There are several types of acne. Comedonal acne is characterized by many small, flesh-colored bumps that make the skin appear bumpy.
Comedones are the skin-colored, small bumps frequently found on the chin and forehead of those with acne. A single lesion is a comedo.
- Open comedones are blackheads; black because of surface pigment (melanin) rather than dirt.
- Closed comedones are whiteheads, and the follicle is completely blocked.
- Macrocomedones are facial closed comedones bigger than 2–3 mm in diameter.
- Microcomedones are so tiny that they are not visible to the naked eye
- A giant comedo is a cyst type in which there is a clear blackhead-like opening in the skin
- Solar comedones are found on the cheeks and chin of older people and are due to sun damage
In this article, we will be discussing Closed comedones in detail. Please keep reading to know more about it.
What are Whiteheads or Closed Comedones?
Every single pore in the skin is home to a hair follicle. Usually, our bodies produce a natural moisturizer called sebum to keep the hair follicle healthy. However, excess sebum, dirt, or dead skin cells can sometimes block this opening, causing comedones and acne formation. Whiteheads are also known as closed comedones. These form because a hair follicle is blocked entirely.
Comedonal acne is noninflammatory. The lesions do generally not contain pus or bacteria that can cause acne. They are typically neither tender nor red to the touch.
People with comedonal acne may have more than one type of comedone at a time. Simultaneously, people with inflammatory acne can also have comedones and more prominent red and tender blemishes.
Comedonal acne differs from other types as well. Because its lesions tend to be minor, nodulocystic and Nodular forms of acne can cause larger, tender, fluid-filled lesions to form. They may appear most often on the chin, forehead, and cheeks. Whiteheads are not painful. They cannot be “popped” as they do not contain pus or an underlying infection.
Symptoms of Closed Comedones
Comedonal acne does not look like typical acne. Many people with comedonal acne do not consider themselves to have acne.
The reason is that comedones are not red or inflamed like a pimple. They do not tend to swell to excessive proportions or have pus. However, they develop as more minor, non-inflamed bumps called papules that can either be open or closed.
Comedones are most common on the chin, forehead, and jawline. They can also develop on the neck, face, back, shoulders, or chest.
Symptoms can range from mild (with a few odd blemishes) to severe (covering a large part of the skin). Comedones can foster on their own or alongside acne vulgaris.
Comedones can sometimes become acne pimples if someone tries to pop them, allowing bacteria easy access to broken tissue.
Should Whitehead or Closed Comedones be Popped?
Closed comedones usually are called whiteheads, which, contrary to popular belief, are not those white, pus-filled pimples that are so often tempted to pop. Actual whiteheads are not even poppable. However, if someone attempts to pop them or gets irritated by bacteria, they can become poppable pimples.
What are the Causes?
A few people enjoy baby-smooth skin from the day they are born with nothing more than the occasional pimple, whereas others are plagued with acne from puberty straight through adulthood. So what is the deal? Certain things increase the chance of developing acne:
Hormones
- High levels of some hormones, like testosterone, can increase the amount of sebum the body produces, making it more likely to have a breakout. Fluctuations in hormones, more common in puberty, pregnancy, and period, can also lead to breakouts.
Skin type
- Some people naturally create more sebum, making it more likely for pores to get clogged.
Inflammation
- Some people experience more inflammation from the natural bacteria on their skin, which causes acne to form.
Diagnosis of Closed Comedones?
If an inflamed, angry-red pimple is the skincare, like a scream, a closed comedones is a threatening whisper. Seemingly unpoppable and headless, closed comedones are white or skin-colored bumps that gradually build beneath the skin’s surface until they are large enough to be visible in profile.
Evaluation
The identification of lesions diagnoses whiteheads or closed comedones. They appear most often on the chin, forehead, and cheeks. There are no specific tests to confirm it. A doctor or dermatologist will examine your skin under a magnifying glass to verify their presence.
How to Get Rid of Closed Comedones?
Minor modifications in your daily routine and lifestyle can help you eliminate whiteheads and prevent them in the future.
Cosmetics
Makeup can be a notorious transgressor when it comes to clogging pores. When purchasing cosmetics, look for brands labeled “non-comedogenic,” meaning they are free of pore-clogging ingredients or excess oil.
Diet
The relationship between acne and diet has been hotly contested for ages. We have probably all heard about fatty foods and chocolate causing breakouts. However, the jury is still out.
The latest evidence has been for avoiding sugary foods and cow’s milk, which seem to cause breakouts for some people. Eating dark chocolate may worsen existing acne.
There needs to be more research to make standard dietary recommendations for everyone. It helps keep a diet log and see if any foods worsen acne.
Prescription treatments
If acne will not go away or has worsened, prescription-strength acne treatments may help. These may include oral antibiotics, antibiotic ointments, oral contraceptive pills for women, and isotretinoin.
Topical antibiotics
Topical antibiotics are applied to the human skin and come in gels, creams, and ointments. The standard topical antibiotic is clindamycin. For optimal results, topical mix clindamycin with benzoyl peroxide.
