How can you tell them apart?
| Feature | Closed comedones | Blackheads |
|---|---|---|
| Pore surface | Intact and closed over the plug | Open, with the plug exposed |
| Colour | White or skin coloured | Grey, brown, black or sometimes orange |
| Appearance | Small raised bumps | Dark dots that can be flat or raised |
| Other name | Whiteheads | Open comedones |
| Treatment approach | Unclog pores and prevent new plugs | Unclog pores and prevent new plugs |
Closed comedones can be skin coloured rather than white, so the name whitehead is not a strict dress code. They are usually uninflamed bumps, not pimples filled with pus. Comedones can give skin a rough texture, and acne dominated by these plugs is called comedonal acne. The forehead and chin are common sites. You can have whiteheads, blackheads and other acne spots at the same time.1346
Why do blackheads turn dark?
Both types start when excess oil and dead skin cells build up in a pore. In a blackhead, the opening widens and the exposed buildup reacts with oxygen in the air, producing the dark colour. Blackheads are not dirt, despite looking like they have been hired to advertise face wash. Scrubbing does not solve the blockage and can irritate skin and worsen acne. A closed comedone keeps its surface intact instead of exposing the plug.47
How do you treat closed comedones and blackheads?
The main treatment overlaps: retinoids help break up both types of plug and prevent clogged pores. Adapalene is available without a prescription in some markets; availability depends on where you live. Salicylic acid is another option that helps remove dead skin cells and prevent follicles from clogging. Benzoyl peroxide targets bacteria that contribute to acne, and a benzoyl peroxide wash can accompany retinoid treatment.25
- 1Wash with a gentle cleanser twice daily. Avoid abrasive scrubbing.
- 2Apply the chosen topical treatment as a thin layer across the affected area, rather than only treating individual visible plugs. General comedonal acne guidance uses treatment once or twice daily; follow your product's directions for its schedule.
- 3Use moisturizer routinely. If a retinoid causes peeling or changes in skin colour, using it every other day or alongside moisturizer can reduce those effects.
- 4Remove makeup at the end of the day and choose skincare and makeup labelled noncomedogenic, meaning formulated not to clog pores.
How long does treatment take?
Give treatment six to eight weeks before assessing whether it is helping. Worthwhile improvement in comedonal acne can take several weeks to months, and continued treatment is often needed to control new plugs. Some shallow blackheads clear on their own, but deeper ones are less likely to disappear without treatment. Persistent bumps are a reason to discuss prescription treatment or professional extraction, not to keep increasing pressure with your fingers.256
Can you squeeze them, and when should you get help?
Do not pick or squeeze either type. Picking whiteheads can lead to more whiteheads and scars; squeezing blackheads can cause infection or permanent scarring. Closed comedones need their surface opened for extraction, which is not a home procedure. See a doctor if treatment is not helping, you have many spots, or acne is deep, painful, scarring or affecting your mental health. Hot, swollen or red skin can signal infection and also needs medical attention. Redness can be harder to see on brown and black skin.347
Where this answer comes from
- 1Comedones: MedlinePlus Medical Encyclopediamedlineplus.gov
- 2How to treat different types of acneaad.org
- 3Comedodermnetnz.org
- 4Acnenhs.uk
- 5Blackheads: What They Look Like, Treatment & Preventionmy.clevelandclinic.org
- 6Comedonal acnedermnetnz.org
- 7Acne: Signs and symptomsaad.org
