Closed comedones develop when tiny openings in the skin become blocked with dead skin cells and oil.
Extraction and anti-inflammatory injections address visible bumps. Reducing recurrence also requires control of dead skin buildup and sebum production at their source.
Management therefore generally combines treatment with care for the underlying causes, rather than relying on one procedure.
➊What treatment is used for closed comedones?
Closed comedones form when the pore opening becomes blocked by dead skin cells and sebum.
They begin as small, noninflamed bumps. If left untreated, sebum continues to accumulate and they often progress to inflammatory acne.
They commonly occur on the forehead, cheeks, and jawline, where sebaceous glands are active, and feel bumpy to the touch.
Although they look like a single symptom, understanding how they form helps guide care accurately.
➋What roles do extraction and anti-inflammatory injections play?
Extraction physically removes the contents of an already blocked comedone.
It can clear visible bumps quickly, but does not change the tendency of pores to become blocked.
Anti-inflammatory injections are used locally in areas that are already red, swollen, or painful to reduce inflammation quickly.
Both effectively address the visible condition at present, but do not stop the skin from becoming blocked again with dead cells and sebum.
| Category | Extraction | Anti-inflammatory injection |
|---|---|---|
| Purpose | Remove comedone contents | Suppress progression of inflammation |
| When used | Noninflamed closed comedones | Red, swollen, or painful lesions |
| Effect on preventing recurrence | Limited | Limited (local) |
“Extraction and anti-inflammatory injections treat existing comedones; they do not prevent new ones from forming.”
➌Which care is right for me?
Management depends on whether the current lesions are inflammatory or noninflammatory and how often they recur.
The approach differs between simply clearing visible bumps and addressing repeated recurrence in the same areas due to excessive sebum.
These decisions are usually made after directly examining the skin during consultation.
- ✓ Mainly noninflamed bumps: focus on extraction
- ✓ Repeated inflammation and recurrence: consider Gold PTT in combination
- ✓ Excessive sebum tendency: manage dead skin buildup and sebum
➍When will I start noticing effects?
Care that acts on sebaceous glands, such as Gold PTT, works differently.
Rather than an obvious change on the day, sebum production and inflammation frequency tend to decline gradually over time. Individual variation makes it difficult to specify a single timeframe.
| Care method | When noticeable | Features |
|---|---|---|
| Extraction | Immediate | Clear visible bumps |
| Anti-inflammatory injection | 1–2 days | Reduce swelling and pain |
| Gold PTT | Several weeks or more | Control sebum secretion |
➎What are the side effects and precautions?
If hygiene is inadequate or extraction is overly forceful, inflammation may worsen and pigmentation or scarring may follow.
Anti-inflammatory injections also require caution: unnecessarily repeated use can thin the skin or cause local pigmentation changes.
Laser-based care, including Gold PTT, may cause temporary redness or flaking in the treated area, which we explain in advance during consultation.
Responses to every procedure vary, so we recommend deciding the method and frequency through consultation.
➏How I advise patients in these situations
If an upcoming event means visible bumps or acute inflammation need to settle promptly, I tend to recommend extraction and anti-inflammatory injections first.
For a short-term improvement in appearance, these two approaches alone often produce satisfactory results.
However, the situation changes if bumps return in the same areas within days, or if sebum production is naturally high.
This is where we often find in consultations that extraction and injections alone cannot maintain a satisfactory condition.
For these patients I also recommend Gold PTT or care to control dead skin buildup and sebum. Since this means adding treatment items, I want to explain this openly in advance.
Ultimately, direction is guided by two criteria: how often acne recurs and the person’s natural level of sebum production. Results may differ between individuals.
“If extraction and anti-inflammatory injections cannot maintain satisfactory results for long, the reason often lies in the tendency to produce sebum rather than in the procedures.”
QFrequently asked questions
Extraction or injections do not change the tendency for thick layers of dead skin cells to build up at pore openings.
The same area may easily become blocked again after treatment, causing recurrence.
The concern is not extraction itself, but forceful squeezing or repeated treatment without proper hygiene, which can worsen inflammation and leave scars.
Performed appropriately, it is an effective care method.
They are used locally when needed for severely inflamed areas. Repeated overuse may thin the skin or change pigmentation, so they are generally given only when necessary.
Gold PTT is known to act on sebaceous glands to reduce inflammatory responses, so it may help manage excessive sebum, a cause of recurrence.
However, individual results vary.
Milia are tiny cysts formed by accumulated keratin and develop differently from inflamed comedonal acne.
They are often difficult to distinguish by appearance alone, so an accurate diagnosis is needed.
The starting point is to assess comedones and skin type in the consultation room.
Based on this, we decide necessary procedures such as extraction, anti-inflammatory injections, or Gold PTT alongside control of dead skin buildup and sebum. The actual plan is tailored in a 1:1 consultation (individual results vary).
Closed comedones are closer to an ongoing skin condition to manage than something permanently resolved by removing them once.
Extraction and anti-inflammatory injections alone make recurrence difficult to prevent; dead skin buildup and sebum secretion also need assessment.
If you want to understand why your comedones keep recurring, please have them assessed during consultation at LUNN Clinic.
Dr. Park Hyungkwon, Director and Dermatologist at LUNN Clinic
As disclosed under medical law, these procedures may cause side effects. Worsened inflammation, pigmentation, scarring, and temporary redness may occur after extraction, anti-inflammatory injections, or Gold PTT.
Treatment and procedure results may vary depending on the individual’s condition.
This column is intended to provide medical information.
