A comedo (plural: comedones) is the most basic form of acne. It occurs when a pore becomes clogged with excess oil (sebum), dead skin cells, and bacteria. This blockage forms a small bump on the skin’s surface—either a whitehead, if the pore remains closed, or a blackhead, if the pore opens and the trapped material oxidizes and turns dark.

Unlike more inflammatory types of acne like papules, pustules, cysts, or nodules, comedones are non-inflammatory. They’re typically painless and less prone to redness or discomfort, but they still affect the skin's appearance and texture.

Types of Comedones

Whiteheads (Closed Comedones)

Whiteheads are small, white or skin-colored bumps that form when a clogged pore remains sealed. Without exposure to air, oxidation doesn’t occur, leaving the blockage enclosed beneath the skin’s surface. Though not inflamed, they can feel slightly raised and contribute to uneven skin texture.

Blackheads (Open Comedones)

Blackheads appear as small, dark spots on the skin due to the oxidation of the clogged material inside an open pore. They’re most common on the nose, chin, forehead, and areas with more oil glands, including the chest and back.

Why Do Comedones Form?

Several key factors lead to the development of comedones:

  1. Excess Sebum Production
    Overactive oil glands produce excess sebum, which combines with dead skin cells and plugs pores.

  2. Poor Skin Cell Turnover
    When the natural shedding of dead skin slows, debris remains trapped within pores.

  3. Bacterial Growth
    Propionibacterium acnes (P. acnes) thrives in clogged pores, contributing to worsening blockages.

  4. Hormonal Fluctuations
    Hormone changes during puberty, menstrual cycles, or due to medication can increase sebum production, leading to more frequent comedones.

  5. Lifestyle and Environmental Factors
    Stress, sleep deprivation, smoking, humidity, and friction from tight clothing or helmets can all contribute to comedone formation.

  6. Use of Occlusive Products
    Oil-based cosmetics, moisturizers, sunscreens, or hair products may clog pores, especially in areas prone to oil buildup.

  7. Genetics
    Acne often runs in families, so if your parents had comedones, you may be more likely to develop them too.

How to Identify a Comedo

Comedones usually show up on areas rich in oil glands—face, neck, chest, back, and sometimes shoulders and upper arms. Whiteheads are small, painless bumps that blend with skin tone. Blackheads are tiny, dark dots—sometimes raised, sometimes flat. Both types contribute to a rough or uneven skin texture.

Dermatologists typically diagnose comedones through visual examination. How often and where they appear can help determine the most effective treatment approach.

Effective Treatment Strategies

Even though comedones are less severe than inflammatory acne, treating them properly is still essential to avoid potential inflammation and scarring. Effective treatment focuses on clearing blocked pores and preventing their return.

Over-the-Counter (OTC) Treatments

  • Retinoids (Topical Vitamin A)
    Products like adapalene (Differin) or tretinoin increase cell turnover, helping to unclog pores. Start with every-other-night use to reduce irritation and build tolerance.

  • Salicylic Acid
    This beta-hydroxy acid penetrates pores to dissolve sebum and exfoliate dead skin. Use in low concentrations (1–2%) in cleansers or spot treatments.

  • Benzoyl Peroxide (2–5%)
    An antibacterial agent useful for reducing P. acnes bacteria. Use in moderation and follow with a moisturizer to avoid dryness.

Prescription Options

  • Higher-strength retinoids (tazarotene, tretinoin creams)

  • Topical combination therapies (benzoyl peroxide + clindamycin or retinoids)

  • Oral medications (rarely needed for comedones unless exacerbated by deeper inflammatory acne)

Professional Extraction

When comedones don’t respond to topical treatments, a dermatologist may use sterile tools to extract them. This helps reduce the risk of scarring or infection compared to trying to remove them at home.

What to Avoid

  • Popping or Picking
    This can introduce bacteria deeper into the skin, increase inflammation, and cause scarring.

  • Over-cleansing or Harsh Scrubs
    Scrubbing disrupts the skin barrier and can worsen oil production, leading to more comedones.

  • Heavy Makeup or Oil-based Products
    These can clog pores and undo the effects of treatment.

  • Tight Accessories
    Hats, headbands, or helmets that trap sweat and oil can cause occlusion and trigger comedones—especially along the hairline and forehead.

  • Tanning Beds and Excess Sun Exposure
    UV light can temporarily dry skin, but it can worsen acne and increase sensitivity when combined with treatments.

Preventing Comedones

Consistency in good skincare and daily habits is essential:

  • Cleanse Gently
    Wash twice daily with a mild, non-comedogenic cleanser. Avoid hot water and harsh soaps.

  • Use Non-Comedogenic Products
    Choose water-based moisturizers, sunscreens, and makeup labeled “non-comedogenic”.

  • Maintain a Balanced Diet
    Reduce high-glycemic foods and limit dairy if acne-prone—some people benefit from these adjustments.

  • Manage Stress & Sleep
    Aim for 7–9 hours of sleep and use stress-relief techniques to balance hormones and reduce oil production.

  • Keep Hair Oil-free
    Shampoo regularly if your hair touches your face, and consider tying it back to reduce contact.

When to Seek Professional Help

Consult a dermatologist if:

  • Comedones persist after 6–8 weeks of consistent treatment.

  • They worsen or begin showing signs of inflammation (redness, pain, swelling).

  • Acne significantly impacts your emotional well-being.

  • You suspect underlying hormonal issues or deeper acne types.

A professional can create an individualized treatment plan, including stronger medications and procedures tailored to your skin type and severity.

Key Takeaways

  • Comedones are non-inflammatory acne caused by clogged pores—they include whiteheads (closed) and blackheads (open).

  • These form from excess oil, dead skin cells, bacteria, and hormonal changes.

  • Mild cases respond well to OTC retinoids, salicylic acid, and benzoyl peroxide, along with proper cleansing and lifestyle habits.

  • Avoid picking or over-treating, which can lead to irritation and scarring.

  • For stubborn or widespread cases, professional help ensures safe and effective treatment.

With patient care—typically 4–8 weeks—you can significantly clear comedones and prevent future breakouts.