Medically reviewed by Dr. A.M. van Coevorden, dermatologist
Comedonal acnemainly blackheads, little inflammation
With comedonal acne you mainly see open and closed comedones and little inflammation. The skin often feels uneven, but there are hardly any red pimples. That can still be very bothersome and calls for a targeted treatment.
Open and closed comedones
A comedo is a blockage of the hair follicle with sebum and dead skin cells. If the build-up stays under the surface of the skin, you see a white bump, a closed comedo or whitehead. If the blockage is in contact with the open air, the contents oxidise and the tip turns dark, an open comedo or blackhead. That dark tip is not dirt, and it does not mean your skin is not clean.
What causes comedones?
The first blockage forms under the surface of the skin and is not yet visible, that is called a microcomedo. Various factors cause a follicle to become blocked: the skin produces more sebum and the duct hardens more quickly. Make-up and oil-based products can play a part. Poor hygiene is not a cause.
How is comedonal acne treated?
Treatment usually starts with a topical product that exfoliates and keeps the ducts open, such as a retinoid. Because the predisposition remains, maintenance is often needed afterwards to stay ahead of new blockages. Your doctor tunes the schedule to your skin.
Can you remove comedones yourself?
Do not squeeze comedones. The pressure pushes sebum into the skin, which causes more inflammation and makes the acne worse. Wash your skin with lukewarm water without scrubbing, and avoid oil-based products.
Can it turn into inflamed acne?
Yes, it can. Bacteria can multiply in a blocked follicle. When the blocked follicle ruptures, the contents enter the surrounding tissue and inflammation develops: red pimples and pustules. That is exactly why it pays to treat comedones before it gets that far.
Frequently asked questions about comedonal acne
How do you get rid of comedones?
With a treatment that tackles the blockage, usually a topical product that exfoliates, such as a retinoid. Give the treatment time: the effect is only assessed after six to twelve weeks.
What causes comedones?
A blockage of the hair follicle with sebum and dead skin cells. The skin produces more sebum and the duct becomes blocked more quickly. Hormones and predisposition are the main causes, oil-based products can play a part.
What is the difference between open and closed comedones?
A closed comedo (whitehead) sits under the surface of the skin and looks white. An open comedo (blackhead) is in contact with the open air, so the contents oxidise and turn dark. The dark tip is not dirt.
Can you squeeze comedones?
Preferably not. The pressure pushes sebum into the skin, which causes more inflammation. A targeted treatment works better and prevents new blockages.
Is comedonal acne serious?
It is the mildest form of acne in terms of inflammation, but it can still be bothersome and call for treatment. Left untreated, comedones can also become inflamed.