What Is Comedonal Acne and How Can It Be Treated?

Blackheads and Bumpy Skin are Signs of Comedonal Acne

Comedonal acne is a common, but sometimes misunderstood, type of acne. Rather than inflamed pimples and pustules, comedonal acne causes bumpy skin, blackheads, and non-inflamed blemishes.

What Is Comedonal Acne?

Comedonal acne doesn't look like what we think of when we think "acne". You'll have few, if any, inflammatory breakouts.

Instead, your skin will look and feel bumpy. These bumps won't be red like your typical pimple. They'll be skin colored. And you'll probably have some blackheads, too.

These bumps and blackheads are a types non-inflamed acne blemishes called comedones.

Comedo (the singular of comedones) is a fancy name for a plug of oil and dead skin cells within the hair follicle or pore. It's similar to the commonly known pimple, only a comedo isn't red and swollen. You may know comedones by the more common term pore blockage.

All inflamed pimples start off as a comedo. So you can think of them as pre-pimples. Comedones don't always progress to inflamed pimples, though, and can stay as an non-inflamed blocked pore just under the skin's surface.

As more oil fills the pore, it pushes up on the skin's surface, creating a bump that you can feel and sometimes see. Comedones aren't painful, just annoying.

Comedonal acne can range from mild (with just a few occasional blemishes) to more severe with blemishes happening over larger areas of the face. It can develop on your face, back, neck, and chest. Most commonly, though, comedonal breakouts happen on the forehead and chin or jawline areas.

Different Types of Comedonal Blemishes

Comedones may be opened or closed and each type determines whether you develop a blackhead or just skin-colored bumps.

An open comedone is what we commonly call a blackhead. It occurs when the plug of oil becomes trapped within the hair follicle near the pore opening. The top of the plug is at the surface of the skin and is exposed to air. The air oxidizes the oil and darkens it, similar to what happens when an apple is cut and left exposed to air. The top of the plug takes on the dark brown color typical of blackheads. If you were to gently extract the blackhead, you can see the dark top portion of the plug is dark while the lower portion that was not exposed to air is creamy white to yellow.

Closed comedones happen when the pore opening is obstructed and the plug of oil and skin cells is not exposed to air. The plug doesn't turn black, instead we mostly just notice a bump on the skin. The bump isn't red, nor inflamed, and it doesn't hurt. It just looks and feels bumpy.

Comedonal Acne Causes

Like most types of acne, comedonal acne is especially common during the preteen and teen years. However, it can occur to anyone at any nearly age, adulthood included. Comedonal acne can be a harbinger of inflammatory acne vulgaris to come, but it doesn't always progress to inflammatory acne.

Comedonal acne tends to run in families. If your parents or siblings had it, you're more likely to have it too. People with oily skin are more prone to comedonal acne as well. 

Sometimes, comedonal acne is caused or exacerbated by things you are putting on your face or hair. Items such as oily skin care products and hair pomades or grease can cause or accentuate this type of acne. Oftentimes, though, it's caused by hormonal factors like puberty.

Comedonal Acne Treatments

Just like other types of acne, comedonal breakouts aren't caused by a lack of hygiene. Scrubbing your skin or washing your face more often isn't going to be enough to clear up your skin. 

While your daily skin care routine alone probably isn't going to clear your skin, there are plenty of treatments that will. If your acne is mild, you may be able to treat it with over-the-counter treatments. For more severe and persistent acne, it's a good idea to see your doctor to discuss treatment options.

There are many effective comedonal acne treatments, both OTC and prescription. Common OTC acne treatment products like benzoyl peroxide or salicylic acid are good for mild acne. Topical retinoids are the go-to prescription medications for comedonal acne.

With any treatment, it can take up to 12 weeks to see an improvement. Stick with it, even if you don't notice any immediate signs that it's working.

Talk to a dermatologist if you're not seeing good results after 3 to 4 months of treatment.

A Word From Verywell

While comedonal acne may not be as apparent or bothersome as other types of acne, you may still be concerned about it. That's completely understandable and why it's best to try and get it under control while it's still a mild case.

If left untreated, it can develop into a more severe breakout and become more difficult to manage. It will take time to notice the benefits of new treatments, so be patient and talk to your doctor if you have any concerns or questions.

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