Why won't a closed comedone go away?

Why does the bump stay there?

A closed comedone, also called a whitehead, forms when excess oil and dead skin cells plug a pore and its opening closes. These bumps are usually small and painless, often appearing on the forehead or chin. Whiteheads can be white or flesh coloured, so the name is doing less identification work than it appears.234

Several things can keep acne going: hormone changes, certain medicines, and skin or hair products that make the skin greasy. Oily hair pomades and some cosmetics can contribute to comedones. Acne is not caused by dirty skin, so a cleanser's job title is not a promise to clear every bump. Stress can worsen acne, but does not cause it.256

What should you do about it?

1. 1Wash gently twice a day. Use a gentle cleanser rather than scrubbing the bump. Scrubbing can irritate skin and make acne worse.
2. 2Check the products touching the affected area. Choose skincare and makeup labelled noncomedogenic, meaning designed not to clog pores. Consider whether greasy hair products are reaching your forehead, and remove makeup at the end of the day.
3. 3Use a treatment that targets clogged pores. Retinoids are recommended for whiteheads; adapalene is available without a prescription in some markets. Salicylic acid is another topical option, and a pharmacist can help you choose an acne treatment.
4. 4Treat the affected area, not just the visible bump. General guidance for topical treatments that clear comedones is a thin layer over the whole affected area once or twice daily. Follow the directions for your particular medicine rather than treating that frequency as a universal dose.
5. 5Give treatment time, then reassess. Allow six to eight weeks before deciding it has not helped. Worthwhile improvement can take several weeks to months.

Other topical treatments used for comedonal acne include azelaic acid, benzoyl peroxide and glycolic acid. A benzoyl peroxide wash can help reduce acne bacteria, while a retinoid targets clogged pores. These treatments have different roles; a stubborn whitehead is not a reason to use every option at once. Treatment often needs to continue long term rather than ending as soon as the bumps improve.23

Should you squeeze it?

Do not pick or squeeze a whitehead. Picking can lead to more whiteheads and acne scars, and squeezing can injure the follicle. Professional comedone extraction is an option for persistent whiteheads, but that is a dermatologist's procedure, not an instruction to force the bump out at home.123

When should a dermatologist check it?

Arrange an assessment if the bump persists after six to eight weeks of treatment, or if self treatment is not improving your acne. Several skin conditions can resemble acne, so a persistent bump should not automatically be treated as a confirmed closed comedone. A dermatologist can check what it is and decide whether extraction or prescription treatment is appropriate.34

Seek medical help sooner for deep or painful lumps, scarring, lots of spots, or acne affecting your mental health. Hot, swollen or red skin can be a sign of infection; redness can be harder to see on brown and black skin. A deep, painful lump is different from the usually painless, superficial bump of a closed comedone and needs a different treatment approach.35