What Is Comedonal Acne And Ways To Treat It

Written by Ramona Sinha

Comedonal acne is a common type of acne. When you have comedones, your skin feels bumpy. These flesh-colored bumps progress into acne or pimples.

These are usually inflammatory and may cause pain. However, there are natural treatment options to reduce and treat comedonal acne. Keep reading to find out more about comedonal acne and how to treat them with medicines and home remedies.

What Is Comedonal Acne?

Comedonal acne is a type of acne that appears like comedones (flesh-colored small bump-like papules that mostly occur on the chin and forehead). They are pores or hair follicles plugged with oil, dirt, and dead skin cells. Blackheads and whiteheads are the most common types of comedonal acne. When the dirt and oil plugs are exposed to air, they oxidize and turn black, resulting in blackheads. When these plugs are set deeper into the pores and are white, you get whiteheads.

In the following section, we will look at the causes and risk factors of comedonal acne.

Comedonal Acne: Causes And Risk Factors

Comedonal acne is caused when the sebaceous ducts are blocked with dirt, debris, and sebum. While anyone can get comedonal acne at any point in time, certain factors increase the risk:

  • Dairy (such as yogurt, milk, and cheese) consumption may cause acne (1).
  • Diet with a high glycemic index/glycemic load may aggravate acne (2). Consuming foods that contain a lot of sugar and fat (such as baked goodies, junk food, and aerated drinks) may cause breakouts.
  • Some believe overhydration may also cause acne. Your skin may get overhydrated due to humid conditions or from excessive use of moisturizers.
  • Smoking may also cause acne and breakouts (3).
  • Using excessive makeup, oily skincare products, and hair pomades may cause acne.
  • Genetics may also be a factor behind comedonal acne. If it runs in your family, you are most likely to get it.
  • Squeezing the existing comedones and excess use of abrasive skin products (such as scrub and chemical peels) may also aggravate your condition and cause comedonal acne.

Apart from blackheads (open comedones) and whiteheads (closed comedones), there are several other types of comedones.

Types Of Comedonal Acne

1. Microcomedones

These are the smallest comedones. They are invisible to the naked eye. They are the first stage of every blackhead, inflamed acne, or pimple.

2. Macrocomedones

These can be both open and closed comedones, but they are larger.

3. Giant Comedones

Giant comedones are large blackheads, with a diameter measuring between a few millimeters to about 2 centimeters. Older adults usually get this type of comedones.

4. Solar Comedones

These are also called senile comedones and are caused by excessive sun exposure. These can be open or closed type comedones and can be large or small. These are common in older adults.

It is very easy to identify comedones once we know what they look like.

How To Identify Comedonal Acne

Here are a few tips to identify comedones:

  • They look like small fleshy bumps. The affected area feels uneven and bumpy.
  • Blackheads will have a tip that appears dark brown or black. You will commonly see them on your nose.
  • Whiteheads look like small whitish or flesh-colored dots on your skin.

If you have comedonal acne, there is nothing to worry about. There are plenty of treatment options to manage them. In the next section, we have discussed these in detail.

How To Treat Comedonal Acne

1. Topical Treatment

Topical treatments are readily available as OTC medicines. However, you need to know the right percentage of the ingredients that will work for your condition. Consult a doctor before trying out any topical treatment. These are available in the form of gels, creams, and face washes. The most common ingredients used for treating comedonal acne are:

  • Benzoyl Peroxide (4)
  • Azelaic Acid (5)
  • Salicylic acid (6)
  • Sulfur (7)
  • Tretinoin (or Retinoids) (8)

Stronger retinoids need to be prescribed by a doctor. This is because using the wrong percentage of retinoids on your skin may exacerbate your acne.

2. Oral Medications

Topical medicines are good for initial acne treatment. However, depending on your needs, the doctor may also prescribe you oral medications such as:

  • Antibiotics
  • Contraceptives or birth control pills (FDA has approved only three contraceptives for acne, so ensure you do not take them without a doctor’s prescription) (9)
  • Accutane or Isotretinoin (mainly used for severe acne) (9)
  • Spironolactone (mainly formulated for hypertension; but this medicine, in low doses, may help hormonal acne as it blocks androgen) (9)

3. Surgical Procedures

If both topical and oral medications fail to deliver results, you may opt for surgical procedures. Some of these procedures include:

  • Electrosurgery: This is used for treating severe comedonal acne. In this procedure, electricity is used to destroy the tissue by dehydration, coagulation, or vaporization. There are two types of electrosurgery – high-frequency electrosurgery and electrocautery.
  • Cryotherapy: In this procedure, the affected area is frozen for 20 seconds using liquid nitrogen or solid carbon dioxide. This eventually destroys the tissues in that area.
  • Microdermabrasion: In this process, a device with a crystal head is rubbed on your skin to remove the top layer of your skin. This helps remove the comedones. Microdermabrasion is often used for treating acne scars.

