores in the ear area. The skin around the ear is similar to the face in terms of oil production, but it’s also more sensitive and can be prone to irritation.

• How to clean: Use a mild facial cleanser or a cleanser specifically designed for sensitive skin. Avoid harsh soaps or strong detergents that could dry out the skin or cause inflammation.Reference: According to the American Academy of Dermatology (AAD), it’s important to use a gentle, non-comedogenic (won’t clog pores) cleanser to avoid exacerbating acne.

2. Exfoliation to Remove Dead Skin Cells

Dead skin cells can clog the pores and contribute to the formation of blackheads. Exfoliating the ear area gently helps to clear the buildup and keep pores clear.

• Physical exfoliation: Use a mild scrub with soft, non-abrasive particles. Avoid scrubbing the ear area too harshly, as it may irritate the delicate skin.
• Chemical exfoliation: Use products containing salicylic acid (a beta-hydroxy acid or BHA). Salicylic acid penetrates the pores, breaking down the oil and skin cells that clog the pores. This is particularly useful for treating blackheads and comedones.Reference: According to Dermatology Times, salicylic acid is one of the most effective ingredients for treating blackheads, as it can penetrate and clean out the pores more deeply than physical exfoliants.

3. Steaming to Open Pores

Steaming softens the skin and helps to open pores, making it easier to extract blackheads. This step is especially useful if the comedones are deeper in the skin.

• How to steam: Boil water, pour it into a bowl, and place your face (and ears) over the steam. Drape a towel over your head to trap the steam. Do this for 5–10 minutes, ensuring the steam is not too hot to avoid burns.Reference: The Journal of Clinical and Aesthetic Dermatology states that steaming can help increase blood flow and soften the skin, which can facilitate the removal of blackheads.

4. Extraction

After steaming, the skin will be more receptive to extractions. You can use a comedone extractor tool (available at pharmacies or online) or gently use your fingers to extract the blackheads. If you use your fingers, always ensure your hands are clean and use tissues to avoid transferring dirt or oils to the skin.

• How to extract: Place the extractor around the blackhead, applying gentle pressure to remove it. Do not force it out, as doing so may cause scarring or further irritation.Reference: According to The International Journal of Dermatology, using professional tools like a comedone extractor can reduce the risk of scarring and infection compared to using hands.

5. Topical Treatments

Post-extraction, it’s important to use products that can help prevent future breakouts and keep the skin clean.

• Salicylic Acid: Apply a toner or serum that contains salicylic acid to prevent future comedones. This helps to keep the pores clear by breaking down oil and dead skin cells.
• Benzoyl Peroxide: If you’re prone to breakouts, a benzoyl peroxide product (in gel or cream form) can help to kill acne-causing bacteria.Reference: The AAD recommends using non-comedogenic acne treatments, which are less likely to clog pores and exacerbate blackheads.

6. Moisturize

Despite treating acne, it’s crucial to moisturize afterward. This helps prevent the skin from drying out and becoming irritated, which can lead to more breakouts.

• How to moisturize: Use a lightweight, non-comedogenic moisturizer to avoid clogging pores. Gel-based moisturizers are often a good choice for oily or acne-prone skin.Reference: According to the American Journal of Clinical Dermatology, keeping the skin hydrated is vital for maintaining a healthy skin barrier, which can help reduce acne and irritation.

7. Regular Maintenance

For best results, make this a regular part of your skincare routine. Gentle cleansing, exfoliating, and treating the ear area with acne-friendly products can help prevent the recurrence of comedones.

• Frequency: Cleanse your ears daily, exfoliate 2-3 times a week, and use salicylic acid or other treatments as needed to keep the skin clear.Reference: The British Journal of Dermatology suggests regular, gentle skincare practices as key to long-term acne management.

Things to Avoid:

• Harsh scrubbing: Over-scrubbing the ear area can irritate the skin, leading to inflammation or increased oil production.
• Popping blackheads with bare hands: This can lead to bacteria introduction and possible scarring or infection.
• Using heavy, oily products: These can clog pores and worsen blackhead formation.

When to See a Dermatologist:

If the comedones are persistent or painful, or if you’re experiencing cystic acne around the ear area, it might be time to consult a dermatologist. They can provide professional extractions or prescribe stronger topical treatments, such as retinoids, which are effective in clearing out pores over time.

By following these detailed steps and using appropriate products, you can help manage and reduce ear comedones effectively.

1. Cleansing Solution

A good cleanser helps to remove excess oil, dirt, and debris from your ear area without causing irritation. Here are some recommended cleansers and how to use them:

• Solution: Gentle Gel Cleanser with Salicylic Acid
  • How it works: Salicylic acid is a BHA (beta-hydroxy acid) that penetrates the pores, helping to exfoliate inside the pores and prevent clogs.
  • Product Example: CeraVe Renewing SA Cleanser or Neutrogena Oil-Free Acne Wash.
  • How to Use: Gently massage the cleanser into the ear area in circular motions. Rinse with lukewarm water and pat dry with a clean towel.

2. Exfoliation Solution

Exfoliation is key for breaking down dead skin cells and preventing clogged pores. Chemical exfoliants are often more effective than physical scrubs, as they can penetrate deeper into the pores.