Combined oral contraceptives
birth control pills are an effective acne cure for some people. These medications contain the hormones progesterone and estrogen and help to regulate hormone changes in the human body which contribute to breakouts.
Some women should not take mixed oral contraceptives, especially those with a history of blood clots, stroke, heart disease, current breast cancer, or pregnant women.
Oral antibiotics
These are more potent than their topical cousins and effectively treat inflamed acne. Common antibiotics for acne include doxycycline and azithromycin.
Oral antibiotics are typically given in combination with topical treatments. After starting antibiotics, checking with the healthcare provider after about three months is a good idea. If acne has improved, they may recommend stopping the antibiotic.
Topical treatments effectively keep skin clear after an initial period of antibiotics. Using antibiotics for a long time is not a good approach, as bacteria can become resistant. Antibiotics may also have side effects: doxycycline, for example, can make skin more sensitive to light, cause stomach aches, and more.
Isotretinoin
Oral isotretinoin is a medication used for the most severe acne cases with painful scarring and cysts. However, it can have serious side effects, which include nosebleeds, dry skin, muscle pain, and vision changes. Isotretinoin can cause miscarriage and severe congenital disabilities in pregnant women.
For that reason, the healthcare provider will require to use birth control while taking the medication. Like topical retinoids, isotretinoin can also make skin more sensitive to sunlight, and one should use sunscreen liberally to protect the skin while taking this medication.
Before prescribing isotretinoin, the healthcare provider will discuss the iPledge risk reduction program. They may also recommend routine blood tests such as cholesterol testing to monitor for side effects while taking isotretinoin.
Fungal Acne vs. Closed Comedones?
Cause
Fungal acne is because of yeast overgrowth. As a matter of choice, closed comedones happen because of a sebum overgrowth underneath a layer of the skin.
Appearance
We might see little difference when comparing fungal acne vs. closed comedones. They can appear and feel almost identical. The critical difference is not in the appearance but in the source.
Fungal acne is a type of folliculitis called Pityrosporum folliculitis. “Folliculitis” means “inflammation of the hair follicles,” which gives this condition its acne-like appearance.
It is essential to analyze the type of acne before treatment. These tiny papules or pustules look a lot like a small acne breakout. However, while comedonal acne can have various kinds and sizes of blemishes, fungal acne tends to appear uniform. Other common symptoms of fungal acne include redness, itching, and sometimes a stinging sensation. Fungal acne can be developed anywhere there is hair, though it is most common on the upper body, scalp, and face.
Infection
No matter how small, each tiny hair on the face grows from an individual hair follicle. When a hair follicle becomes infected, a small bump develops. In fungal acne, infection occurs when a naturally occurring yeast on the skin, Malassezia yeast, proliferates abnormally.
Treatment
Comedonal acne can be treated with topical retinoids and drying agents. Moreover, stopping the overproduction of oils in the skin can effectively target comedones.
If someone has closed comedones and inflammatory acne, he may need a prescription for systemic antibiotics. Alternatively, hormonal medication (such as contraceptives) can also help with severe cases of acne.
However, antibiotics will not do much in case of fungal acne. Instead, the condition needs antifungal medication. First, try a topical antifungal cream; more will be required if the issue is severe.
Moreover, if the skin does not respond to topical treatment, it may need to try oral antifungal medication under the supervision of a board-certified dermatologist.
Do Close Comedones Go Away on Their Own?
Seldom closed comedones go away on their own without much treatment. Nevertheless, even if they do, it can take weeks or months. If they do not disappear, they can progress in the other direction, becoming painful, red, and more challenging to treat.
Closed comedones as an initial step toward inflammatory acne. All it takes is more stress for them to reach that state. It may come in the shape of a hormonal surge, a buildup of sweat, or an increase in oil production and bacteria around the clogged hair follicles.
Applying stress to closed comedones (squeezing or trying to pop them) will have a similar effect. They will become irritated, and inflamed and grow into red, tender-to-the-touch papules or pustules.
Skip exfoliation, if the body is using too many drying products at once and prone to dead skin buildup, can also play a role in exacerbating preexisting closed comedones. However, beyond that, these habits can even cause more.
How to Treat Closed Comedones and Prevent More in the Long Run?
The following are prescription medications for closed comedones, especially if they are not healing and increasing in number.
Topical retinoids are an excellent choice; dermatologists will likely try them first. These medications include:
- Differin
- Tazorac
- Retin-A
- Retin-A Micro
They help to remove existing pore blockages and keep new ones from forming. They also have the additional benefit of smoothing and softening the skin.
Other treatments that dermatologists might suggest are benzoyl peroxide or azelaic acid. For women, birth control pills (when used with topical treatments) may also help keep those closed comedones from showing up on their skin.
The best way to cure comedones is with topical treatments (applied directly to the skin) containing a topical retinoid or benzoyl peroxide. Opt for a cleanser, moisturizer, and treatment cream for spot treatment.
