What is a closed comedo?

What does a closed comedo look like?

Closed comedones give skin a bumpy or rough texture. They commonly appear on the forehead and chin, but can also affect the nose, cheeks and back. Some look slightly yellowish rather than white. They are usually not swollen or tender, although an individual whitehead can be slightly tender.245

The difference from a blackhead is the opening: a closed comedo has an intact surface, while an open comedo has an exposed opening. A blackhead's dark tip is not dirt. A pustule is different again: it is an inflamed bump filled with pus, rather than simply a covered plug.134

Why do closed comedones form?

The blockage forms inside a hair follicle, the opening from which a hair grows. Excess sebum, your skin's natural oil, and dead skin cells build up there. Hormonal changes during puberty, periods, menopause or pregnancy can contribute, as can certain medicines and greasy skin or hair products. Whiteheads are common in teenagers, but adults get them too, including for the first time in adulthood.256

How do you treat closed comedones?

Treatments applied to the skin include salicylic acid, retinoids, azelaic acid, benzoyl peroxide and glycolic acid. Salicylic acid dissolves dead skin cells to help prevent blocked follicles. Retinoids, medicines related to vitamin A, help break up whiteheads and prevent clogged pores. A pharmacist can help you choose an acne treatment; persistent acne can need prescription treatment.256

1. 1Wash gently with a mild cleanser in the morning and evening. Do not scrub, which can irritate skin and make acne worse.
2. 2Apply a thin layer of the acne treatment across the affected area, rather than treating only individual bumps. Comedone treatments are generally applied once or twice daily, depending on the medicine.
3. 3Use moisturizer regularly. If a retinoid causes peeling or a change in skin color, using it every other day or alongside moisturizer can reduce these effects.
4. 4Wear sunscreen daily, and remove makeup at the end of the day.

Choose oil free, water based products labelled noncomedogenic, meaning designed not to clog pores. Makeup does not have to be abandoned; noncomedogenic is the useful label to look for, even if the word needs most of the packaging.25

How long do they take to clear?

An individual whitehead can go away on its own. Repeated comedonal breakouts take longer to manage: with consistent care and treatment, you may notice improvement in eight to twelve weeks, while clearing can take many months. Treatment often needs to continue long term because comedonal acne can return.235

Should you squeeze it or see a doctor?

Do not pick or squeeze closed comedones: this can cause scars, infection and further damage to the follicle. Persistent plugs can sometimes be removed professionally. See a doctor if treatment is not helping, acne becomes deep or painful, scars develop, or your skin is hot, swollen and red. Redness can be harder to see on brown or black skin. Report medication side effects to your healthcare provider, and seek help if acne is affecting your mental health.256