Acne is tricky. Just when you think you have it under control, it outsmarts your medication. Or better yet (tongue in cheek) your medication doesn't even mount a useful attack against your facial foe. I came across a paper this past weekend that I found interesting. Truth be told, I find something interesting about EVERY paper I ever read, but since this was applicable to everyone with acne, I wanted to share. In the study, researchers used a microscopy technique to "watch" what happened to a comedone a week after it was removed. Previous research has shown that comedones have a cyclical nature, either forming into inflammatory acne, re-appearing, or resolving. Based on clinical experience, this cycle was estimated to take between 2-6 weeks (due to the amount of time for normal physiologic skin turnover). However, no studies had been done that provided direct evidence for this timeline. A week after the comedone was extracted, the skin appeared to resolve (to the naked eye). Under a microscope, however, researchers found that dead skin cells and sebum were already beginning to accumulate and reform the comedone. This highlights the importance of continuing acne treatment even after the skin looks like it has cleared. This may also provide evidence for the use of acne treatments over the entire face or affected area instead of spot treating. Further research with this technique could show how acne treatments prevent this comedone reformation, if there is individual variation on this reformation, what changes in the skin cells is causing the excess build up, and how long a lesion needs to be treated before the pore returns to normal.