Best products for closed comedones

What are closed comedones?

Closed comedones are whiteheads: small follicles blocked with oil and dead skin cells, with skin covering the opening. They can look white, yellowish or the same color as your skin. Unlike a pus filled pimple, a closed comedone usually is not swollen or tender. The forehead and chin are common locations, although the cheeks, nose and back can also be affected. A routine aimed at clogged pores makes sense for these bumps; deep, painful lumps need a different treatment plan.12

Which treatment should you buy?

Adapalene is a practical first choice

Retinoids are medicines derived from vitamin A. They are an established first treatment for comedonal acne, not just products for smoothing the appearance of skin. Adapalene is available without a prescription in the US; access differs by country. Differin is one example. Tretinoin, tazarotene and trifarotene are prescription options. Cosmetic retinol and retinaldehyde also belong to the retinoid family, but choose an acne medicine when your purpose is treating closed comedones.356

Texture matters if irritation has stopped you using a retinoid before. Retinoid creams tend to be less irritating than gels, while gels are less noticeable on the skin. Adapalene is generally less irritating than tretinoin. These are useful differences to discuss with a pharmacist or dermatologist, rather than assuming a stronger prescription is automatically the better starting point. Apply a topical retinoid in the evening as directed, and avoid applying it close to the eyes or lips.35

When salicylic acid or azelaic acid makes sense

Salicylic acid is a reasonable alternative for whiteheads. It dissolves dead skin cells that can block follicles and comes in cleansers and lotions, so the application method depends on the product you buy. Azelaic acid addresses clogged pores, bacteria and inflammation, and can also treat dark spots left after acne clears. Ask a pharmacist which product and strength to start with. A cleanser and a product left on the skin have different directions; follow the directions for the exact formula.367

Does benzoyl peroxide help closed comedones?

Benzoyl peroxide targets bacteria rather than doing the same job as a retinoid. A benzoyl peroxide wash can accompany a retinoid for whiteheads and blackheads. It is particularly relevant when your routine also needs to address inflamed pimples. Lower concentrations and wash formulations are less irritating than stronger or leave on options, although dryness remains a common side effect. Prescription combinations can put a retinoid and benzoyl peroxide into one medicine; use them exactly as prescribed.136

How to build the routine

Cleansing, moisturizing and sun protection support the treatment routine, even if the bathroom shelf would prefer a larger staff. Choose gentle, oil free, noncomedogenic products, meaning products formulated not to clog pores.2

1. 1In the morning, wash gently with a mild cleanser. Use warm water and do not scrub. If a benzoyl peroxide wash is part of your treatment plan, follow its directions.
2. 2Apply moisturizer. Regular moisturizing is part of caring for skin with whiteheads, not something reserved for skin without acne.
3. 3Use a noncomedogenic, broad spectrum sunscreen with SPF 30 or higher and water resistance. Seek shade and use protective clothing as well.
4. 4In the evening, remove makeup and cleanse gently. Apply your acne treatment as directed. For a treatment left on the skin, use a thin layer over the affected area rather than only dabbing individual bumps.
5. 5Moisturize regularly. If you use a prescription retinoid and need to change the amount, frequency or moisturizer order because of irritation, ask your dermatologist to adjust the plan.

What to look for in the supporting products

Look for oil free, water based, noncomedogenic cleansers, moisturizers and makeup. Oily or greasy skin and hair products can contribute to comedonal acne, so keep hair products away from your face. Makeup does not need to be abandoned, which is welcome news for products that have already claimed a drawer. Remove it before bed. Wash gently morning and night and after exercise. Abrasive scrubbing can irritate skin and worsen acne; it is not a shortcut to empty pores.267

How long do products take to work?

Give an acne treatment six to eight weeks before judging early progress. Closed comedones can be slower: a noticeable difference can take eight to 12 weeks, and clearing can take several months. Some retinoid treatments need 12 weeks or longer before improvement appears. If bumps remain after six to eight weeks, arrange a review rather than repeatedly replacing products. Treatment often needs to continue after improvement because comedonal acne can recur over years.124

Who should be careful with retinoids?

Retinoids can cause dryness, redness, peeling and sun sensitivity, and their drying effect can worsen eczema. If your skin is sensitive or you previously stopped a retinoid because of irritation, tell your dermatologist before restarting. Some topical retinoids are contraindicated during pregnancy. If you are pregnant or planning pregnancy, check the specific medicine with your healthcare professional before using it. Suitability for children also depends on the medicine and country. Report medication side effects to your provider instead of continuing unchanged through irritation.25

When products are not enough

See a doctor if self treatment is not helping, spots are deep or painful, scarring is developing, or acne is affecting your mental health. Hot, swollen skin with redness can signal infection; redness can be harder to see on brown or black skin. A dermatologist can confirm whether the bumps are acne and consider prescription treatment or professional extraction. Do not squeeze or attempt extraction yourself. This can damage follicles, cause infection and scarring, and make the blemishes more noticeable.237