Author: [Generated for Academic Use] Date: October 2023 Abstract While comedones (blackheads and whiteheads) are classically associated with the sebaceous-rich zones of the face (nose, forehead, chin) and back, their presence in the axillae (underarms) presents a unique diagnostic and therapeutic challenge. Axillary blackheads, or open comedones , arise from the follicular plugging of the pilosebaceous unit. Due to the region’s distinct combination of apocrine and eccrine sweat glands, friction, and occlusive clothing, the etiology, prevention, and treatment of underarm blackheads differ significantly from facial acne. This paper reviews the pathophysiology, differential diagnosis, and evidence-based management strategies for axillary open comedones. 1. Introduction The axilla is a specialized anatomical region characterized by a high density of hair follicles, apocrine sweat glands (responsible for body odor), and eccrine sweat glands (responsible for thermoregulation). Unlike the face, the underarm is a closed environment subject to chronic friction, occlusion from clothing, and exposure to topical products such as deodorants, antiperspirants, and shaving creams.