Plenty of excellent over-the-counter options for mild to moderate acne or occasional outbreaks are available at any local drugstore or pharmacy. The most common side effects are skin irritation and dryness, associated often with overuse.
Topical retinoids
Adapalene or tretinoin is the recommended first-line treatment for comedones. Derived from vitamin A, these treatments keep the skin clear by promoting natural exfoliation, clearing dead skin cells, and keeping pores clean.
They also help fight inflammation and calm the skin. Safe and effective, topical retinoids are the go-to recommendation of dermatologists for whiteheads.
When using these treatments, the skin may be more sensitive to sunlight. Consider limiting these products to night-time usage and applying sunscreen during the day (even if you spend most of the day indoors).
Benzoyl peroxide
This is another effective treatment for white, black, and full-blown acne. It works by killing skin cells and inhibiting the growth of bacteria. Certain brands have formulas that combine benzoyl peroxide with a topical retinoid or antibiotic, like clindamycin, for more effective results.
Azelaic acid
It is an alternative acne treatment, often used for pimples that have become inflamed and irritated. Azelaic acid may also help treat dark patches known as hyperpigmentation which can appear in people who have regular outbreaks.
Extractions
Blemish extractions can also be helpful. This procedure is where a dermatologist uses a unique tool called a comedones extractor or fingers to remove the plug causing the blemish.
Extractions do not keep closed comedones from forming. The human body will still need treatment to prevent them from coming back. However, they can help jump-start treatment. They can make the skin look better while waiting for comedonal acne treatments to work.
Microdermabrasion
Dermatologists use a specialized instrument to “sand” skin. Removing the top layers of skin frees the clogs that cause blackheads.
Over-the-counter Medications
OTC glycolic acid or salicylic acid helps keep pores from clogging and speeds up dead skin cell shedding. Over-the-counter ointments take some time to work. Use them for at least eight weeks before expecting to see improvement in how the skin looks.
Natural and Home Remedies
Some natural remedies for comedonal acne are simple. Ingredients like tea tree oil, clay masks, and charcoal masks can help.
Tea tree oil
It is anti-inflammatory and reduces sebum, so use medications or tea tree oil products.
Mattifying masks
Work well to dry out the sebum in pores. They also help extract trapped dirt and make the removal easier.
Clay or Charcoal masks
With comedonal acne, clay, and charcoal masks are much more effective than other formulations because they help dry out trapped sebum in pores. They can even help remove trapped dirt and skin cells, making removal easier.
Good Skin Hygiene
Good skincare practices include cleansing and moisturizing twice daily. Adopting the following tips can help:
- Wash the face for 30 seconds using gentle circular motions. No harsh scrubbing!
- Follow up with witch an OTC toner.
- Let moisturizer dry before the application of sunscreen or makeup.
- Wash the face after exercise or workout in the middle of the day.
- Never sleep with makeup on, as this can trap more oil in pores.
- Try out a pre-cleanser to remove sunscreen, makeup, and oil. Using Pre-Cleanse, for example, before applying of cleanser for a deeper clean.
Diet
Eat low-glycemic foods made of complex carbohydrates to reduce the risk of developing acne. Complex carbohydrates are found in the following:
- whole grains
- legumes
- unprocessed fruits and vegetables
Foods containing the following ingredients are also thought to be beneficial for the skin:
- the mineral zinc
- vitamins A and E
- chemicals called antioxidants
Some skin-friendly diet choices include:
- Orange or yellow vegetables and fruits such as apricots, carrots, and sweet potatoes
- blueberries
- turkey
- spinach and other green and leafy vegetables
- whole-wheat bread
- brown rice
- quinoa
- tomatoes
- pumpkin seeds
- beans, peas, and lentils
- salmon, mackerel, and different kinds of fatty fish
- nuts
Everyone’s body is different; some people find more acne when eating certain foods.
When to see a Healthcare Provider for Closed Comedones?
If the body has more than just a few closed comedones or has been battling these bumps for a long time, see a dermatologist (skin doctor) for prescription medication.
FAQs About Closed Comedones Answered by Your Doctors Online Team
Comedonal acne can sometimes be caused or worsened by things you put on your face or skin. These include oily skin care products or hair pomades. High humidity and air pollution can also contribute.
Look for products containing salicylic acid, glycolic acid, and benzoyl peroxide. These classic acne-fighting ingredients kill the bacteria that often fuels pimples and clogs pores.
Blackheads form when a hair follicle becomes clogged. Dead skin cells and excess oil collect in the follicle’s opening, which shows as a bump. If the skin over the bump opens, the air exposure causes the plug to look black, thus forming a blackhead.
If a comedone rests on your face, it is possible that its bacteria can spread to other areas of your face or body. Spreading from person to person as a cold or flu can not occur.
Yes, you can use Vitamin C. It effectively reduces blackheads and closed comedones as they reduce sebum oxidation by functioning as antioxidants.
