Dealing with those tiny, skin-colored bumps that just won’t go away? You can’t even pop them, and they leave scars? You’re not alone! I’ve encountered these too—they’re known as closed comedones or whiteheads. Unlike typical acne, they aren’t red or swollen. They can be a bit stubborn at times, pushing your patience to the limit! But hang in there: they’re manageable with a little persistence.

In this post, I’ll break down everything you need to know about closed comedones, how to identify them, OTC treatments, and some common mistakes that might be making your battle against them harder.

What Are Closed Comedones?

Closed comedones are essentially clogged pores that result in small, flesh-colored bumps trapped under the skin. Unlike inflamed acne (like pustules or cysts), they don’t cause redness or swelling unless they become irritated, and if bacteria interact with them, they can transform into pustules. They aren’t painful or itchy and can occur at any age.

Why are they called “closed”? The pore is blocked at the surface, trapping dead skin cells, dirt, and sebum (the skin’s natural oil) inside, which leads to a tiny bump that doesn’t open up to the air.

If they have an opening and interact with oxygen, they darken and are known as open comedones or blackheads.

Closed comedones are often found on the forehead, cheeks, chin, and even the jawline. As someone who has struggled with these pesky bumps, I can tell you how frustrating they can be. It often feels like no matter what you do, they just refuse to go away.

What Causes Closed Comedones?

As you already know, closed comedones are caused by dirt, excess sebum, and dead skin buildup blocking the hair follicle and skin’s natural oil-producing glands. Here are a few more reasons that can lead to the formation of closed comedones:

• Damaged Skin: When your skin barrier is damaged from over-exfoliation, sun exposure, rubbing, or using certain products, you’re more likely to develop closed comedones.
• Skincare Products: Introducing new products with active ingredients such as retinol or tretinoin, or ingredients that speed up the cell turnover process, can contribute to the formation of closed comedones. This is also known as purging comedones.
• Hormonal Fluctuations: Hormonal changes, especially during puberty, menstrual cycles, or pregnancy, can increase sebum production and trigger closed comedones.
• Over-moisturizing: Using heavy moisturizers, oils, or using excess moisturizing ingredients can clog pores and cause closed comedones.
• Stress: Believe it or not, stress can also play a role. When you’re stressed, your body releases hormones that can lead to increased oil production.
• Diet: Consuming too much dairy or sugar can also trigger closed comedones in some people.

I personally developed closed comedones from excessive face massaging with too much pressure and overusing oils. This was due to a medical condition I was dealing with—Bell’s palsy. It was a tough time, and the combination of heavy oils and constant massaging, while trying to aid my recovery, ended up clogging my pores. I’ll share the full story in another blog.

How to Identify Closed Comedones

Closed comedones are often confused with milia (tiny white cysts), fungal acne, or sebaceous filaments. Here’s how you can identify closed comedones:

• Appearance: Closed comedones appear as small, skin-colored, or white bumps under the skin. They aren’t red or inflamed like pimples, nor are they dark like blackheads.
• Texture: If you run your fingers over areas like your forehead, chin, or cheeks and notice a bumpy texture, you’re likely dealing with closed comedones. They aren’t painful or itchy, and they don’t pop like regular pimples because they’re sealed under the skin. Trying to extract them can actually make them worse.

Closed Comedones vs. Milia vs. Sebaceous Filaments vs. Fungal Acne

How to Differentiate Closed Comedones from Other Types of Acne

• Closed Comedones vs. Pustules: Pustules are inflamed pimples filled with pus. While closed comedones are non-inflamed, pustules are red, tender, and often painful.
• Closed Comedones vs. Papules: Papules are small, red, and inflamed bumps, whereas closed comedones are not inflamed or discolored.

Treatments for Closed Comedones: OTC and Medical Options

1. Over-the-Counter (OTC) Treatments

OTC treatments are often effective for managing mild to moderate cases of closed comedones. Here are the most common and accessible options:

• Salicylic Acid (BHA)

  • How It Works: Salicylic acid is a beta hydroxy acid that penetrates deep into the pores to exfoliate from within, dissolving oil and dead skin cells that clog pores.
  • Usage: Use salicylic acid cleansers, toners, or serums to treat closed comedones.
  • Best For: Oily and combination skin types, as it helps control excess oil and prevent further breakouts.

