Blackheads and small white bumps seen on the skin surface are most often formations referred to as comedones. Comedones, which can develop as a result of pores becoming clogged with oil, dead skin cells, and other debris, are among the non‑inflammatory early lesions of acne. These lesions, which can be seen especially on the forehead, nose, chin, and cheeks, may appear in two different forms: open comedones and closed comedones. In comedo formation, oil production in the skin, accumulation of dead skin cells in the pores, hormonal changes, and certain environmental factors may play a role.
What Is a Comedo?
Comedo is a skin lesion that develops when the hair follicles and pores in the skin become clogged with oil (sebum), dead skin cells, and various residues. Comedones, which are among the non‑inflammatory early lesions of acne, can be seen in two different forms: open comedones and closed comedones.
What Is an Open Comedo?
An open comedo is a type of comedo in which the opening of the pore remains open. Commonly known as a blackhead, these formations gain a dark appearance when the oil and dead skin cells accumulated within the pore come into contact with air. The black color is not due to dirt, but to oxidation of the pore contents.
What Is a Closed Comedo?
A closed comedo is a type of comedo in which the opening of the pore is covered by the skin surface. Commonly referred to as a whitehead, these formations may appear on the skin as small, skin‑colored or white bumps.
Since the pore contents in closed comedones do not come into contact with the external environment, a black color does not form. They are particularly common on the forehead, cheeks, and chin. Closed comedones, which can cause a rough texture on the skin surface, may in some cases turn into inflammatory acne lesions.
What Causes Comedones?
Comedo formation can occur as a result of skin pores becoming clogged for various reasons. Increased production of oil (sebum) in the skin, inadequate removal of dead skin cells from the pores, and certain environmental or hormonal factors may predispose to the development of comedones. The main factors that may play a role in comedo formation are:
- Excess Sebum Production
Sebum is a natural oil that helps maintain the skin’s moisture balance. However, if the sebaceous glands are overactive, accumulation of oil in the pores may increase. The accumulated oil can combine with dead skin cells, leading to clogged pores and the formation of comedones.
- Dead Skin Cells
During the skin renewal process, dead skin cells that need to be shed may in some cases accumulate within the pores. This accumulation can narrow the pore opening and contribute to the development of comedones.
- Hormonal Changes
Hormonal changes are among the factors that can affect the activity of sebaceous glands. During puberty, the pregnancy period, or in certain conditions that can alter hormonal balance, an increase in sebum production may be observed. This situation can increase the risk of comedo formation.
- Cosmetic Products That Can Clog Pores
Some cosmetic and personal care products that are not suitable for the skin type may contribute to pore blockage. In particular, leaving heavy‑textured products on the skin surface for long periods is considered one of the factors that facilitate comedo formation.
- Genetic and Environmental Factors
It is thought that genetic predisposition may also be effective in the development of comedones. In addition, stress, air pollution, high humidity, and certain lifestyle‑related factors can affect the skin’s oil balance and lead to comedo formation.
- Certain Medications and Medical Conditions
The use of certain medications or some health conditions that can affect the hormonal system may alter oil production in the skin. These changes may be associated with the development of comedones in some individuals.
Why Do Closed Comedones Form?
Closed comedones form when the opening of the pore remains covered by the skin surface. Since the sebum, dead skin cells, and other residues accumulated within the pore cannot come into contact with the external environment, they may appear on the skin as small, white or skin‑colored bumps.
Increased oil production in the skin, inadequate removal of dead skin cells from the pores, hormonal changes, and certain cosmetic products that can clog pores may cause closed comedo formation. Closed comedones, which are frequently seen particularly on the forehead, cheeks, and chin, may in some cases gradually evolve into inflammatory acne lesions.
How Do Comedones Resolve?
Reduction or control of comedones may vary depending on their cause, the skin type, and the extent of the lesions. Therefore, the approach to comedones should be evaluated on an individual basis.
In the management of comedones, it is necessary to cleanse the skin regularly, identify factors that may clog pores, and maintain appropriate skin care habits. In some individuals, skin care practices alone may not be sufficient, and dermatological treatment methods may also be required.
Since open and closed comedones may have different characteristics, the approaches that can be used may also differ. Especially in comedones that are extensive, persistent, or accompanied by acne, evaluation by a dermatologist can help determine an appropriate treatment plan.
How Is Comedo Treatment Performed?
Comedo treatment can be planned according to the type and extent of the lesions, the individual’s skin type, and the presence of accompanying acne. The aim of treatment is to reduce blockage in the pores and control the formation of new comedones.
