Comedonesare small flesh-colored, white, or dark bumps on your skin.
A single bump is called acomedo.
A closed comedo is not open to the skin’s surface and is commonly known as a whitehead.
Verywell / JR Bee
Comedonal acne is a common pop in of acne that consists of comedones rather thaninflamed pimples.
This article will discuss types of comedones and the prevention and treatment of comedones and comedonal acne.
Symptoms of Comedones
Comedonal acne doesn’t look like typical acne.
Reproduced with permission from © DermNetdermnetnz.org2023.
Comedonal acne causes few if any, inflammatory breakouts.
It can develop on your face, back, neck, shoulders, and chest.
Comedones can appear on their own or alongside inflamed acne.
Reproduced with permission from DermNetdermnetnz.org2023.
Types of Comedones
Comedones are brought on by two things: skin-cell growth and increased oil production.
A comedo forms when dead skin cells and oil form a plug that blocks your hair follicle.
There are several types of comedones.
Open Comedones
An open comedo is what is commonly call a blackhead.
It triggers when the plug of oil becomes trapped within the hair follicle near the pore opening.
The top of the plug is at the surface of the skin and is exposed to air.
The top of the plug takes on the dark brown color typical of blackheads.
The hair follicle is completely blocked.
The plug doesn’t turn black; instead, a whitish or flesh-colored bump appears on the skin.
The bump isn’t red or inflamed, and it doesn’t hurt.
These whiteheads most often appear on the forehead, chin, and cheeks.
Every pimple and blackhead begins as a microcomedo.
Macrocomedones
Macrocomedones are open (more common) or closed comedones that are larger than average.
They typically occur singly and in older adults.
Solar Comedones
Also called senile comedones, these lesions are due to excessive sun exposure over time.
They can also be found as part of Favre-Racouchot syndrome.
They may be small or large, open or closed.
What Causes Comedones?
All comedones begin as a plug ofsebum, skin oil, and dead skin cells trapped in the follicle.
This plug blocks the follicle opening.
This is what creates the bump that you might feel and see.
Comedones aren’t typically painful, just annoying.
Think of them as pre-pimples because all inflamed pimples get their start as a comedo.
Like most types of acne, comedonal acne is especially common during the preteen and teen years.
However, it can occur to anyone at nearly any age, adulthood included.
Comedonal acne can be a harbinger of inflammatoryacne vulgaris, especially when it appears during puberty.
Comedonal acne tends to run in families.
If your parents or siblings had it, you’re more likely to have it, too.
People with oily skin are more prone to comedonal acne as well.
What Makes Acne Worse?
Many things can make acne progress and worsen.
Scrubbing your skin orwashing your face more oftenisn’t enough to clear up your skin.
There are plenty of treatments that will, though, available both over the counter and by prescription.
Any treatment can take up to 12 weeks to see an improvement.
Stick with it, even if you don’t notice any immediate signs that it’s working.
Talk to a dermatologist if you’re not seeing good results after three months of treatment.
Should You Pop Your Comedonal Acne?
Birth Control Pills: People who menstruate may have skin flare-ups during specific times of the monthly menstrual cycle.
Birth control pills can mediate the hormones that lead to these flare-ups.
Spironolactone: This medication is given to females to help prevent severe acne breakouts.
It may also be prescribed with birth control pills for increased effectiveness in treating acne.
It is also often prescribed with birth control pills because spironolactone can cause severe congenital disabilities.
Isotretinoin: This medication is typically used for severe acne in males and females.
Surgical Procedures
Procedures to extract comedones can be performed in a healthcare provider’s office.
However, this is not usually done unless other forms of topical therapy have been tried first.
Large comedones are most likely to need surgical removal.
A comedone extractor is pressed against the skin, and the material inside the pore is pushed outward.
For small lesions, most surgical procedures can be performed with topical lidocaine or even without anesthesia at all.
In this case, over-the-counter acne products or prescription medications are needed to keep comedones from forming.
How long it takes to see progress depends on the treatment.
Surgical treatment is apparent on the same day.
Oral treatments can take six weeks to a few months before noticeable clearing.
See a healthcare provider if you are still experiencing troublesome symptoms after trying over-the-counter remedies.
Persistent comedones can be treated more aggressively.
Summary
As with all types of acne, treating comedonal acne as soon as possible is best.
For minor blemishes, OTC products are often enough.
More severe, widespread, or long-lasting cases can be effectively treated with prescription medications.
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