• Benzoyl Peroxide

  • How It Works: Benzoyl peroxide is a powerful antibacterial agent that reduces the bacteria associated with acne. (Although closed comedones are non-inflammatory, it can prevent them from developing into pimples.)
  • Usage: Available in spot treatments or cleansers with varying strengths (2.5% to 10%).
  • Best For: Acne-prone skin, especially when there’s a mix of inflammatory acne and closed comedones.

• Retinoids (Adapalene – Differin Gel)

  • How It Works: Retinoids accelerate skin cell turnover, helping to push out clogged material from the pores and preventing new comedones from forming.
  • Usage: Start slowly (2-3 times per week) to allow the skin to adjust and prevent irritation.
  • Best For: All skin types, but particularly effective for those with persistent comedonal acne.

• Glycolic Acid (AHA)

  • How It Works: Glycolic acid, an alpha hydroxy acid, exfoliates the surface of the skin, promoting the shedding of dead skin cells and keeping pores clear.
  • Usage: Found in cleansers, toners, masks, and serums.
  • Best For: Dry to normal skin types, as glycolic acid also has hydrating properties.

• Azelaic Acid

  • How It Works: Azelaic acid is a gentle exfoliant with anti-inflammatory properties, making it a good option for people with sensitive skin or rosacea alongside comedones.
  • Usage: Can be used in combination with other treatments like retinoids or benzoyl peroxide.
  • Best For: Sensitive and redness-prone skin types.

• Niacinamide

  • How It Works: Niacinamide (Vitamin B3) is not a direct treatment for closed comedones, but it helps regulate oil production and reduces inflammation and redness that can sometimes accompany other acne types.
  • Usage: Often found in serums and moisturizers.
  • Best For: All skin types, especially those looking for anti-inflammatory benefits.

2. Medical Treatments

For more severe cases or when OTC treatments aren’t enough, medical interventions might be necessary. These treatments should always be guided by a dermatologist.

• Prescription Retinoids (Tretinoin, Tazarotene)

  • How It Works: These are stronger versions of OTC retinoids and are more effective at treating stubborn closed comedones by increasing cell turnover at a faster rate.
  • Usage: Applied topically, they can cause initial irritation (redness, peeling) but are highly effective in long-term management.
  • Best For: Severe or persistent comedonal acne that hasn’t responded to OTC retinoids.

• Oral Retinoids (Isotretinoin)

  • How It Works: Isotretinoin (Accutane) is a powerful oral medication that reduces oil production and shrinks sebaceous glands, making it highly effective for severe acne, including closed comedones.
  • Usage: A course of isotretinoin lasts around 4-6 months, with strict monitoring for side effects.
  • Best For: Severe acne cases with a mix of comedones, cysts, and pustules.

• Chemical Peels (Salicylic, Glycolic, or Jessner Peels)

  • How It Works: These peels exfoliate the outer layer of skin and help unclog pores. A dermatologist may recommend a series of peels to improve the appearance of closed comedones.
  • Usage: Professional treatments should be spaced a few weeks apart for best results.
  • Best For: All skin types, depending on the type of peel used.

Mistakes That Could Be Making Your Closed Comedones Worse

• Over-exfoliating: It’s tempting to scrub away those bumps, but over-exfoliating can actually damage your skin barrier, making comedones worse. Stick to gentle exfoliation, 2-3 times a week.
• Popping or Picking: Trying to extract closed comedones at home can lead to inflammation, infection, and scarring.
• Using Heavy, Comedogenic Products: Avoid oils or creams that are heavy and comedogenic (pore-clogging), as they can worsen the situation. Opt for lightweight, non-comedogenic options.
• Skipping Moisturizer: Even oily or acne-prone skin needs moisture. Dehydration can cause your skin to produce more oil, potentially worsening comedones.
  
  In the next post, I’ll dive into the best ways to treat and prevent closed comedones, from gentle exfoliants to ingredients you should avoid. Stay tuned for tips on how to keep your skin smooth and clear!