By Gary M. White, MD


Macrocomedones are large whiteheads and are seen in acne patients.


Two to three millimeter white papules, some with pores, on the face are seen. They may become more apparent near the end of a course of isotretinoin as the acne is cleared. When this is the case, the periodic rupture of a macrocomedone can mimic ongoing acne. More isotretinoin is not needed. Acne surgery is.


Acne surgery is effective. Isotretinoin does not work. Epilating needle or low cautery with pretreatment EMLA has also been recommended.


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