Treating Closed Comedones

Acne vulgaris is one of the most common skin conditions in the United States, affecting as many as 50 million Americans each year, according to the American Academy of Dermatology. Many people think about acne breakouts as affecting primarily adolescents during puberty; however, people of any age can experience pimples, blemishes, and acne lesions. While acne in itself is harmless, acne breakouts and blemishes can cause anxiety, feelings of frustration, and self-consciousness, leading patients to look for safe and effective acne treatment options. One of the critical components of effective treatment is identifying the type of acne you are dealing with and choosing the skin care products or procedures that will eliminate the breakout without making it worse. One of the most common forms of acne is comedonal acne, characterized by flesh-colored bumps that commonly form on the forehead and chin when excess sebum clogs the pores and hair follicles. Comedonal acne can be easily eliminated when you seek proper treatment from an expert, board-certified dermatologist, such as Dr. Michele Green.

With many treatment options available, both over-the-counter and as a prescription, it can be challenging to know the best treatment option. Luckily, Dr. Green is an expert at generating individualized, tailored treatment plans for each patient based on the underlying cause of the closed comedones, the location of the blemishes, and the patient’s skin type. For some, topical treatments, such as topical products containing benzoyl peroxide, beta hydroxy acids like salicylic acid, azelaic acid, glycolic acid, retinoids, or niacinamide, are the best place to start with closed comedone treatment. For more stubborn breakouts, Dr. Green may prescribe higher-strength retinol like Retin-A (tretinoin) or Differin (Adapalene) than what is available over the counter or antibiotics that can be taken orally or applied topically. Dr. Green can also recommend non-comedogenic, oil-free skincare products to help prevent future acne breakouts. Schedule your initial consultation with Dr. Green to start generating your acne treatment plan today.

Experienced, board-certified dermatologist Dr. Michele Green has been treating patients in her Upper East Side New York City dermatology office for more than 25 years. With her proprietary line of skincare products, MGSKINLABs, and years of treating all forms of acne on all skin types, Dr. Green is an expert at creating individualized treatment plans to provide patients with clear, smooth, blemish-free skin. In addition to topical treatment options, Dr. Green is a master at many cosmetic procedures, including chemical peels, microdermabrasion, Botox, dermal fillers, laser treatment, and more to address signs of the natural aging process, dark spots, sun damage, and more. Applauded for her high patient satisfaction, Dr. Green has been voted one of New York City’s best healthcare providers by such publications as Castle Connolly, Super Doctors, and New York Magazine.

What is comedonal acne?

Comedonal acne is a form of acne characterized by tiny bumps close to the skin’s surface, leading to an uneven appearance. Commonly occurring in areas of the face where oil production is exceptionally high, such as the forehead and chin, comedonal acne lesions are typically skin-colored or slightly lighter than the surrounding skin. Comedonal acne differs from forms of inflammatory acne, such as papules, pustules, and cysts, because they do not contain bacteria and are not typically red or painful to touch. There are several different types of comedonal acne lesions, including closed comedones (whiteheads), open comedones (blackheads), macrocomedones, microcomedones, giant comedones, and solar comedones. Most often, comedonal acne occurs in clusters, though a single lesion is possible and is known as a comedo. There can be multiple types of comedones within a single breakout, ranging in size from macrocomedones, which are closed comedones that are bigger than 2-3 mm in diameter, to microcomedones, which are very small closed comedones that are usually difficult to see, to giant comedones, which are large open comedones with the characteristic blackhead. While comedonal acne breakouts are most common during puberty (14-17 years old for females and 16-19 for males), comedonal acne breakouts can occur at any time in life.

Are whiteheads the same as closed comedones?

Closed comedones are a type of comedone acne characterized by small closed bumps caused by clogged pores or hair follicles. Closed comedones form when oil on the skin’s surface, called sebum, becomes trapped in pores or hair follicles and dead skin cells, dirt, or other debris. They are often slightly lighter in color than the surrounding skin, contributing to their alternate name of whiteheads, and appear in small clusters. They do not usually hurt to touch but can cause the skin to appear uneven in texture.

What are closed comedones caused by?

