Have you seen the internet discussion boards where people are asking "what are sebaceous filaments?" Yes, 'sebaceous filaments' is a trending term but not one that we've commonly used in clinical medicine. That's not to say that 'sebaceous filaments' don't exist or were not described in the medical journals, it's just that we didn't characterize the phenomenon with that name. It's actually a good name though because it's descriptive for what's going on in the pore.
What are sebaceous filaments?
Sebaceous filaments are a form of clogged pore. You will find them more commonly in the T-zone of your face, especially around your nose. These are the areas where you have the greatest density of pores and those pores have high sebum output.
Sebaceous filaments are structurally like a cast within a pore. The cast is encased by a cylinder of dead skin cells that is somewhat like a tube. Within this cast is a mixture of sebum, bacteria, some keratin dead cell debris, and often a hair. The material, when squeezed out from the pore, is a soft, yellow waxy material that comes out like a little 'filament', maintaining the shape of the pore. The pore clogging debris of sebaceous filaments may appear slightly dark and simulate a blackhead. Importantly, however, sebum can move through this encased tubular structure so the pore is not blocked.
Sebaceous filaments were first described in the 'modern' medical literature in a German medical journal in 1976. They are common and I have seen them every day in my clinical practice. That said, the term 'sebaceous filament' has not come into common usage until recently. I've always referred to this phenomenon as 'schmutzy pores', congested pores or clogged pores - clogged with an abundance of normal pore contents and not a blackhead or little hairs (as in another common condition called trichostasis spinulosa where a tuft of tiny hairs in a keratin sheath form in, and stick out of, a pore).
What causes sebaceous filaments?
Sebaceous filaments form due to normal oil production, especially in people with oily skin and who are prone to having large pores. The phenomenon of sebaceous filaments are also associated with a condition called seborrheic dermatitis, a.k.a. dandruff, that can cause redness, flaking and a greasy feel on your skin in the T-zone, creases of your nose, eyebrows and mid-cheeks. Sun damage has also been associated with the formation of sebaceous filaments.
What is a blackhead?
Blackheads, on the other hand, are a hard plug within a pore that limits oil secretion. This plug is formed of hardened dead cells, sebum, bacteria and debris that create a solid plug that blocks the pore, impedes the passage of sebum, and may lead to pimples. The plug is open to the air and oxidation of the contents cause the black color - it's not dirt, it's chemistry!
What causes blackheads?
Blackheads are part of the acne process and are formed in pores due to the same factors that lead to pimples. Blackheads are non-inflammatory acne lesions. Pimples are inflammatory acne lesions. We don't actually know what causes acne but it is often a combination of hormones, dietary triggers, bacteria and occasionally skin yeast, and increased oil production associated with post-puberty life.
How do you tell the difference between sebaceous filaments and blackheads?
Sebaceous filaments and blackheads can look similar. They both accentuate the appearance of the pores because they often both contain the presence of a dark brown/black material within the pore.
- Blackheads are a firm plug that gradually increase in diameter, often becoming very large and stretching the diameter of the pore. They can also develop an almost blackened top that makes them very visible.
- Sebaceous filaments contain a softer material that may be yellow or have a brown color in the opening of the pore.
Can sebaceous filaments and/or blackheads be popped or pushed out?
Both blackheads and sebaceous filaments can be extruded from the pores but you need to know what you are doing because this process can damage skin and lead to scarring. Gently compressing the skin may extrude both sebaceous filaments and blackheads if they are soft. It is important to soften clogged pore material with the use of keratolytic skin care products that break up the debris such as my Acne Treatment Cleanser which contains medical-grade BHA/AHA (more on keratolytics below).
A comedone extractor can be a useful tool for extraction of blackheads. It is a small circular loop that can be gently pressed on the skin around the pore to extrude the blackhead plug. You need to know how to use it correctly and you need to keep it disinfected!
What treatments, products or ingredients can help remove or prevent sebaceous filaments and blackheads?
Using keratolytic ingredients in your skin care routine will help to prevent the dead cells from sticking together to form either the encasing tubular structure of a sebaceous filament or the plug of a blackhead. It's important to use keratolytics on a regular basis because both sebaceous filaments and acne are likely to return.
The most effective keratolytics in skin care products include:
- salicylic acid (a BHA), which is particularly effective at penetrating oily pores
- benzoyl peroxide
- glycolic acid (which is an AHA)
The use of keratolytic ingredients in your skin care routine will help soften both sebaceous filaments and blackheads, shrinking them and making them easier to extract. Dermatologist Dr. Cynthia Bailey
My Ultimate Acne Solutions Kit contains the 3 best keratolytics to target pores including:
- The highest concentration allowed of salicylic acid combined with 10% glycolic acid in a pH balanced facial cleanser.
- 5% benzoyl peroxide, which also helps to kill the acne causing bacteria called C. acnes, formerly P. acnes.
- An acne friendly moisturizer to balance skin hydration.
The Ultimate Acne Solutions Kit contains medical-grade keratolytic skin care products to target sebaceous filaments and blackheads.
'Medical-grade' means a product is made with a high concentration of active ingredients that are the most potent, pure and stable you can get.
Why do sebaceous filaments come back so quickly?
Sebaceous filaments will form in about a month after being extracted. That is the time it takes to rebuild the encasing dead cells and fill the tubular encasement with sebum, bacteria and another hair. By using a daily skin care routine with medical-grade keratolytic ingredients, it will be much more difficult for the keratin cast to form in the pore to support the presence of a sebaceous filament. In my clinical experience, a keratolytic skin care routine is highly effective for keeping pores clean and unclogged.
Additional dermatologist-recommended treatments to prevent sebaceous filaments
- Using a sonic skin cleansing brush system (such as the Clarisonic or Foreo) with a medical-grade keratolytic facial cleanser (such as the Acne Treatment Cleanser) will help to keep pores clearer.
- Getting a professional facial that includes extractions helps to keep pores clearer.
- Acne Treatment Pads used after the Acne Treatment Cleanser. The pads contain medical-grade 2% salicylic acid and 10% glycolic acid in a base that helps to remove additional retained skin oil.
- Adding a retinoid as a bedtime treatment product will help to reduce keratin debris in the pore. Prescription tretinoin (Retin A) or non-prescription medical-grade Retinol are my top choices.
How to use retinol to reduce sebaceous filaments?
Retinoids, like my medical-grade Retinol Night Cream, are used at bedtime. I recommend applying my Retinol Cream under the moisturizer in the Ultimate Acne Kit after cleansing your face with the Acne Treatment Cleanser.
We don't apply retinoids at the same time that we apply benzoyl peroxide so you would use the Retinol Cream in place of benzoyl peroxide at night. Benzoyl peroxide would applied after washing during the day.
Creating a skin care routine that combines all 4 of the best pore-cleaning keratolytics is a powerful way to reduce both blackheads and sebaceous filaments. It's also a great way to brighten your complexion.