Treating Comedonal Acne

How to Treat Blackheads, Whiteheads, and Non-Inflamed Blemishes

A close-up of blackheads.
Blackheads. Photo (c) A.D.A.M.

Even though they aren't red and inflamed like your typical pimple, blackheads, and whiteheads (also known as milia) can be just as annoying. 

But comedonal acne, which is what we call the type of acne that is made up of mainly non-inflamed blemishes, can be cleared up.  You just have to know the best way to treat it, and you have several different options.

For Mild Cases try an OTC Treatment

If you have just minor blackheads and bumpiness, try an over-the-counter acne treatment first.

  The key here is to get one with an effective active ingredient.  Read the ingredients listing on the back and look for benzoyl peroxide, salicylic acid or glycolic acid.

These ingredients can be found in cleansers, toners and pads, and leave-on lotions.  It doesn't really matter what type of product you choose, just get one that you'll use regularly.  And then use it regularly.  Consistency is so important, especially when trying to improve comedonal breakouts.

Just remember that blackheads and whiteheads aren't caused by a lack of good skin care.  So scrubbing your face or washing more often isn't going to improve blemishes. 

Do, though, take a quick look at what types of moisturizers, lotions, hair products, and cosmetics you're using.  If they are heavy, oily, or thick, they may be contributing to your breakouts.  Try switching to oil-free, noncomedogenic products and see if you get any improvement.

Prescription Medications are Needed for Stubborn or Severe Cases

If OTC products just aren't cutting it, or if your breakouts are more severe, you'll want a prescription medication.  Not only are the ingredients above available in prescription-strength, but there are a few other options too.

Topical retinoids are considered very effective at treating comedonal acne.

  They also have the added benefit of smoothing and softening the skin, and are great anti-agers. 

Azelaic acid isn't prescribed as often as topical retinoids, but it's still a good option for treating non-inflamed blemishes.

Isotretinoin, because it slows down oil production, can also improve comedonal acne.  This medication is only prescribed in very severe cases, and when no others have worked.

In-office Procedures can Make a Huge Improvement Quickly

If you're looking for an immediate improvement in the look of your skin, you may want to head to your local salon or skin spa. Treatments like microdermabrasion and comedonal extractions won't stop breakouts from forming, but they can help you feel better about your appearance while waiting for your treatments to really start working.

Estheticians can safely remove blackheads, and in some cases milia, at the salon.  If your breakouts are very severe, though, it's best to have these procedures done at your dermatologist's office.

Whichever treatment you choose, remember those bumps and blackheads are stubborn!

  You really have to make a point to be very consistent and patient.  It can take several months to really get those breakouts under control.  

Sources:

Del Rosso JQ, Kircik LH.  "The Sequence of Inflammation, Relevant Biomarkers, and the Pathogenesis of Acne Vulgaris: What Does Recent Research Show and What Does It Mean to the Clinician?"  Journal of Drugs in Dermatology 12.8 (2013): S109-15.

Feldman S, Careccia RE, Barham KL, Hancox J. "Diagnosis and Treatment of Acne." American Family Physician 69.9 (2004): 2123-2130.

United States. NIAMS. "Questions and Answers About Acne." Bethesda, MD: National Institutes of Health, 2006.

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