Comedonal non-inflammatory acne forms due to clogged pores, usually caused by a buildup of excess oil, dead skin cells, and other debris from the skin’s surface. Several risk factors can contribute to the formation of comedonal acne, including:

• Hormonal changes or fluctuations leading to increased production of testosterone and over-activation of the sebaceous glands
• Skin irritation from the use of certain products, such as oils, scented cleansers, and dyes
• Rough exfoliation or damage to the skin, including chemical peels and popping pimples
• High humidity or moisturizers that are too heavy and over-hydrate the skin
• Smoking
• Consuming a diet high in sugar, dairy, and carbohydrates
• Stress leading to hormone fluctuations

Comedonal acne can be prevented by practicing a healthy skincare routine and adjusting to avoid triggering products or environments.

How to treat closed comedones

Patients often wonder, “How to get rid of closed comedones.” Many treatment options are available over-the-counter or via prescription to treat closed comedones. The best place to start when generating a treatment plan is to schedule an appointment with expert board-certified dermatologist Dr. Michele Green, who can recommend the treatment—or series of treatments—that will best meet your needs.

Topical treatment options for closed comedones include:

Benzoyl peroxide, which is available in many formulations and found in gels, washes, creams, and lotions, is an antimicrobial and anti-inflammatory ingredient. Most often used in mild-to-moderate acne, benzoyl peroxide is a highly effective treatment option. Side effects of benzoyl peroxide products can include dermatitis, redness, dryness, and irritation, especially when used in higher concentrations.

Salicylic acid is a type of beta hydroxy acid (BHA), which is an oil-soluble solution used to unclog the pores and exfoliate the skin. Salicylic acid is available in many creams and ointments over-the-counter in 1-2% concentrations. When applied to the skin, salicylic acid helps to reduce sebum production and increase skin cell turnover to clear the pores of excess oil and debris.

Azelaic acid is another highly effective ingredient in over-the-counter topical closed comedone acne treatments, helping to reduce and eliminate breakouts on oily skin and acne-prone skin. Azelaic acid is effective in reducing clogged pores and has anti-inflammatory properties, which helps to address the red pigment associated with acne breakouts for clear skin.

Topical retinoids, which are derivatives of vitamin A, have been used to treat comedonal acne for more than 30 years and are highly effective at reducing inflammation and follicular clogging. Many formulations of topical retinoids are available, including tretinoin, adapalene (Differin), tazarotene, and isotretinoin. Retinoids are often combined with benzoyl peroxide but should be taken at different times of the day (benzoyl peroxide in the morning and topical retinoids at night) to avoid any adverse effects.

Topical antibiotics manage acne breakouts by eliminating the bacteria responsible for causing acne vulgaris and reducing inflammation. The most common topical antibiotics prescribed for treating closed comedones are erythromycin and clindamycin, which can be found in concentrations of 1-4%. It is best to limit the amount of time that you are using antibiotics as acne therapy to avoid bacterial resistance to the treatment. Side effects of topical antibiotics can include erythema (redness), dryness, itching, and burning.

Chemical Peels are an in-office treatment option for patients experiencing mild acne breakouts. Dr. Green will apply a chemical solution to the treatment area containing such ingredients as salicylic acid, glycolic acid, or retinoic acid, causing dead skin, debris, and excess oil to slough off for smooth, clear skin. Chemical peels may also improve the overall appearance of the skin, as the treatment promotes skin cell turnover for smoother, brighter, clearer skin.

How to get rid of closed comedones on the face

The most common area for closed comedones is the face, though closed comedones may appear on the chest and back as well. Closed comedones tend to form in areas with a high buildup of sebum, which occurs most frequently on the forehead, nose, chin, upper back, and chest. Many treatment options are available for treating closed comedones on the face, including topical solutions like benzoyl peroxide, salicylic acid, glycolic acid, azelaic acid, and topical retinoids. In-office or prescription treatment options may be the most effective for patients with stubborn acne breakouts.

How to get rid of closed comedones on the forehead

The forehead is one of the most common areas of the face where acne breakouts occur, particularly closed comedones. Patients experiencing closed comedones on the forehead may want to examine the underlying cause of their breakout before deciding on the best treatment solution. Heavy makeup products, harsh scented shampoos, and hair dyes are all products that can increase the risk of developing closed comedones on the forehead. Patients should consider adjusting their haircare and skincare products to oil-free or non-comedogenic products before undergoing treatment with topical solutions like benzoyl peroxide, salicylic acid, azelaic acid, or retinoids.

