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Int J Cosmet Sci. 2011 Apr;33(2):99-104. doi: 10.1111/j.1468-2494.2010.00610.x. Epub 2010 Aug 30.

Expert opinion and review article: The timing of comedone extraction in the treatment of premenstrual acne--a proposed therapeutic approach.

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FaceWorkshops Skincare Consultancy, Beverley, East Yorkshire, UK.


The face is the most exposed part of our body, and deterioration of facial appearance, through disease or ageing, causes psychological distress. Acne lesions and subsequent pigmentation changes contribute to the unevenness of skin colour that is detrimental to facial attractiveness and leads to rejection and stigmatization in our society. The purpose of this review is to look at the root causes of premenstrual acne and, for the first time ever, propose that the specific timing of treatment can, at least in part, resolve the acne lesions. We postulate that it is the timing of the manual extraction that matters in resolving premenstrual acne and that the effectiveness of this therapy could be improved. Based on the reviewed evidence, we propose that it is important to remove the comedones at the time of ovulation, prior to the reduction of the size of the sebaceous orifice and epidermal barrier function, to counteract the onset of increased sebum production, prevent blockage of the pores and subsequent bacterial colonization and inflammation. If performed successfully, the extraction may contribute to a reduction in inflamed acne lesions and thus benefit women by increasing their facial attractiveness, well-being, social function and thereby decrease psychological stress.

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