Comedones

What are they?
Hair follicle openings that are blocked by oil and dead skin cells

What causes them?
Excess oil production

What treatments are available?
Topical retinoids, salicylic acid, glycolic acid, benzoyl peroxide, azelaic acid
Chemical peels
Comedone extraction

Comedones, more commonly known as whiteheads and blackheads, are really common and can be stubborn to treat. Most often seen in acne, they’re the result of excess oil production. Usually, a combination of measures including chemical exfoliants and retinoids can bring them under control. 

What are comedones?

Comedones are blocked pores, or follicular openings in the skin. They develop when the opening of a hair follicle becomes blocked with excess oil and dead skin cells. 

Why am I getting comedones?

Comedones are most commonly seen in acne, and result from excess oil production. They can also occur in some other skin conditions and sun damaged skin. They’re more common in smokers, and a diet high in dairy products and high GI foods may increase the likelihood of developing them. 

What’s the difference between blackheads and whiteheads?

Open comedones, otherwise known as blackheads, occur when the contents have become exposed to the air and oxidise, turning black. Closed comedones, otherwise known as whiteheads, have closed surfaces so are not exposed to the air. 

How can I treat comedones?

Treatments include topical retinoids, alpha and beta hydroxy acids, benzoyl peroxide, azelaic acid, and niacinamide. A good place to start is with a salicylic acid cleanser or serum used in the morning, and a retinoid serum or cream at night. Chemical peels containing salicylic acid can also be helpful. Comedone extraction, whereby the contents of the blocked follicles are manually extracted with a tool called a comedone extractor, is very useful for stubborn or large comedones.

References
Aghasi M, Golzarand M, Shab-Bidar S, Aminianfar A, Omidian M, Taheri F. Dairy intake and acne development: A meta-analysis of observational studies. Clin Nutr. 2019 Jun;38(3):1067-1075.

Gold MH, Baldwin H, Lin T. Management of comedonal acne vulgaris with fixed-combination topical therapy. J Cosmet Dermatol. 2018 Apr;17(2):227-231. 

Kucharska A, Szmurło A, Sińska B. Significance of diet in treated and untreated acne vulgaris. Postepy Dermatol Alergol. 2016;33(2):81-86. 

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ABOUT THE AUTHOR

Dr-Julia-Rhodes

Spotlight on Skin was created by award-winning Melbourne-based dermatologist, Dr Julia Rhodes.

Julia knows first-hand how overwhelming the skincare world can be, and that’s with over 10 years of experience practicing dermatology. Given that even she gets overwhelmed, she appreciates how hard it can be for those of you without a scientific background to make sense of all the information available, and choose products that are right for your skin…