How to get rid of closed comedones on the chin

Closed comedones may form on the chin for a number of reasons, including hormonal changes, the use of heavy makeup or moisturizers, or increased contact with unclean, oily surfaces like the hands. Eliminating and addressing the underlying cause of acne breakouts can help to prevent future breakouts for clearer skin. In addition to addressing the underlying cause, patients can turn to topical acne treatments to incorporate into their regular skincare routine.

How to get rid of closed comedones on the cheeks

Though less common than on the forehead, nose, and chin, closed comedones can form on the cheeks as well. Closed comedones on the cheeks can form for a number of reasons, including harsh or heavy skincare products, hormone fluctuations, a diet rich in sugars, dairy, or carbohydrates, or over-exfoliation of the skin. While it may seem like frequent exfoliation would be positive for clearing the pores, over-exfoliation can create skin irritation and over-production of sebum, which can lead to more clogged pores, inflammation, and redness on the skin’s surface. To address closed comedones on the cheeks, patients can turn to topical acne treatments or in-office treatments like chemical peels.

How to treat closed comedones naturally

Patients often wonder, “How to get rid of closed comedones naturally.” Patients who are wary of chemical solutions can turn to some natural products to address closed comedones. However, many “natural solutions” have not been heavily studied or proven to be clearly effective. Additionally, patients should always use caution when applying natural products to the skin, as they can still cause irritation, redness, and inflammation. As with any new skincare product, Dr. Green recommends trying natural topical treatments on a small area of the skin to see how the skin reacts. Some natural products that may improve acne breakouts include aloe vera, tea tree oil, honey, green tea extract, and ginseng extract.

Do closed comedones go away on their own?

Unfortunately, closed comedones do not typically resolve on their own. While it may seem daunting to seek out a treatment solution, leaving closed comedones without treatment may result in worsening breakouts, spreading of bacteria to other areas of the face, and acne scarring. It is best to treat acne breakouts early to decrease the risk of acne scarring, as acne scars, which can be characterized by depressions in the skin, raised scars, dark spots, or discoloration, are much harder to treat than acne breakouts. The best first step to clearing a breakout of whiteheads is to schedule a consultation with Dr. Green, who can help you generate the treatment plan that will work best for you.

How long does it take for closed comedones to go away?

Even with a steady, regular treatment plan and an effective skincare routine, it can take some time for closed comedones to go away completely. The keys to effective treatment are patience and consistency. Patients should always keep their face clean by washing with a gentle, mild cleanser twice per day, applying an oil-free moisturizer to prevent excess oil production, and wearing sunscreen every day before leaving the house. Consistency in a patient’s use of their acne treatment is essential for clearing up breakouts as well. Depending on the patient, it can take anywhere between several weeks and several months to fully clear up whitehead acne breakouts.

How to get rid of closed comedones fast

Patients looking for fast results will often wonder, “How to get rid of closed comedones overnight.” Unfortunately, getting rid of acne can take some time. Dr. Green often reminds patients not to pop acne lesions, as popping pimples can spread bacteria to other areas of the face and result in acne scars. The fastest way to get rid of acne is to consult a board-certified dermatologist like Dr. Michele Green. As there are many different causes of acne breakouts, the first step in treatment is determining the underlying cause contributing to your breakout. After determining the root cause of the breakout, Dr. Green will recommend the treatment plan that will work best for your skin type and acne type. Prescription-strength topical or oral solutions may be the fastest way to clear the skin of blemishes.

How to get rid of closed comedones at home

Practicing a consistent at-home skincare routine with non-comedogenic products can help to reduce acne breakouts and clear up existing ones. To help achieve clear skin, patients should wash their face with a gentle, mild cleanser twice a day, avoiding cleansers or soaps that are scented or contain harsh irritants. Next, patients can apply topical, over-the-counter acne treatments, such as ointments or creams containing ingredients like benzoyl peroxide, salicylic acid, azelaic acid, or glycolic acid. Closed comedone treatment may work best when patients combine acne treatments, such as applying benzoyl peroxide in the morning and a topical retinoid in the evening. After applying acne treatments, patients may choose to apply serums rich in antioxidants to help protect the skin from free radicals in the air. Following treatments and serums, patients should apply a moisturizer to keep the skin hydrated. Even patients with oily skin should apply a light moisturizer, as hydrating the skin can help reduce sebum production. Every morning, patients should also apply sunscreen of SPF 30 or higher to help prevent sun damage.