• Solution: Salicylic Acid Exfoliant (BHA)
  • How it works: Salicylic acid helps to clear out the pores and reduce inflammation, preventing new comedones from forming.
  • Product Example: The Ordinary Salicylic Acid 2% Solution or Paula’s Choice Skin Perfecting 2% BHA Liquid Exfoliant.
  • How to Use: After cleansing, apply the solution with a cotton pad or your fingers to the affected area. Let it dry before applying other products. Use 2-3 times a week depending on your skin’s tolerance.
• Alternative Option: Alpha-Hydroxy Acids (AHAs), like glycolic acid, can also help exfoliate and prevent comedones.
  • Product Example: Lactic Acid 5% from The Ordinary.

3. Steam Treatment

Steaming helps to open pores, making it easier to extract the comedones. This is especially useful for deeper, more stubborn blackheads in the ear area.

• Solution: Steaming with Essential Oils
  • How it works: Adding essential oils such as tea tree or lavender to hot water can offer additional antibacterial and soothing benefits.
  • How to Use: Boil a pot of water, add a few drops of essential oil, and lean over the bowl with a towel draped over your head to trap the steam. Steam for 5-10 minutes to open pores.

4. Extraction (Manual Removal)

Manual extraction should only be done if the comedones are easy to remove. Always use proper tools to prevent damage to your skin.

• Solution: Comedone Extractor Tool
  • How it works: These tools are designed to safely extract blackheads without causing scarring or pushing bacteria deeper into the skin.
  • Product Example: Tweezerman Stainless Steel Comedone Extractor.
  • How to Use: After steaming, position the loop end of the tool around the blackhead and gently press to release the blockage. Don’t force it, and avoid using your fingers.

5. Acne Treatment Creams

After extraction or exfoliation, using a treatment solution can help to prevent future breakouts and reduce inflammation.

• Solution: Benzoyl Peroxide Gel or Cream
  • How it works: Benzoyl peroxide kills acne-causing bacteria and helps to dry out and clear blocked pores.
  • Product Example: Clean & Clear Persa-Gel 10 or Neutrogena On-the-Spot Acne Treatment.
  • How to Use: Apply a thin layer to the affected area after cleansing and before moisturizing. Use once a day initially, and increase to twice daily if your skin tolerates it.
• Alternative Solution: Topical Retinoids (like Adapalene)
  • How it works: Retinoids are derivatives of Vitamin A that help to increase skin turnover, preventing pores from becoming clogged and reducing blackheads.
  • Product Example: Differin Gel (Adapalene 0.1%).
  • How to Use: Apply a pea-sized amount to the entire ear area (or affected regions) at night after cleansing and exfoliating. Start with a few times per week, gradually increasing usage as your skin adjusts.

6. Moisturizing Solution

Moisturizing is essential, even if you have acne-prone skin. It helps maintain the skin’s barrier and prevent over-drying, which can lead to more oil production and breakouts.

• Solution: Non-Comedogenic Moisturizer
  • How it works: A lightweight, non-comedogenic moisturizer helps hydrate the skin without clogging pores.
  • Product Example: Neutrogena Hydro Boost Water Gel or CeraVe PM Facial Moisturizing Lotion.
  • How to Use: Apply a small amount after treating your skin with acne products. This will lock in moisture and maintain skin hydration.

7. Spot Treatments for Immediate Action

For particularly stubborn or inflamed comedones, spot treatments can be used to target and treat specific areas.

• Solution: Sulfur-Based Acne Treatment
  • How it works: Sulfur is a natural ingredient that helps to dry out blackheads and reduce inflammation, making it a great option for spot treatment.
  • Product Example: Mario Badescu Drying Lotion.
  • How to Use: Apply directly onto the affected area using a cotton swab before bedtime. Let it dry overnight and rinse off in the morning.

8. Professional Treatments for Persistent Comedones

If your ear comedones are persistent or causing irritation, it might be worth seeing a dermatologist for professional treatment.

• Solution: Chemical Peels (e.g., Glycolic or Salicylic Acid Peel)
  • How it works: A dermatologist can apply a stronger chemical peel to exfoliate the skin deeply, clear clogged pores, and reduce blackheads.
• Solution: Extraction by a Dermatologist
  • How it works: A dermatologist or esthetician can perform extractions using professional tools to remove stubborn comedones safely and without causing damage or scarring.
• Solution: Laser Treatments
  • How it works: Lasers like the Nd:YAG laser can treat acne by targeting sebaceous glands, reducing oil production, and preventing future breakouts.

Treatment Routine Example

Here’s a simple treatment routine you can follow:

1. Morning:
   • Cleanse with a gentle salicylic acid-based cleanser.
   • Apply a light moisturizer.
   • Optionally, use a benzoyl peroxide gel on active comedones.
2. Evening:
   • Cleanse again.
   • Apply a salicylic acid or retinoid product (start with 2-3 times a week for retinoids).
   • Follow up with a lightweight, non-comedogenic moisturizer.

By following this routine and using the suggested treatments, you should be able to manage and reduce ear comedones effectively.