Pores clogged with sebum metabolite and cuticles cause open comedones or blackheads which can be developed to acne vulgaris. This is caused by the excess sebum secretion due to increasing androgen during adolescence.

An open comedone is also known as a blackhead simply because of its appearance. The opening in such comedone allows the content inside to contact with air and become oxidized and blackened. Open comedone favors the colonization of propionibacterium acnes (acne-causing bacteria), leading to infections and inflammations and forms acnes of different levels: pustules, nodules, cysts etc. Mishandling of acne can result in permanent scars or hyperpigmentation.


Most of the following topical medications contain ingredients that are antibacterial and have the effect of altering the composition of sebum and/or reduce inflammation.

  • Benzoyl peroxide
  • Sulfur
  • Salicylic acid
  • clindamycin, erythromycin, and metronidazole
  • Retinoids
  • Azelaic acid

For moderate to severe acne that has not responded to topical medications, oral antibiotics can be used. Common types of oral antibiotics include tetracycline, minocycline, erythromycin, and doxycycline.

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