How to get rid of stubborn closed comedones

Patients who are experiencing stubborn closed comedones that do not go away with over-the-counter topical treatments can turn to prescription medications or in-office treatment options to achieve clear skin. The best first step is to schedule a consultation with Dr. Green, who will examine the treatment area and determine the best medication for you. Some patients may benefit from prescription-strength topical retinoids or other vitamin A-based treatments, such as Retin-A (tretinoin), Differin 0.3 concentration (Adapalene), or Tazorac (tazarotene). Other patients may require a topical or oral antibiotic or may benefit from birth control pills to help control hormone fluctuations. In some cases, Dr. Green may need to perform an extraction, which is an in-office procedure for clearing the pores.

Does tretinoin treat closed comedones?

Tretinoin is a retinoid that can be effectively used to treat closed comedones. Retinoids are vitamin-A derivatives that can be used to help exfoliate the outer layer of the skin, clearing away dead skin cells, debris, and sebum to clear and prevent clogged pores. Tretinoin helps to boost skin cell turnover, which improves skin tone and texture while reducing the size of the sebaceous glands that produce excess sebum. Patients who use tretinoin may experience common side effects like dry skin, redness, and mild irritation.

Does clindamycin treat closed comedones?

Many forms of acne are caused when bacteria become trapped in the pores, leading to inflammation, redness, and tenderness. To treat bacterial acne breakouts, Dr. Green may prescribe a topical antibiotic, such as clindamycin, which kills acne-causing bacteria on the skin’s surface. To find out if clindamycin is the best treatment option for you, schedule your initial consultation with expert board-certified dermatologist Dr. Michele Green.

What is the best treatment for closed comedones?

The best treatment for closed comedones depends on several factors, including the underlying cause of the acne blemishes, the location, and the scope of the breakout. Typically, Dr. Green will recommend that patients begin their treatment process with topical acne treatments, such as benzoyl peroxide, topical retinoids, salicylic acid, or azelaic acid. Some patients may benefit from a combination of topical solutions, with one treatment being applied in the morning and one in the evening. It is often best to begin treatment with lower-strength products and then gradually increase the strength and frequency to avoid skin irritation. For stubborn cases, patients may require prescription acne medication, such as prescription-strength retinoids or topical antibiotics. In-office treatments, such as chemical peels and extractions, can also be performed by a board-certified dermatologist, such as Dr. Green.

Are closed comedones acne?

Closed comedones are a type of acne that forms due to clogged pores. These blemishes are non-inflammatory acne, meaning they are not typically infected with bacteria, nor are they filled with pus or painful to the touch. Closed comedones, also known as whiteheads, differ from open comedones in that the pores are completely closed, giving them a lighter color than the surrounding skin. Whiteheads can range in size from microcomedones, which are nearly invisible, to macrocomedones, which can be as large as 3 millimeters in diameter. While they are not inherently harmful, closed comedones can be frustrating for patients, creating an uneven texture to the skin. Luckily, they are relatively easy to treat with topical acne treatments such as benzoyl peroxide and topical retinoids.

How to get started with comedonal acne treatment today

Comedonal acne is characterized by tiny bumps on the skin’s surface due to clogged pores and hair follicles. There are two main types of comedonal acne – closed comedones and open comedones – that differ in whether the pores are closed over or open to the environment. Comedones can vary in size from practically invisible to several millimeters in diameter. While they are not particularly painful, comedones can create a bumpy texture on the skin, leading to stress and anxiety about appearance. Luckily, there are many treatment options available to eliminate comedonal acne breakouts. From helping you choose products for your daily skincare routine to prescribing retinoids to fight an active breakout, Dr. Green can create a treatment plan to keep your skin smooth, clear, and bright.

Dr. Michele Green is an internationally renowned board-certified dermatologist with over two and a half decades of experience providing her patients with the best non-invasive treatment options. Dr. Green takes a holistic approach and embraces a less-is-more philosophy, creating customized skincare routines and treatment plans that cater to the unique concerns and aesthetic goals of her patients. She is consistently identified as one of New York’s best dermatologists by Castle Connolly, New York Magazine, and Super Doctors for her dedication to her patients and expertise. Please call us at 212-535-3088 or email our New York City-based office today to schedule a consultation with Dr. Michele Green and determine the best treatment option to fight comedonal acne.