Skin Health Acne Causes and Treatment of Closed Comedones By Angela Palmer facebook Angela Palmer is a licensed esthetician specializing in acne treatment. Learn about our editorial process Angela Palmer Medically reviewed by Medically reviewed by Casey Gallagher, MD on November 07, 2019 Casey Gallagher, MD, is board-certified in dermatology. He is a clinical professor at the University of Colorado in Denver, and co-founder and practicing dermatologist at the Boulder Valley Center for Dermatology in Colorado. His research has been published in the New England Journal of Medicine. Learn about our Medical Review Board Casey Gallagher, MD Updated on January 09, 2020 Print Table of Contents View All Symptoms Causes Treatment 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. This photo contains content that some people may find graphic or disturbing. See Photo Closed comedones on forehead. DermNet / CC BY-NC-ND Symptoms 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. Other Types of Comedones Causes 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 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. Overview of Comedonal Acne Treatment 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 (OTC) acne treatment product. Over-the-Counter Treatments OTC salicylic acid or glycolic acid, ingredients that speed up the natural ability of skin cells to slough off, help keep 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. Prescription Medications 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 women, birth control pills (when used along with topical treatments) can also help keep those closed comedones in check. Extractions 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. How Comedonal Acne Is Treated Was this page helpful? Thanks for your feedback! Dealing with acne can be frustrating. Our free guide provides expert tips to help you take control. Sign up and get yours today. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Berk DR, Bayliss SJ. Milia: a review and classification. J Am Acad Dermatol. 2008;59(6):1050-63. doi:10.1016/j.jaad.2008.07.034 Tanghetti EA. The role of inflammation in the pathology of acne. J Clin Aesthet Dermatol. 2013;6(9):27–35. Ayer J, Burrows N. Acne: more than skin deep. Postgrad Med J. 2006;82(970):500–506. doi:10.1136/pgmj.2006.045377 Leyden J, Stein-Gold L, Weiss J. Why Topical Retinoids Are Mainstay of Therapy for Acne. Dermatol Ther (Heidelb). 2017;7(3):293–304. doi:10.1007/s13555-017-0185-2 Słopień R, Milewska E, Rynio P, Męczekalski B. Use of oral contraceptives for management of acne vulgaris and hirsutism in women of reproductive and late reproductive age. Prz Menopauzalny. 2018;17(1):1–4. doi:10.5114/pm.2018.74895 Steventon K. Expert opinion and review article: The timing of comedone extraction in the treatment of premenstrual acne--a proposed therapeutic approach. Int J Cosmet Sci. 2011;33(2):99-104. doi:10.1111/j.1468-2494.2010.00610.x Additional Reading Bowe W, Kober M. Therapeutic update: acne. J Drugs Dermatol. 2014;13(3):235-8. Titus S, Hodge J. Diagnosis and Treatment of Acne. Am Fam Physician. 2012;86(8):734-40.