COMEDONES OR COMEDO:
(pl. comedones) a blackhead; a collection of sebaceous (oily) material and dead cells retained in the hair follicle and excretory duct of the sebaceous gland, the surface covered with a dark crust. It is the primary lesion of acne vulgaris
This name is applied to an affection of the skin characterized by little black points corresponding to the openings of the sebaceous follicles. If the skin in the neighborhood of these specks be squeezed between the finger-nails, the sebaceous plug which fills the follicles will be pressed out. This affection is more frequent in youth and adolescence than at any other ages. The glands of the face are the ones that are chiefly affected. The causes of comedo are probably similar to those which lead to the development of ordinary acne simplex, in company with which affection they are usually found, though they sometimes exist without any inflammatory complication. One author holds that comedones in children differ from those of adults in being mainly dependent on local causes, on their greater tendency to group and to be more closely set, in their involving the hairy scalp, and finally to their being generally readily amenable to treatment, all that is usually required being friction with a weak soft soap and spirit liniment, or a weak sulphur application may be employed in mild cases, preceded by fomentation with very hot water.
A peculiar variety is described by Dr. Dumesnil, as occurring in two patients. In both cases, the unusual eruption occurred on the back, which was also well covered with acne. The comedones, in both cases, were well marked, the skin not being elevated at the sites where they existed. The distribution of these comedones was all over the back, though inclined to be discrete. One peculiarity of the distribution was, that many of them were in pairs, the distance between each varying from one-eighth or less to about three-sixteenths of an inch, with a channel connecting them. By bringing firm lateral pressure upon one of the comedones in the direction of the other, both follicles were emptied from one point, and a fine probe introduced at one opening would appear at the other. There was but one plug, and that was black at both extremities.
Treatment
The comedones may in most instances be readily removed by pressure with the fingers or aided by some one of the many comedone extractors.
Sexual hygiene is to be enforced if the trouble is to be radically cured
. The principal internal remedies are Baryta carb. and Selenium
.
Others may be indicated as follows :
Bellad. Comedos in young full-blooded people.
Cicuta Black spots on the skin.
Digitalis Black comedos on the skin of the face, which suppurate.
Mezereum Small comedos on the nose and cheeks.
Nitr. ac. Black sweat pores in the skin of the face.
Sabina Comedos that can be easily pressed out, in the cheeks and about the nose.
Sulphur Blackish pores in the face.
Sumbul Numerous black pores on the face; skin pale.
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