This article discusses what the different types of comedones look like and what causes them.
It also covers how they’re diagnosed and how to treat or prevent them.
What Is Comedonal Acne?
Verywell / JR Bee
Comedonal acne is when a hair follicle is blocked by skin oil and dead cells.
A single bump is referred to as acomedo, and multiple bumps are calledcomedones.
Comedonal acne does not have inflamedpimplesandpustuleslike inflammatory acne(the most common form ofacne vulgaris).
Reproduced with permission from © DermNetdermnetnz.org2023.
Instead, comedonal acne causes bumpy skin,blackheads, and non-inflamed blemishes.
Reproduced with permission from A DermNetdermnetnz.org2023.
What Comedonal Acne Looks Like
Comedonal acne does not look like typical acne.
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In fact, many people with comedonal acne do not think they have acne.
Comedonal acneblackheads andwhiteheadsdo not have inflammation.
They are not painful, red, or filled with pus.
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Comedones are not red orinflamedlike a common pimple.
Instead, they start as smaller, non-inflamed bumps (papules) that can either be closed or open.
Comedones are most common on the forehead, chin, and jawline.
DermNet /CC BY-NC-ND
They can also form on the face, neck, shoulders, back, or chest.
Comedones can form on their own or along with acne vulgaris.
Types
There are several types of comedonal acne blemishes.
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Closed Comedones
Closed comedones, or whiteheads, range in color from creamy white to flesh-toned.
They happen when an oil plug develops down below the opening (pore) of the hair follicle.
They most often show up on the forehead, chin, and cheeks.
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Whiteheads are not painful and cannot be popped since they do not contain pus or infection.
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Microcomedones
Microcomedones are the smallest of all acne blemishes.
These comedones are invisible to the naked eye and are the seeds from which larger comedones form.
Comedones and inflamed pimples start out as microcomedones.
Macrocomedones and Giant Comedones
Macrocomedones are either closed or open comedones that are bigger than usual.
They can range from one millimeter (0.04 inches) to three millimeters (0.12 inches) in diameter.
They can be small or large and open or closed.
This usually happens around the eyes and on the nose, cheeks, or forehead.
Solar comedones most often occur in people over the age of 60.
However, they can start to develop as early as your 40s if youve had extreme sun exposure.
Favre-Racouchot syndrome is a sun-related disorder that causes clusters of blackheads on sun-damaged skin.
This typically happens under the eyes and around the temples.
Comedonal Acne Causes
Comedones are associated with thepilosebaceousunit, which includes a hair follicle andsebaceous gland.
Sebaceous glands make sebum, the waxy oil that coats, moisturizes, and protects the skin.
The pilosebaceous units are densely clustered on the face, neck, upper chest, shoulders, and back.
However, it can happen at nearly every age, including adulthood.
Comedonal acne can sometimes be a sign of acne vulgaris to come, especially when it starts during puberty.
However, having comedones does not necessarily mean youll get pimples.
Other factors (including genetics) also play a role in who gets acne.
Comedonal acne tends to run in families.
If your parents or siblings had it, you are more likely to have it as well.
Puberty also can contribute to the increased production of hormones calledandrogensthat can put the sebaceous glands into overdrive.
The same can occur before the onset of a menstrual period when hormone levels spike.
Comedonal acne can also be caused or made worse by the products you put on your face or skin.
This includes oily skin care products or hair pomades.
High humidity and air pollution can also contribute to skin problems like comedonal acne.
How Comedonal Acne Is Diagnosed
Comedonal acne can usually be diagnosed just by how it looks.
As important asdaily skincareis, it cannot cure or prevent comedonal acne on its own.
For more severe or persistent comedonal acne, you might need to see a dermatologist for treatment.
Stick with it even if there are no immediate changes.
A face wash containing benzoyl peroxide can also help prevent bacteria on the skin from infecting comedones.
It can take six to eight weeks for blackheads or whiteheads to clear up after home treatment.
If you do not see results within three to four months, ask your provider about other treatments.
They may suggest stronger therapies for acne.
You are more likely to damage your skin and cause a blemish.
Adhesivepore stripsand clay masks can help extract tiny blackheads.
Whiteheads should be left alone and treated topically.
Closed comedones, or whiteheads, form under a pore opening.
Open comedones, or blackheads, form near the pore opening.
Comedones are especially common during the teenage years, but they can happen at any age.
Hormone changes can be a contributing factor.
Oily skin care products and humidity can also make it worse.
give a shot to be patient.
It can take weeks or even months of consistent treatment and lifestyle habits to clear up your skin.
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