Stage 1 acne is characterized by the presence of open and closed comedones (blackheads & whiteheads). Comedones occur due to the plugging of the sebaceous gland opening with keratin and dead cells. Sometimes comedones become stubborn and are not able to get treated by topical creams so best treatment for comedones is to extract them. Our dermatologist does comedones extraction needling, radiofrequency or comedones extractor in an expert manner so that it does not leave any pigmentation or scarring.