4. Home Remedies

You may also take care of comedones at home by trying a few home remedies using simple and effective ingredients:

1. Tea Tree Oil

Five percent topical tea tree oil was found to be effective in treating mild to moderate acne (10).

You Will Need
  • 2-3 drops of tea tree oil
  • 1 teaspoon of any carrier oil (you may use jojoba, olive, sweet almond oils)
  1. Mix the oils.
  2. Massage the mixture on the affected area.
  3. Leave it on for at least 20-30 minutes.
  4. Wash off.
How Often

2 times every day.

2. Witch Hazel

Witch hazel is commonly used for relieving inflammation and skin irritation(11). Though there is a lack of direct evidence, anecdotal evidence suggests that it has an astringent effect and can help minimize acne.

You Will Need
  • A tablespoon of witch hazel
  • Cotton pad
  1. Wash your face and pat it dry.
  2. Saturate the cotton pad with witch hazel.
  3. Apply it as a toner to your skin.
  4. Let it dry.
  5. Follow it up with a non-comedogenic moisturizer.
How Often

Once every day (do not overuse as it may dry your skin out).

3. Charcoal And Clay Mask

Activated charcoal is works as an absorbent (12). It can eliminate dirt and sebum from your skin. The clay (especially bentonite clay) can soothe the skin and heal skin lesions (13).

You Will Need
  • ½ teaspoon of activated charcoal powder
  • 2 tablespoons of bentonite clay
  • Water for mixing (you may use rosewater)
  1. Mix the charcoal powder and the clay.
  2. Add water or rosewater as per the desired consistency and mix well.
  3. Spread the mixture on the affected area.
  4. Let it dry.
  5. Wash off with warm water.
  6. Follow up with a non-comedogenic moisturizer.
How Often

Not more than 2 times a week.

4. Apple Cider Vinegar

Though there is no direct evidence, anecdotal evidence suggests that the vinegar may work well as a toner. It also may act as an astringent and minimize skin pores, thus helping relieve acne. However, never use ACV without diluting it.

You Will Need
  • ½ teaspoon of apple cider vinegar
  • 2 tablespoons of distilled water (to dilute the ACV)
  • Cotton pad
  1. Wash your face and pat it dry.
  2. Mix the ACV and distilled water.
  3. Saturate the cotton pad with the mixture and apply it to your face as a toner.
  4. Let it dry and then apply a non-comedogenic moisturizer.

In addition to these treatment options, modifying your lifestyle also helps. In the following section, we have discussed the measures you can take to prevent comedonal acne.

Ways To Prevent Comedonal Acne

1. Wash Your Face Twice A Day

Use a mild cleanser or a cleanser containing salicylic acid to wash your face two times a day.

2. Use Non-comedogenic Products

Whether it is makeup or skincare, ensure you use non-comedogenic products. This way, your skin pores won’t get clogged, and you can prevent comedonal acne.

3. Remove Makeup Before Going To Bed

Removing makeup before hitting the bed allows your skin to breathe and heal itself while you sleep.

4. Keep Your Skin Accessories Clean

Clean your makeup applicators, brushes, and beauty blenders thoroughly after every use. Dirty accessories may accumulate germs and cause acne.

5. Follow A Healthy Diet

Reduce the intake of fried or processed foods, baked goodies, and sugary drinks. If possible, try to limit your milk intake. Instead, consume a lot of fresh produce and lean protein.

Following a daily skincare routine and a healthy lifestyle can help keep your skin clear to an extent. However, you may face breakouts from time to time, and you need to treat them properly. The methods outlined in this article can help. In case you have severe acne, it always is better to consult a doctor.

Frequently Asked Questions

Does Accutane help treat comedonal acne?

Yes, it works for severe acne. Accutane is a form of vitamin A that reduces the amount of oil released by the skin’s oil glands. However, you shouldn’t take it without consulting your doctor.

Do closed comedones heal?

They can heal with proper treatment. However, if left untreated, they may turn into a serious issue.

Is comedonal acne hormonal?

Comedonal acne is mainly caused during the pre-teen years and is regulated by hormones. However, one may even experience them at a later point of their lives. Apart from hormonal changes, another major cause of this type of acne is poor skin hygiene. Certain products (shampoos, makeup, hair pomades) may also lead to comedonal acne as these contain chemicals and oils that may block the pores.


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Ramona is a journalist-turned-content writer. She holds a Master’s degree in English Literature and has been writing for the digital world for over five years. She specializes in writing for Skin Care. She has done a certificate course titled ‘Dermatology: Trip To The Skin’, offered by Novosibirsk State University. She believes that beauty begins with a good skin care regimen and is on a mission to eliminate all toxins from her routine. She helps and guides readers in selecting products and ingredients specific to their skin type/issue. When Ramona is not working, her books and passion for music, good food, and traveling keep her busy.