...The primary lesions of acne are comedones. Closed comedones (whiteheads) are obstructive lesions formed from impacted lipids or oils and keratin that plug the dilated follicle. They are small, whitish papules with minute follicular openings that generally cannot be seen. These closed comedones may evolve into open comedones, in which the contents of the ducts are in open communication with the external environment. The color of open comedones (blackheads) results not from dirt, but from an accumulation of lipid, bacterial, and epithelial debris....»
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