- Topical Treatment Approaches
In comedo treatment, certain topical products deemed appropriate by a dermatologist can be used. Applications containing salicylic acid (BHA), alpha hydroxy acids (AHA), and retinoids may help remove oil and dead skin cells accumulated in the pores. The type of products to be used and the method of application may vary from person to person.
- Treatments Containing Retinoids
Retinoids are vitamin A derivatives that can help regulate the skin cell renewal process. They are among the commonly used approaches in dermatology practice for the treatment of open and closed comedones.
- Dermatological Procedures
In some cases, dermatological procedures aimed at clearing comedones may be considered. These procedures are performed under appropriate conditions by healthcare professionals, and it is not recommended for individuals to squeeze or attempt to extract comedones on their own.
- Medication Treatments
In widespread or treatment‑resistant comedones, various medication therapies may be planned by a dermatologist. The choice of treatment is made by considering the extent of the comedones, accompanying acne lesions, and the individual’s overall health status.
Which Medications Are Used in Comedo Treatment?
Medications that may be used in comedo treatment can vary depending on the type and extent of the comedones, the individual’s skin type, and accompanying skin problems. Therefore, drug therapy is planned after an evaluation by a dermatologist.
During the treatment process, topical therapies that may help reduce blockage in the pores and regulate the skin renewal process can be used. In some cases, treatment options containing retinoid‑derived medications, salicylic acid applications, azelaic acid, or different active ingredients may be considered.
In situations where comedones are accompanied by inflammatory acne lesions, different treatment approaches may also come into play. Since the type, dose, and duration of medications to be used may vary from person to person, using drugs without medical advice is not appropriate.
How Long Does Comedo Treatment Take?
The duration of comedo treatment may vary depending on the extent and type of the comedones, the individual’s skin type, and the treatment method used. Therefore, there is no single treatment duration applicable to everyone.
When topical treatments are used, it usually takes several weeks to notice changes in the skin. In more extensive or long‑standing comedones, the treatment process may take longer and may require regular follow‑up.
During treatment, it is important to consistently follow the practices recommended by the dermatologist. Uninformed squeezing of comedones, irregular application of treatment, or practices that may irritate the skin can adversely affect the healing process.
How Can Comedo Formation Be Prevented?
Reducing factors that may cause the accumulation of oil, dead skin cells, and other debris in the pores can be effective in preventing comedo formation.
Regular cleansing of the skin, choosing products suitable for the skin type, and avoiding cosmetic products that can clog pores are among the factors that can influence comedo formation. However, squeezing comedones or choosing practices that may damage the skin surface is not recommended.
- Tea Tree Oil
Tea tree oil is one of the herbal ingredients commonly used in skin care. Although its possible effects on acne‑prone skin have been examined in some studies, its effectiveness in preventing comedo formation has not been scientifically proven definitively; its effect may vary from person to person.
Pure tea tree oil may cause irritation or sensitivity in the skin of some individuals. Therefore, it is recommended to consult a dermatologist regarding the use of products containing tea tree oil.
- Clay Masks and Similar Applications
Clay masks and various skin care procedures may help remove excess oil from the skin surface. However, since the effectiveness and suitability of these applications may differ according to the individual’s skin type, determining the frequency of use and product choice with the recommendation of a dermatologist is considered a safer approach. Incorrect or excessive use may damage the skin barrier.
- Lifestyle Habits
It is thought that sleep patterns, stress levels, environmental factors, and dietary habits may have an impact on skin health. However, since comedo formation does not develop due to a single cause, the effect of these factors may vary from person to person.
Frequently Asked Questions
Are comedones and acne the same thing?
Comedones are among the initial lesions of acne. However, not every comedo progresses to inflammatory acne.
Do closed comedones go away on their own?
Some closed comedones may regress over time. However, in long‑lasting or spreading cases, a dermatological evaluation may be necessary.
Should comedones be squeezed?
Uninformed squeezing of comedones is not recommended. This may lead to irritation, infection, or pigmentation marks on the skin.
On which areas are comedones most commonly seen?
Comedones are most commonly seen on the forehead, nose, chin, cheeks, back, and chest.
How long does comedo treatment take?
The duration of comedo treatment may vary depending on the extent and type of the comedones, the individual’s skin type, and the treatment method used. When appropriate products and treatment are applied regularly, visible improvement usually begins within 4 to 8 weeks. For completely smooth‑looking skin, a period of up to 3 months may be required.
How do comedones resolve?
In the management of comedones, skin care habits such as cleansers containing salicylic acid (BHA), regular exfoliation of dead skin, and choosing non‑comedogenic products can be supportive. However, since each individual’s skin type is different, which approach is appropriate should be evaluated by a dermatologist. In resistant or widespread comedones, it is strongly recommended that treatment be planned under specialist supervision.
