You’ve Probably Had Comedonal Acne — Here’s How to Make It Go Away
Dermatologists share their best tips for banishing these bumps.
Zits. Pimples. Pustules. Acne gets called a lot of things, but “comedones” isn’t one you hear your friends say often. That being said, you’ve probably dealt with them before. Comedonal acne refers to open and closed comedones—tiny, painless zits or blackheads that typically appear in clusters on your chin, nose, or forehead. If you’ve ever had a smattering of inexplicable “bumpy skin,” comedonal acne might be to blame.
Unlike your standard zit or pimple, comedonal acne isn’t inflammatory, so it doesn’t come with the redness, pain, and swelling you usually associate with, say, cystic acne. It is super common and the good news is, it’s easy to treat. We asked some acne experts what causes open and closed comedones and how you can resurface your smooth skin.
Meet the experts:
Michele Green is a board-certified cosmetic dermatologist in New York City.
Sheila Farhang is a board-certified dermatologist and cosmetic surgeon in Tucson, Arizona.
Amy Wechsler is a board-certified dermatologist and psychiatrist in New York City.
In this story:
What are open comedones and what causes them?
What are closed comedones and what causes them?
What is comedonal acne?
Let’s start from the beginning: “Comedonal acne is formed when excessive sebum [the oil your skin produces to hydrate and protect] is combined with dead skin cells, bacteria, and dirt to clog pores,” says Michele Green, a board-certified dermatologist in New York City. The result is a cluster of small, firm bumps close to the skin’s surface. These bumps, or comedones, can be closed or open. “They’re typically characterized as whiteheads and blackheads,” says Sheila Farhang, a dermatologist in Tucson, Arizona. (We’ll get into this more below).
At first glance, comedonal acne doesn’t really look or feel like acne. “Comedonal acne is a type of non-inflammatory acne,” says Dr. Farhang. “Which means it doesn’t have the redness, swelling, pain, or pus typically associated with acne.” If you try to squeeze a comedone, for instance, there’s a good possibility nothing will come out (and you’ll risk aggravating it, turning it into a full-blown zit).
Alas, acne it is: Comedonal acne, like any other type of acne, is caused by clogged pores or hair follicles. “Other factors such as oil-based skin-care or cosmetic products, genetics, and hormones can cause a comedonal acne breakout,” says Dr. Farhang. At the end of the day, “comedones are a form of acne,” says Amy Wechsler, a dermatologist and psychiatrist in New York City. “Acne is caused by a combination of genetic and hormonal factors, coupled with stress and, in some instances, medications or products.”
Ultimately, that means you treat open and closed comedones the same way you would treat an acne breakout. Dr. Wechsler says topical treatments like retinoids, salicylic acid, and benzoyl peroxide should do the trick. “Oral treatments work as well but are often not needed if the acne is purely comedonal,” she says. Dr. Farhang recommends Neutrogena Stubborn Marks for slow-release retinol, or try Benzac Benzoyl Peroxide Spot Treatment Gel.
Benzac Benzoyl Peroxide Spot Treatment Gel
“This is formulated with 2 percent salicylic acid, which goes deep into the pores and breaks up the oil,” says Dr. Farhang. “Salicylic acid is a beta hydroxy acid that exfoliates the skin, helping to remove dead skin cells and unclog pores. I like that this is a spot treatment—full-face salicylic acne products can be really drying.”
“This is formulated with slow-release retinol which works longer and doesn’t irritate the skin,” says Dr. Farhang. “Retinoids are derived from Vitamin A and are highly effective in treating comedonal acne. They work by promoting cell turnover, preventing the formation of new comedones and reducing the appearance of existing ones.”
This facial cleanser is powered by benzoyl peroxide. “Benzoyl peroxide is an antibacterial agent that helps kill the bacteria within the clogged pores,” says Dr. Farhang. “And it reduces any inflammation.”
What are open comedones and what causes them?
Open comedones have, you guessed it, an opening on the skin’s surface. “The air exposure oxidizes the buildup of sebum and dead skin cells, leading to the dark coloration,” says Dr. Green. Sound familiar? You might know closed comedones by their more common name: blackheads.
