What Are Closed Comedones?

Closed Comedones - Acne Breakouts
Closed comedones give the skin a rough and bumpy look. Photo (c) A.D.A.M.

Is your skin rough and bumpy?  Most of us call those pesky little bumps blocked pores or clogged pores.  You might be surprised to learn that these bumps are actually types of acne blemishes called closed comedones

What are Closed Comedones?

Closed comedones look like little bumps across the skin's surface. They're not red and inflamed like your typical pimple, and they don't hurt.

A closed comedo (singular of comedones) develops when a plug of skin cells and oil becomes trapped within the hair follicle.

  The plug fills the follicle, swelling it out and creating that bump that you see on your skin. 

Closed comedones can happen anywhere on the skin, but they most often pop up on the face, neck, chest, and back.

Unlike with open comedones (better known as blackheads), in closed comedones the pore openings are obstructed. The oil plug is not exposed to air, so it doesn't take on a brown/black color.

In fact, some closed comedones develop a very obvious white head.  These types of closed comedones are called milia.

If bacteria invade or the follicle wall ruptures, closed comedones can develop into inflamed pimples. 

What Causes Closed Comedones?

Some people are more prone to developing comedones, or pore blockages, than others. Everyone gets closed comedones every now and then. But if you have a lot of them, and they're fairly constant, you probably have a type of acne called comedonal acne.

Closed comedones are really common during the tween and teen years, as the skin's sebaceous glands (also known as your oil glands) ramp up production.

  With all that excess oil, comedones are more likely to form.

But teens aren't the only people who get these blemishes.  They're also common in adults with oily skin.  Some studies suggest that smokers are more likely to develop closed comedones, too. 

Not only that, but certain products that you put on your skin might be contributing to these blemishes.

  Heavy creams and lotions are often the culprits.  Makeup, especially oil-based products, can also do it. 

If your breakouts are concentrated mostly around the hairline, you might want to take a closer look at your hair products.  They might be triggering your blemishes. 

With the Right Treatment, You Can Get Rid of Closed Comedones

Closed comedones can be super aggravating, but you can treat them.

For treating mild bumpiness and minor breakouts, you can first try an over-the-counter acne treatment product.  OTC salicylic acid or glycolic acid helps keep those pores from getting clogged in the first place.

Over-the-counter products take some time to work, so try them for at least eight weeks before expecting to see improvement.

If you have more than just a few closed comedones, or if you've been battling these bumps for a long time, you'll want to see a dermatologist for a prescription medication.

Topical retinoids are a great option and most likely what your dermatologist will have you try first.

  These medications (like Retin-A and Retin-A Micro, Differin and Tazorac) help clear out existing pore blockages, keeps new ones from forming. They have the added benefit of smoothing and softening the skin.

Other treatments that your dermatologist might suggest are azelaic acid or benzoyl peroxide.  For the ladies, birth control pills (when used along with topical treatments) can also help keep those closed comedones in check.

Blemish extractions can also be extremely helpful.  This is where a dermatologist or esthetician manually removes the plug causing the blemish. 

Extractions don't keep closed comedones from forming, though, so you'll still need a preventative treatment.  But they can help jump start your treatment, and make the skin look better more quickly while you're waiting for your comedonal acne treatments to work.

Sources:

Bowe W, Kober M.  "Therapeutic update: acne."  J Drugs Dermatol.  2014 Mar; 13(3):235-238.

Titus S, Hodge J.  "Diagnosis and Treatment of Acne."  Am Fam Physician. 2012 Oct 15; 86(8):734-740.

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