Medically reviewed by The Dermatologists and written by Dr. Alexander Börve
- Requires medical diagnosis
- Symptoms: Blackhead or whitehead bumps with rough texture
- Color: Typically flesh-colored, white or dark
- Location: Anywhere on the skin most exposed to the sun
- Treatment: Laser treatment, surgical removal, acne medication
Comedones are clogged pores, either resulting in a blackhead or a whitehead pimples.
This process most often occurs in adolescents when their increase in hormone levels increases oil production. Clogged pores result in a buildup of oils in the hair follicle, which can then become infected and/or inflamed, resulting in acne.
Comedones in adults are triggered by hormonal imbalances caused by medication and other hormonal disturbing drugs, such as steroid treatments which can have a tremendous effect on the body’s hormone levels.
Pre-menstrual syndrome as well as heavily smoking can trigger comedones. Certain skin and hair products can block pores and worsen the skin. Rupture of the follicle by injury such as squeezing pimples, abrasive washing, chemical peels or laser treatments can also cause comedones.
Other factors include excessive activity of the male sex hormone 5-testosterone (DHT) within skin cells, free fatty acids made from sebum by acne bacteria and diet with large amounts of dairy product, sugars and fats.
Symptoms of Comedones
Comedones are small, flesh-colored, white, or dark bumps that give skin a rough texture. You can find them at the opening of skin pores. They often have a solid core in the middle. They appear most commonly on the face, neck, chest, and back. Depending on the amount of comedones and the inflammation of papules (pimples), comedones are classified as acne.
Comedones can occur in various forms: a blackhead is open and a whitehead is closed by the skin. The black substance in a blackhead is not dirt, but rather melanin (a pigment producing cell). Whitehead occurs because the follicle is completely blocked.
What can I do?
Over-washing and scrubbing the skin can worsen comedones, causing an infection and irritation. Do not touch or pick at the lesions. Use mild soaps and products that don’t clog pores, labeled noncomedogenic. Squeezing pimples can damage the skin and increases susceptibility to infection.
Should I seek medical care?
Many teenagers suffer from oily skin and in some of the more extreme cases, where the production of sebum is going into overdrive, the onset of some of the more severe forms of acne may occur. It is wise to seek medical advice at an early age and when the onset of acne first appears. This can reduce the risk of unnecessary scarring that can be caused by acne and its related skin conditions.
Treatment for Comedones
Laser treatment can reduce comedones, and large comedones (>1 mm) can be surgically removed. However, there are many commonly available acne medications such as retinoids that can treat acne and comedones.
U.S. National Library of Medicine. Comedones. Available at: https://www.nlm.nih.gov/medlineplus/ency/article/003236.htm
DermNet NZ. Comedonal acne. Available at: http://www.dermnetnz.org/acne/comedonal-acne.html
Clear skin study. Comedones. Available at: http://www.clearskinstudy.com/what-are-comedones-and-why-do-i-get-them/
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