Like any type of acne, the biggest culprits behind open comedones are excess sebum and hormonal fluctuations. “Excess sebum combines with bacteria, debris, and dead skin cells to clog pores,” says Dr. Green. Meanwhile, changes in androgen production (the sex hormones found in humans of all genders) “can increase acne-causing bacteria, inflammation, and sebum production,” she explains, “leading to clogged pores.” Cortisol, a stress hormone, can also cause increased inflammation and excess sebum, resulting in clogged pores. And clogged pores lead to comedones.
How do I treat open comedones?
You’ve probably tried those sticky pore strips to pull the oil and debris from your skin. Dr. Wechsler says those can be used with some success on open comedones, but topical treatments are your best bet when it comes to clearing and preventing open comedones and clogged pores.
Start with a facial cleanser containing salicylic acid. “Salicylic acid penetrates deep into pores to break up clogged sebum and debris, and exfoliate the skin,” says Dr. Green. Allure editors love CeraVe Renewing SA Cleanser with salicylic acid and ceramides.
CeraVe Renewing SA Cleanser
From there, “open comedones can be treated with retinoids, which are Vitamin A derivatives that exfoliate dead skin cells, sebum, and debris from the top layer of the skin,” says Dr. Green. “Differin Gel [which contains adapalene, a type of retinoid] is an excellent topical treatment for preventing open comedones from forming.”
For a deep, deep clean, our experts recommend getting a HydraFacial, “a three-step office treatment that cleans, exfoliates, and hydrates the skin,” explains Dr. Green. During a HydraFacial, a technician uses a special device to vacuum out your pores and exfoliate your skin—so you can start fresh. Just be sure to consult with a board-certified dermatologist who has been trained in this treatment.
What are closed comedones and what causes them?
Closed comedones appear as tiny, fleshy bumps that give your skin a rough and bumpy texture. These tiny zits typically aren’t filled with pus like a pimple might be—instead, if you manage to pop one (and we don’t recommend you try), you’ll find a combo of dead skin and buildup, says Dr. Farhang. And because closed comedones have no opening, the debris isn’t exposed to air, keeping the comedones white or flesh-colored.
Closed comedones, like open ones, are the result of clogged pores. They’re typically caused by excess sebum and hormonal changes. “Comedones are very common in teenagers,” says Dr. Green, “but can also develop during menstrual cycles, pregnancy, and menopause due to fluctuations in estrogen.” Certain types of ingredients in food—like dairy, sugars, and fats—can also contribute to comedonal acne. Basically, if you have pores and hormones, or eat food, you’ll probably experience comedonal acne at some point.
How do I treat closed comedones?
The steps to treat closed comedones might sound familiar—start with a facial cleanser containing salicylic acid and follow up with a topical retinoid, like Differin Gel. “Retinoids and retinoid-like products help to clear excess sebum from the skin and promote new cell turnover,” says Dr. Green.
Because comedones are so susceptible to hormone fluctuations, Dr. Green recommends speaking to your dermatologist about androgen inhibitors. “Winlevi is another excellent topical acne treatment containing clascoterone, an androgen inhibitor that blocks hormones like testosterone from producing excess sebum, helping to prevent pores from clogging,” she says.
To reduce the appearance of closed comedones right away, our experts recommend checking out microdermabrasion. “Microdermabrasion is an office treatment that eliminates impurities on the skin’s surface to reduce the appearance of closed comedones and create a smooth complexion,” says Dr. Green. At-home microdermabrasion treatments are available and can be effective, but Dr. Green warns against being too aggressive with at-home treatments, which can cause redness, inflammation, and bruising. It’s always best to consult a board-certified dermatologist.
The consensus on comedones
Open and closed comedones are the result of clogged pores due to excess sebum and buildup. It sounds a lot like acne—because it is acne… just not the painful, red, inflamed acne you might be used to. This means the things that treat acne, like washing your face with salicylic acid cleansers and using topical retinoid creams, also treat comedones.
Keep in mind that clear skin rarely ever happens overnight. “It may take several months to see improvement in the appearance of comedones on the skin,” warns Dr. Green. “Using products labeled ‘non-comedogenic’ or ‘oil-free’ is an excellent first step in dealing with open and closed comedones.” If your comedonal acne is annoyingly persistent or resilient, or you’re interested in trying a more aggressive treatment, it’s time to consult with your board-certified dermatologist.
