Closed comedones on the nose: what helps?

What do closed comedones look like?

A comedo is a plugged opening of a hair follicle. Closed comedones, also called whiteheads, have an intact surface and can give skin a rough texture. They usually look like small raised bumps without obvious swelling or tenderness. Their contents sit beneath the surface rather than in an open pore.145

Blackheads have an open surface and look darker; they are not dirt that needs scrubbing away. A bump filled with pus is a different acne lesion, called a pustule. If you cannot tell what the nose bumps are, a clinician can examine them: some conditions that resemble acne need different treatment.26

Which treatments help?

Retinoids clear clogged pores and treat whiteheads and blackheads. Adapalene is available without a prescription in the US; availability differs by country, and other acne retinoids require a prescription. Dermatologists also use retinoids for maintenance after acne is controlled, because treatment is not only about removing today's bumps.36

Salicylic acid opens clogged pores and exfoliates the skin, making it another option for whiteheads. Azelaic acid also opens pores and helps keep them open. Benzoyl peroxide reduces acne causing bacteria and can be used alongside a treatment that addresses clogged pores. A pharmacist can help you choose an acne product.36

Acne treatments come as creams, gels and lotions, so the bottle shape is not a treatment plan.3

How should you care for the nose area?

1. 1Wash gently morning and night with a mild cleanser. Do not scrub the bumps.
2. 2Apply your acne medication as directed. General comedonal acne guidance is a thin layer over the entire affected area, rather than only individual bumps. The product directions or your prescription determine the frequency; topical retinoids are often applied in the evening.
3. 3Moisturize morning and night. If a retinoid irritates your skin, ask your dermatologist about adjusting the amount, frequency or applying moisturizer first rather than changing a prescription yourself.
4. 4Use sunscreen daily. During retinoid treatment, choose a noncomedogenic sunscreen with broad spectrum protection, SPF 30 or higher and water resistance.
5. 5Remove makeup before bed.

Oil free cosmetics are a sensible choice for comedonal acne, even if the packaging would rather discuss radiance. Look for cleansers, moisturizers and makeup labelled noncomedogenic, meaning formulated not to clog pores.17

How long does clearing take?

Give acne treatment six to eight weeks before judging early progress. Comedonal acne can take eight to twelve weeks to show a noticeable difference, and complete clearing can take many months. Treatment often needs to continue long term because comedones can return. If bumps remain after six to eight weeks, a dermatologist can review the diagnosis and treatment rather than leaving you to keep switching products.127

When should you get help?

Do not squeeze, puncture or extract closed comedones yourself. Professional extraction can help persistent bumps, but home extraction can cause scars, infection and damage that leads to more comedones.1

Contact your clinician if medication causes side effects. See a doctor if bumps become deep or painful, cause scars, or the area becomes hot, swollen and red. Redness can be harder to see on brown and black skin. Acne that affects your mental health is also a reason to seek help.13