My nose pores are always clogged and I have more clogged pores on my cheeks and chin.

The definition of clogged is when hair follicle pores are filled with debris causing a comedone.

Clogged pores are caused when the skin's natural exfoliation process called desquamation is disrupted.

This disruption is caused by:

skin issues that affect desquamation like acne and dry skin

using the the wrong skin care products

using the wrong products together in your skin care routine

habits such as over exfoliating the skin.

hormone fluctuations

Comedones are clogged pores. They are very common on the face, especially the nose and forehead where the skin has an increased amount of sebaceous glands (oil glands).

Clogged pores are more common in oily skin types. However, dry skin types are also at risk for clogged pores. We explain why dry skin causes clogged pores below.

Clogged pores can be caused by comedogenic skin care ingredients, over exfoliating or using the wrong skin care products for your Baumann Skin Type.

blackheads (closed comedones)

whiteheads (open comedones)

milia

acne cysts

hard sebum plugs in pores

congested skin

seed like thing in my skin

sebaceous filaments

white stuff in pores

black stuff in pores

smelly stuff in pores

hard white plugs

white worm pimple

White worm pimple is my favorite term that my dermatology patients use. Its so descriptive of how the white pus looks when you squeeze it out of the pore.

Skin cells that hold onto each other instead of separating and desquamation off of the skin's surface build up inside the hair follicle.

Clogged pores look like a dilated pore filled with white or black stuff.

The white stringy stuff in pores is a mix of dead skin cells, sebum, dirt, and comedogenic ingredients from skin care products.

Clogged pores can be white, skin colored, or brown or black.

Pores with white stuff are clogged with dead skin cells and oils like sebum.

The dark stuff in pores is oxidized dead skin cells. The air causes a chemicals change that makes them look dark.

Antioxidants can block oxidation which prevents the stuff in pores from turning black.

This is why you will see antioxidants in moisturizer to prevent clogged pores.

The white or dark things sticking out of clogged pores are a mixture of these 6 things:

1. desquamated skin cells
2. sebum
3. pus
4. immune cells
5. bacteria
6. comedogenic ingredient that clogged the pore in the first place

It is best to have your clogged pores extracted is by a trained medical aesthetician.

You most likely will be tempted to

If you are like many of my patients in my dermatology practice, you might believe that exfoliating the skin will help clogged pores.

However, over-exfoliating the skin is actually a cause of clogged pores.

Over exfoliating disrupts the desquamation process, which causes pores to get filled with dead skin cells.

When you squeeze your pores, white strings come out.

The white stuff is dead skin cells mixed with sebum and dirt. This white stringy discharge from pores may be smelly if it contains alot of skin bacteria. Skin bacteria has a distinctive smell.

The stringy pus should be washed off your skin with a cleanser to prevent spreading bacteria to other hair follicles.

Black liquid that comes out of pores is dead skin cells and sebum that have oxidized and turned dark in color.

Clogged pores are defined as "when the opening of the hair follicle to the skin’s surface is blocked by debris. "

Blocked pores are filled with debris. What is in the debris that is blocking the pores?

Keratinocytes (skin cells) that have not desquamated properly.

Keratin protein build up inside the hair follicle.

Oil (sebum)

Bacteria

Inflammatory fluids containing inflammatory factors

The normal outward movement (powered by desquamation) of the hair follicle contents pushes this debris up to the hair follicle opening.

When there are too many dead skin cells, oil, keratin and debris, there is a traffic jam at the pore opening.

A closed comedone occurs when the pore is very tightly packed with debris.

An open comedone occurs when the pore is slightly packed but not completely obstructed.

Why do the pore openings of the hair follicle get clogged?

Pores get blocked when the desquamation process inside the hair follicle is not working properly. This is called dyskeratinization or abnormal follicular keratinization.

When dyskeratinization occurs, the keratinocytes clump together and clog up the hair follicle.

What causes the keratinocytes to clump together and block the hair follicle? Why does dyskeratinization occur?

There are many things that can cause dyskeratinization or the skin cells to cling to each other and clog the hair follicle and pore such as:

Using the wrong skin care products for your skin type

Inflammation

Dehydration

Over-exfoliation

Genetics

Medications

Increase sebum (oil)- depending upon the types of lipids in your sebum

The types of lipids found in sebum (which can be related to diet)

Growth factors like epidermal-derived growth hormone

Low Vitamin A levels

Many hair products to smooth the hair and get rid of frizziness can clog pores. Avoid use of hair products that contain acne causing ingredients such as isopropyl myristate and coconut oil. Wash your face after rinsing off hair conditioners.

The face should be washed thoroughly at night to remove all sweat, dirt, oil, hair products and makeup from the skin.

One interesting study showed that the medication Metformin can reduce the amount of comedones. This is likely due to Metformin's effects on the types of lipids found in sebum.

But there are much easier ways to get rid of comedones. The best way is to use the right skin care products for your Baumann Skin Type!

Remember - every single product you put on your skin matters. and the order that you use them is important.

Using the wrong cleanser or moisturizer can cause comedones because it can lead to inflammation and/ or dehydration that are known to cause clogged pores.

Avoid comedogenic ingredients if you have a problem with clogged pores, comedones, and milia.

The two best ingredients to clear pores are salicylic acid and retinol- but make sure these are right or your Baumann Skin Type before you use them.

You can find a list of comedogenic cosmeceutical ingredient here at this link.

References:

1. Lavker, R. M., Leyden, J. J., & McGinley, K. J. (1981). The relationship between bacteria and the abnormal follicular keratinization in acne vulgaris. Journal of Investigative Dermatology, 77(3), 325-330.
2. Heilman, E. R., & Lavker, R. M. (1983). Abnormal follicular keratinization. Dermatologic clinics, 1(3), 353-359.
3. Yamamoto, A., Takenouchi, K., & Ito, M. (1995). Impaired water barrier function in acne vulgaris. Archives of dermatological research, 287(2), 214-218.
4. Kamboj, P., Bishnoi, A., Handa, S., Dutta, P., Nahar Saikia, U., Pal, A., & De, D. (2021). Effects of metformin on experimentally induced acne on rabbit ear. Experimental Dermatology, 30(7), 966-972.