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Closed comedones form primarily due to the following factors: Overproduction of sebum (oil) by the skin Accumulation of dead skin cells Hormonal fluctuations, particularly during puberty or menstrual cycles In addition to these primary causes, environmental factors such as pollution and humidity can exacerbate the condition

The 2025 meta-analysis by Alfalasi and colleagues, published via PMC, synthesized data from 16 studies and 6,098 total participants

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In humans, this enzyme family serves as one of the critical antioxidant mechanisms, readily scavenging reactive oxides and peroxides that are naturally or exogenously produced, protecting cells and structures from oxidative damage 31