Closed Comedones - Causes, Side Effects, Prevention and Treatment

What Is Comedonal Acne?

Comedonal acne are small bumps that form close to the skin surface and are different from regular inflammatory acne. They are of different types, namely,

• Whiteheads or closed comedones.

• Blackheads or open comedones.

• Solar comedones.

• Microcomedones.

• Macrocomedones.

• Giant comedones.

What Are Whiteheads or Closed Comedones?

The hair follicles are a tunnel-like structure that gets the shape of a bump when filled with a plug. A single bump is called comedo, while a group of bumps is called comedones. Closed comedones are formed when the underlying hair follicles are closed by a plug formed by oil or dead skin cells. These closed comedones most commonly occur on the face, neck, chest, and back. Closed comedones appear white or yellow in color and are rightly called whiteheads.

In Whom Are Whiteheads Prevalent?

Although most commonly seen in adolescents, closed comedones can occur among people of all groups. In a few cases, individuals might get whiteheads only after they become adults. It has been reported that almost every individual develops whiteheads at some point in their life.

Where Do Whiteheads Most Commonly Occur?

Since closed comedones are formed due to the trapping of dead skin cells and oil inside the hair follicle, it can occur anywhere in the body where sebaceous glands are present.

However, closed comedones most commonly occur in the following areas:

• Face - Nose, forehead, cheeks, chin, and around the lips.

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• Upper arms.

• Neck.

• Chest.

• Back.

• In rare cases, it can also be seen in the scalp, ears, thighs, armpits, butt, and genitals.

How Are Blackheads Different From Whiteheads?

Both blackheads and whiteheads are types of comedonal acne; the difference is that blackheads are open comedones and whiteheads are closed comedones. Blackheads appear like dark spots on the skin, while whiteheads appear white or yellow in color. The appearance of blackheads might seem like they contain trapped dirt, but that is not the case. The color is only due to irregular light reflection. In whiteheads, the formed oil plug is not exposed to air, so it does not appear black or brown like open comedones.

What Causes Whiteheads?

The formation of closed comedones has been attributed to the inflammation of sebaceous glands or hair follicles. Sebaceous glands are located close to the skin, producing sebum, an oily substance that hydrates the hair and skin. Most of these sebaceous glands are connected with a hair follicle. Inflammation of the hair follicle or sebaceous gland can occur due to any of the following:

• Abnormal Keratin Formation - Keratin is a protein needed to grow and repair hair, nails, and skin.

• Raised sebum production.

• Presence of an increased number of acne-producing bacteria.

In addition to this, specific makeup and hair care products might also aggravate the formation of closed comedones. Using oily creams and lotions can clog the hair follicles, resulting in the formation of closed comedones.

How Are Whiteheads Manifested?

As they are only a mild form of acne, closed comedones usually do not exhibit any symptoms except for slight pain in some cases. The presence of white or yellow bumps on the skin is the characteristic feature of closed comedones.

What Is the Effect of Whiteheads?

Whiteheads are not a severe condition that affects the physical health of an individual. But the effect it brings on the appearance has a mental and psychosocial impact.

Can Closed Comedones Spread From One Person to Another?

Closed comedones are not caused by any microorganism and, therefore, not contagious; that is, they cannot be spread from one person to another.

How Can We Identify Whiteheads?

Since whiteheads or closed comedones are easily recognizable, visual examination is all that is needed to identify them. Even without the help of a healthcare professional, it can be identified. However, a dermatologist's assistance should be sought when it occurs with severe acne.

How Can We Treat Whiteheads?

The following methods can treat whiteheads that appear on the face:

A. Over-the-Counter Medications:

1. Salicylic Acid - It acts by dissolving the dead skin cells that clog the pores and removing the affected skin layer. These are available in the form of cleansers or lotions. These should be used for a period of at least eight weeks to have the maximum effect.

B. Prescription Medications:

When over-the-counter medications are not helpful, prescription medications can be taken with advice from a dermatologist. The following are the prescriptions medicines most commonly suggested:

1. Benzoyl Peroxide - It helps treat whiteheads by removing the bacteria which aggravates the formation of acne. An important side-effect of using Benzoyl peroxide is irritation; however, lower concentrations do not produce much skin irritation. Washes or face-on gel are the available forms.

2. Azelaic Acid - A naturally found acid in wheat, rye, and barley called Azelaic acid, helps remove the bacteria and decrease swelling.

3. Retinoids - Retinoids are vitamin A derivatives that prevent the clogging of pores, which is evident by the peeling or color change in the skin.

4. Oral Contraceptives - In women, taking oral contraceptive pills along with the above topical treatment has been proved to have an additive effect.

C. Other Treatment Methods:

1. Microdermabrasion - In this method, the superficial layer of the skin is removed to unclog the pores. This is usually done with the help of a specialized pump.

2. Laser Skin Resurfacing - In cases where there is excess sebum production, laser skin resurfacing is advised. During this procedure, short, concentrated, pulsating light beams are targeted on the whiteheads, which reduces the amount of sebum produced.

3. Chemical Peels - In some cases, a mild chemical is used to peel off the top layer of skin, thus treating whiteheads.

What Should I Do to Manage Whiteheads?

• Do not touch or squeeze the whiteheads.

• Clean the items like helmets, pillow covers, cell phones, sunglasses, clothes, etc., that come in contact with your face.

• Be cautious while shaving in areas where whiteheads are present.

What Should I Do to Prevent Whiteheads?

• Use a mild cleanser and warm water to wash your face.

• Do use non-comedogenic makeup products.

• Always use a moisturizer.

• Do not forget to remove the makeup before going to bed.

• Take frequent hair baths.

• Do not touch your face often.

• Make sure the hair care products do not contact your face.

Can I Squeeze My Whiteheads?

It is not advisable to squeeze the whiteheads for the following reasons:

• There can be a scar formation.

• Bacteria can enter the whiteheads and bring about an infection.

• Skin irritation can occur.

Conclusion:

Whiteheads or closed comedones are a widely prevalent, less severe condition. However, they can have a severe toll on the mental health of the affected individual. Therefore, it is advisable to reach out to a dermatologist and get the earliest treatment when it occurs.