What Is a Comedo? Understanding Blackheads and Whiteheads

Medically reviewed by William Truswell, MD

A comedo is a type of acne caused by pores that have become clogged with excess bacteria, oil, and dead skin cells. These blocked pores cause a small bump to form on the skin. These small bumps can be flesh-colored, white, or dark. The color depends on whether the comedo is closed or open.

A comedo can appear flesh-colored or white when the pore is closed. A closed pore, or closed comedo, is called a whitehead. If the pore is open, the comedo appears dark. An open comedo is called a blackhead. If you have more than one comdeo, they are referred to as comedones.

While you might not like the look of comedones, they are not harmful. Affecting both teens and adults, comedones are a non-inflammatory type of acne and are more easily treated than inflammatory types like pustules (pus-filled pimples) or papules (small, hard, red bumps).

Comedo Symptoms

The symptoms of comedones differ depending on whether the pores are closed (whiteheads) or open (blackheads).

Whiteheads appear as a small, raised, white or flesh-colored bump at a closed pore. They may feel a bit bumpy.

Blackheads appear as a visible dark spot at the opening of a pore.

Comedones—whether they are whiteheads or blackheads—are commonly found on the face, chest, and back. Both types of comedones may also appear on the upper arms.

Regardless of whether they are open or closed, comedones can give skin a rough, textured appearance.

What Causes a Comedo?

A comedo can develop when a pore becomes clogged by an excess of bacteria, oil, and dead skin cells.

Whether you develop a whitehead or blackhead depends on if the skin's surface is involved. If the surface stays closed, then a whitehead can form. If the skin surface is disrupted, the comdeo is considered open, and a a blackhead can form.

Blackheads form when buildup from excess oils and dead skin cells cause a sebum (oil) plug at the opening of a pore. This plug pushes through the opening of the pore, causing it to widen and expose the buildup to outside air. When the buildup of oils and dead skin cells reacts with air, a chemical reaction occurs that makes the spot turn a dark color.

Risk Factors

Some people might be likelier to develop comedones than others. Contributing causes of whiteheads and blackheads include:

• Family history of acne: If one or both of your parents or another blood relative had acne, then you are at higher risk of getting acne.

• Hormones: During puberty, male sex hormones called androgens increase the size of your skin's oil glands. This causes the glands to produce more oil, which can clog your pores.

• Smoking: Research has found that people who smoke are more likely than those who do not smoke to have acne.

Comedones vs. Other Types of Acne

Comedones are a mild type of non-inflammatory acne. Unlike moderate- to-severe types of acne, comedones do not appear red or inflamed. They are also painless, unlike deep, painful types of acne called nodules or cysts.

Additionally, comedones do not have any pus in the center, which distinguishes it from an inflammatory type of acne called pustules. Another type of inflammatory acne are papules, which appear as red, swollen, hard bumps on the skin.

If you have a lot of inflammatory acne, it may be helpful to visit a dermatologist (a doctor who specializes in treating conditions affecting the skin, hair, and nails) for treatment. Inflammatory acne may require a topical (applied to skin) prescription or treatment with antibiotic therapy. In comparison, most types of comedones can be treated with over-the-counter remedies.

How to Get Rid of a Comedo

Even though comedones are a more mild form of acne, they can still affect your overall sense of well-being. For instance, comedones and other types of visible acne can lead to depression, anxiety, and poor self-worth if not treated effectively or in a timely manner. Fortunately, closed and open comedones can be treated using a variety of safe and effective methods.

Closed comedones (whiteheads) can be treated with a benzoyl peroxide wash or lotion to eliminate acne-causing bacteria. You can also consider trying an over-the-counter or prescription retinoids (skincare products derived from vitamin A), such as tretinoin, to unclog pores, speed up skin cell turnover, and reduce skin oiliness.

Open comedones (blackheads) can also be treated with over-the-counter or prescription retinoids. You can apply salicylic acid creams to unplug blocked pores and reduce swelling and redness, too.

If at-home treatment methods aren't enough to eradicate comedones in six to eight weeks, schedule an appointment with a healthcare provider like a dermatologist, who can assess your symptoms and recommend the appropriate treatment plan for your skin.

For instance, a dermatologist might perform an in-office extractions to get rid of your blackheads. The manual procedure removes open comedones with the use of a large-bore needle or a surgical blade.

Precautions

When managing comedones, there are some helpful dos and don'ts you'll want to consider implementing into your routine:

• Don't touch or pop comedones: Keep your hands away from your face. Touching, squeezing or picking your comedones can delay healing, cause an infection, or result in a permanent scar.

• Don't wear tight hats or headbands: Wearing accessories that are too tight around your forehead can irritate the skin and trap sweat and oil, providing the perfect breeding ground for acne. Ensure your hats or headbands fit your head properly and allow for a bit of breathing room.

• Do get enough sleep: Lack of sleep may make existing acne worse. Teenagers should get eight to 10 hours of sleep each night, and adults should get at least seven hours of sleep each night.

• Do use non-pore clogging skincare products: Look for skincare products that are labeled as "noncomedogenic" (non-pore clogging) and formulated with water-based ingredients (instead of oil-based). These types of products are less likely to clog pores.

How to Prevent a Comedo

To prevent comedones from developing, there are certain self-care practices you can take to reduce the accumulation of oil, bacteria, and dead skin cells. Try the following tips:

• Remove all dirt and makeup from your skin by gently cleansing yourself with a mild soap or acne-fighting cleanser made with salicylic acid or benzoyl peroxide. Avoid products containing rubbing alcohol or products that are overly drying to the skin.

• Avoid oil-based cosmetics.

• Wash your face (and other acne-prone areas of your body) once or twice a day.

• Keep your hair out of your face.

• If you have oily hair, shampoo it daily.

To prevent comedones from returning, make these practices a regular part of your daily routine.

A Quick Review

Comedones are a common, mild form of acne. Both closed comedones (whiteheads) and open comedones (blackheads) are formed by clogged pores that contain a buildup of excess bacteria, oil, and dead skin cells.

Closed comedones are small, dome-shaped, white or skin-colored bumps that can be managed with topical treatments such as retinoids and benzoyl peroxide. Open comedones are tiny, dark-colored bumps that can be treated and prevented with retinoids, salicylic acid, or in-office extractions.

There are a number of strategies you can implement to prevent and manage comedones, including keeping your hands off your face, getting enough sleep, and avoiding the use of oily or greasy cosmetics.

If over-the-counter treatments are not effective and comedones remain beyond six to eight weeks, consider making an appointment with a healthcare provider to discuss other treatment options.

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