How to get rid of closed comedones

Which treatment should you try first?

Dermatologists recommend a retinoid to unclog pores, and adapalene is one retinoid available without a prescription. Salicylic acid is another option that works well on whiteheads and blackheads. Choose one acne treatment to try first rather than starting several at once. Tretinoin is a prescription topical retinoid, so use it with a prescriber's directions.23

Benzoyl peroxide is also used for acne, but it is especially effective for mild pimples. If you choose it for acne that includes pimples, starting at 2.5 percent can help limit dryness, irritation, or a burning feeling. Over the counter acne products can also cause redness, dryness, or peeling, so use them sparingly and follow the product directions.24

How to use an acne treatment

1. 1Wash your skin gently with a mild cleanser twice a day. Do not scrub or repeatedly wash it, since that can irritate skin and worsen acne.
2. 2Choose one active ingredient for your first trial. Adapalene and salicylic acid are options for whiteheads; use a product that matches the directions on its label.
3. 3Apply a thin layer across the whole acne prone area, not only on visible bumps. Topical comedolytic treatments are generally applied once or twice daily as a thin layer over the whole area; follow the specific product directions for timing and frequency.
4. 4Use the treatment consistently for six to eight weeks before deciding whether it is helping. Do not add another acne treatment during that trial.

What causes closed comedones?

A comedone is a plug that forms when oil and dead skin cells block a hair follicle. When the opening is closed, the bump looks white or skin colored; an open plug looks dark and is called a blackhead. The word comedone gives a small pore plug an unusually official title.45

Hormonal factors, humid weather, and oily cosmetics can aggravate comedonal acne; a pore apparently does not require a single point of failure. Oily sunscreens and petroleum based moisturizers are among the products that can aggravate it. Choose noncomedogenic skin care and makeup products, which are made not to clog pores. Products used on the skin or hair that make skin greasy can also contribute.35

High dairy intake and high glycemic foods have been linked to acne in some people, but the evidence is weak and the connection is controversial.34

How long does it take to work?

Acne medication does not work overnight. With treatment that works, some people see fewer breakouts after four to eight weeks, while clearing can take 16 weeks. Significant improvement in comedonal acne can take several months. Give the chosen treatment a consistent trial before switching; if stubborn whiteheads remain after six to eight weeks, a dermatologist can discuss prescription treatment or comedo extraction.123

When should you be careful?

If you are pregnant or trying to get pregnant, speak with a dermatologist before treating acne on your own. Some acne treatments sold without a prescription are not safe during pregnancy. Acne products can cause redness, dryness, burning, or peeling; follow the label and use products sparingly.24

When should you see a doctor?

See a doctor if self care is not improving your acne, or if you have many spots, deep or painful bumps, or scars. Get medical help if your skin is hot, swollen, and red, if the acne is getting worse, or if it is affecting your mental health. Do not pick or squeeze closed comedones, since picking can cause scars.5