Comedones are flesh-colored acne bumps that are small and typically develop on the chin, forehead or wherever acne occurs. Both blackheads and whiteheads are types of comedones. Some of very tiny and some are considered “giant.”
When you run your finger across a comedo, a single lesion, it will feel a tiny bump. Unlike a typical pimple that’s red and inflamed, comedones don’t hurt, and they are barely visible.
When most lesions on the face are comedones, it’s called comedonal acne. This is primarily an issue on the forehead and chin.
Comedones occur when hair follicles are blocked by sebum and dead skin cells. The color and size of these blemishes vary.
Here’s a breakdown of the types of comedones and why they occur:
- Open comedones: Open comedones are blackheads that look like small black-brown dots on the skin. They occur when oil is clogged near the pore opening. The dark color is caused by melanin, which causes dead skin cells to oxidize when exposed to oxygen, turning it a dark color.
- Closed comedones: Closed comedones are called whiteheads, and they occur when oil develops beneath the hair follicle opening. They are flesh-toned or white in color.
- Microcomedones: These are the very tiny comedones that go unnoticed to the naked eye. They begin in this state and become larger blemishes over time.
- Macrocomedones: These are larger comedones that are noticeable and cause bumps or blemishes.
- Giant comedo: Giant comedos are very large blackheads that are noticeable and typically affect old adults.
- Solar comedones: Solar or senile comedones occur after long-term exposure to UV radiation. These occur in older adults and can vary in size and color.
Comedonal acne isn’t typically painful. The small bumps come in a few colors and sizes, depending on where the plug occurred and the size of the pore.
Unlike pimples that are on the surface of the skin, comedones can’t be popped, and they aren’t red or inflamed.
A comedo is barely visible and feels like a small bump if you run your finger across the area.
Comedonal acne occurs when follicle pores are plugged with keratin, a protein that’s found in the skin, and sebum, an oily, waxy substance that’s naturally produced by the body’s sebaceous glands. Although serum moisturizes and protects the skin, when it’s mixed with skin debris, it can form a plug that causes a blemish.
There are several factors that contribute to the formation of comedonal acne. It’s common for preteens and young adults, especially during puberty.
However, it can occur in people of all ages. A shift in hormone levels can alter the activity of sebaceous glands, causing clogged pores.
Other causes of comedones include:
- pregnancy and menopause
- environmental/air pollution
- skin care products
- poor diet (including refined grains, carbohydrates and unhealthy fats)
- poor sleep habits
- friction and irritation to skin
- chronic stress
For people with comedonal acne, there are conventional treatments available both over-the-counter and through your dermatologist. Comedolytic topical medications are applied topically to the affected area one to two times per day.
Over-the-counter topicals include:
- Retinoids: These are vitamin A-containing compounds that are used to improve acne and speed up the turnover of superficial skin cells.
- Salicylic acid: Helps remove excess skin cells that trap serum and bacteria inside pores.
- Benzoyl peroxide: Kills bacteria inside pores, helping prevent pore clogging.
- Glycolic acid: Used to exfoliate dead skin cells on the outermost layer in order to avoid plugged pores.
- Azelaic acid: This is commonly used for acne because it has antimicrobial and anti-inflammatory properties.
Antibiotics are sometimes prescribed in order to fight bacteria that can get trapped inside pores.
There are also surgical procedures that are used to fight comedonal acne. Procedures open and remove comedones in severe cases.
Before turning to conventional treatments for comedones, there are natural remedies that you can bring into your skin care routine to fight bacteria, shed dead skin cells and reduce pore clogging. Here are some simple ways to treat comedones at home:
1. Use a Gentle Cleanser
It’s important to clean your skin twice daily, but avoid harsh cleansers and chemicals that can lead to even more breakouts. Opt for gentle and natural cleansers that are made with soothing ingredients like honey, coconut oil, olive oil, jojoba oil and tea tree oil.
You can also make your own face cleanser at home, like this homemade face wash with lavender, frankincense and lemon essential oils.
Stick to washing your face morning and night, unless you’ve been sweating or exposed to dirt and debris. Removing makeup before you go to sleep also helps fight plugged pores. Wash your face with warm water, and pat your skin dry to avoid irritation.
2. Exfoliate Your Skin
Exfoliating your skin one to two times per week helps get rid of dead skin cells and debris that may clog your pores. Exfoliating deeply cleanses the skin and allows new skin cells to emerge.
Use a gentle exfoliator, or make your own, like this DIY face scrub.
3. Moisturize Daily
Keeping your skin hydrated is important for regulating sebum levels. If your skin becomes too dry, your body will produce more oil, which can contribute to clogged pores and more comedones.
The best moisturizers to use for acne-prone skin are those that mimic sebum, like jojoba oil and other natural oils.
Simply smoothing a natural moisturizer over your clean face helps balance hydration levels and prevents the accumulation of dead skin cells.
4. Avoid Excess Sun Exposure
Although getting your 20 minutes of sun exposure daily is important for maintaining healthy vitamin D levels, too much time in the sun can cause solar comedones and other skin issues over time. Research shows that reducing environmental sun exposure is important for acne management.
If you spend multiple hours in the sun, apply a natural and safe sunscreen to protect your skin.
5. Spot Treat with Essential Oils
If you have a problematic area, which usually occurs on the forehead, nose and chin, try spot treating with antimicrobial and soothing essential oils for skin. Tea tree oil, frankincense and lavender are excellent choices for fighting bacterial growth and pore clogging.
Add two to three drops to a clean cotton ball, and gently apply it to affected areas once daily.
6. Avoid Trigger Foods
To improve comedonal acne, avoid triggering inflammatory foods. Sugary foods, refined carbohydrates and conventional dairy products may exacerbate acne.
There’s even evidence suggesting that glycemic load can greatly affect acne severity, so it’s important to stick to low glycemic foods.
Some of the best foods you can eat to fight acne and inflammation include:
- lean, organic meats
- healthy fats, like avocado, nuts and coconut oil
- zinc-rich foods, like pumpkin seeds and yogurt
- high-fiber foods
- vitamin A foods, including leafy greens
- anti-inflammatory foods, like berries, broccoli and bone broth
7. Take Probiotics
Research indicates that the health of your microbiome plays a role in acne severity. An unhealthy gut can cause inflammation and an imbalance of bacteria.
Researchers have been discussing the presence of a gut-brain-skin axis that connects gut microbes, oral probiotics and diet to acne severity.
Because your gut is likely involved in the pathogenic process of acne, taking a high-quality probiotic supplement is an excellent way to improve the healthy balance of gut bacteria and promote better gut integrity. This may improve the health of your skin and help fight comedonal acne.
Risks and Side Effects
If you’re dealing with a serious case of comedonal acne that isn’t improving after trying at-home remedies, consult your dermatologist about the best form of treatment.
If you experience skin irritation, such as redness, itchiness or stinging, after trying any of these treatments or remedies, discontinue use of any new product immediately.
- Comedones are acne bumps that typically develop on the chin, forehead or wherever acne occurs. They can be blackheads, whiteheads or flesh-colored.
- These bumps occur when pores are plugged with sebum, dead skin cells and debris.
- There are conventional and natural ways to improve comedonal acne, including topical creams, probiotic supplements, avoiding triggering foods and using gentle skin care products.
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