Closed comedones on the forehead: what helps?

What do closed comedones look like?

Closed comedones, also called whiteheads, form when dead skin cells and sebum, your skin's natural oil, block a pore beneath its surface. They usually feel like small, firm bumps without tenderness or swelling. They do not need a visible white tip. Red or darker inflamed bumps, pus filled spots and deep painful lumps are different acne lesions and can occur alongside them.45

Could your hair products be causing them?

Closely packed bumps along the hairline or upper forehead can come from hair products. Oils in pomades, styling products, shampoos and conditioners can reach the skin and clog pores. Hair products belong in the routine review, even if their job description never mentions your forehead. Stop a likely culprit and look for replacements labelled oil free, noncomedogenic or "won't clog pores".3

Wash pillowcases, sheets, hats and headbands that carry product residue. If hair products are responsible, clearing can take four to six weeks after you stop the contact. See a dermatologist if the bumps have not cleared by six weeks.3

Hair products are not the only possible cause. Hormones, family tendency, high humidity and pore blocking cosmetics can contribute to acne. The forehead location is a reason to check hair products, not enough to identify the cause by itself.6

How do you treat closed comedones on the forehead?

Retinoids help unclog pores; adapalene is available without a prescription in some markets. Salicylic acid and azelaic acid are other topical options. A benzoyl peroxide wash can help reduce acne bacteria. A pharmacist can help you choose a treatment, particularly if you also have inflamed spots.245

For adapalene gel or cream, follow this sequence:

1. 1Gently wash the affected skin with a mild cleanser and pat dry. Do not scrub.
2. 2Spread a thin film over the entire affected forehead, not just individual bumps. Keep it away from your eyes, nose and mouth.
3. 3Use it as directed on the package or prescription, usually once daily at bedtime. Applying more or using it more often does not speed results.

Wash and moisturize morning and night, remove makeup before bed, and wear sunscreen daily. Choose oil free, noncomedogenic skincare and makeup, meaning products intended not to clog pores. Avoid picking or squeezing; home extraction can cause scars, infection and more comedones.4

How long does treatment take?

Give acne treatment six to eight weeks before assessing progress. Comedonal acne can take eight to twelve weeks to start improving and several months to clear. Treatment often needs to continue over the long term. Adapalene can initially bring unseen pimples to the surface, and its full benefit can take eight to twelve weeks or longer.1247

When should you be careful or get help?

Do not apply adapalene to sunburned, broken or eczema affected skin. Speak to your doctor if it causes burning, stinging or irritation; they can advise on moisturizer or less frequent use. Discuss pregnancy, plans for pregnancy, breastfeeding and existing medicines before using it. Seek immediate medical help for breathing difficulty or swelling of the face, lips, tongue or throat.7

See a clinician for persistent bumps despite treatment, deep painful spots, scarring, hot swollen skin or acne affecting your mental health. A dermatologist can confirm what the bumps are and offer prescription treatment or professional comedone extraction.25