Closed comedones: what is this, causes, symptoms, diagnostics, treatment, prevention

Whiteheads; Closed comedones; Pimples

Closed comedones, also known as whiteheads, are a common skin disease, which many people suffer from. These are small white or flesh-colored bumps., that appear on the skin, usually on the face, neck, chest and back. Although they are not painful or dangerous, for some people, they can be unsightly and embarrassing..

What are closed comedones?

Closed comedones are a type of acne, which is formed, when dead skin cells, fat and bacteria clog hair follicles. They are called closed comedones., because the bump remains covered with skin, preventing the leakage of the contents of the follicle. As a result, the bump looks like a small, white or flesh-coloured, pimple-like lesion. Unlike acne, which are open comedones, closed comedones do not contain dark pigmentation and are not visible to the naked eye.

Causes of closed comedones

The main cause of closed comedones is the intensive production of sebum from the sebaceous glands.. Sebum helps moisturize the skin, but when it is produced in excess, it can clog hair follicles and lead to the formation of closed comedones. Other factors, which can contribute to the formation of closed comedones, relate:

• Hormonal changes. Hormonal changes, eg, occurring during puberty, pregnancy or menopause, can lead to, that the sebaceous glands will produce more sebum, which will lead to the formation of closed comedones.
• Genetics. Some people may be genetically predisposed to developing closed comedones..
• Bacteria. Propionibacterium acnes, type of bacteria, which occur naturally on the skin, may contribute to the formation of closed comedones, causing inflammation and infection in clogged hair follicles.
• Some medications. Some medications, such as androgens and lithium, can increase sebum production and promote the formation of closed comedones.

Symptoms of closed comedones

The main symptom of closed comedones is the appearance on the skin of small tubercles of white or flesh color.. These bumps may be raised or flat and are usually not painful or itchy.. In some cases, they may be accompanied by redness and inflammation..

When to contact a healthcare professional

In most cases, closed comedones do not cause concern and are treatable at home.. But, if you have concerns about your skin or if closed comedones are accompanied by pain, swelling or redness, you should see a doctor. Besides, if you are using over-the-counter acne remedies and do not see improvements, perhaps, it's time to see a dermatologist for a professional assessment and treatment plan.

Questions, that your doctor may ask

When you see a healthcare professional about closed comedones, it, probably, ask you a series of questions, to help determine the underlying cause of your symptoms. Some of the questions, that your doctor may ask, include:

• When Did You First Notice Closed Comedones?
• Have you previously used over-the-counter acne remedies?
• You have noticed any changes in your skin recently?
• Are you taking any medications or hormones?, which can contribute to closed comedones?
• Do you have a history of acne or skin conditions??

Diagnosis of closed comedones

In most cases, the diagnosis of closed comedones is simple and can be made based on the appearance of the tubercles.. However, in some cases, a dermatologist may perform a biopsy., to confirm the diagnosis and exclude other skin diseases, who may have similar symptoms. During a biopsy, a small sample of skin is taken and analyzed under a microscope..

Treatment of closed comedones

Treatment of closed comedones depends on the severity of the condition and the underlying cause. In most cases, over-the-counter acne remedies, such as salicylic acid and benzoyl peroxide, can be effective in reducing the number of closed comedones. In more severe cases, a dermatologist may prescribe topical or oral medications., such as retinoids, antibiotics or hormonal drugs, to control symptoms.

Home treatment of closed comedones

There are several home remedies, which can help reduce the appearance of closed comedones, including:

• Keep skin clean: wash your face twice daily with a mild, non-comedogenic cleanser. Avoid using hot water, as this can deprive the skin of its natural defenses and aggravate symptoms.
• Use non-comedogenic moisturizers: choose oil-free and non-comedogenic moisturizers, which help keep the skin moisturized, without clogging pores.
• Avoid touching your face: touching the face can lead to the spread of bacteria and sebum, which will exacerbate the symptoms of closed comedones.
• Exfoliate your skin regularly: gently exfoliate the skin once or twice a week, to remove dead skin cells and prevent the formation of closed comedones.
• Avoid heavy makeup: choose a light non-comedogenic makeup, to reduce the risk of clogged pores and closed comedones.

Prevention of closed comedones

Although it is not always possible to prevent closed comedones, there are several steps, you can take, to reduce the risk of developing this condition:

• Follow a healthy diet. Dieting, rich in fruits, vegetables and whole grains, low in processed foods, can help maintain healthy skin and reduce the risk of closed comedone formation.
• Avoid using aggressive skin care products: choose soft, non-comedogenic skin care products and avoid using products, containing alcohol or other aggressive ingredients.
• Keep skin hydrated: drink plenty of water and use a mild non-comedogenic moisturizer, to keep the skin moisturized and reduce the risk of closed comedones.
• Limit sun exposure: Excessive sun exposure can damage the skin and increase the risk of closed comedones. Always apply a broad-spectrum sunscreen with SPF 30 or higher and look for a shadow if possible.

In conclusion, closed comedones are a common skin disease, which affects many people. Although they are not painful or dangerous, for some, they can be unsightly and embarrassing.. To reduce the risk of closed comedone formation, it is important to follow a healthy diet, use gentle skin care products and limit sun exposure. If you're worried about your skin or experiencing symptoms of closed comedones, be sure to contact a healthcare professional for a professional assessment and treatment plan.

Used sources and literature

Dinulos JGH. Acne, rosacea, and related disorders. In: Dinulos JGH, ed. Habif’s Clinical Dermatology: A Color Guide in Diagnosis and Therapy. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 7.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Acne. In: James WD, Elston DM, Treat JR, Rosenbach, MA, Neuhaus IM, eds. Andrews’ Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 13.