Comedonal Acne: Causes & Treatment

For education only

This guide cannot diagnose a condition or recommend a personal treatment plan. Discuss medical questions with a qualified professional.

Locations:

AdvertisementAdvertisement

Comedonal acne is a breakout of blemishes called comedones. Comedones are small bumps that appear when pores or hair follicles clog up with sebum and dead skin cells. Proper skin care, topical products, prescription medications and procedures can help treat comedonal acne.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Care at Cleveland Clinic

Image content: This image is available to view online.

View image online (https://my.clevelandclinic.org/-/scassets/images/org/health/articles/comedonal-acne)

Comedonal acne looks like many small bumps on your skin — often on your face — that aren’t inflamed. The bumps are pores or follicles that are clogged with sebum (an oily substance) and skin cells.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

This type of acne is different from pimples, or inflammatory acne. Pimples are discolored (red, purple, brown, black) — usually darker than your normal skin tone — and filled with pus. Comedonal acne bumps are mostly the same color as the surrounding skin and not tender or swollen.

Comedonal acne (pronounced “KO-meh-DOH-nul” “AK-nee”) is very common. It most often affects preteens and teenagers. But many adults have it as well. It can occur in combination with other types of acne, like inflammatory papules and pustules.

There are two types of comedones:

Closed (whitehead): These are small, plugged follicles that are covered with skin. The contents of them aren’t exposed at the surface of your skin.
Open (blackhead): These are small, plugged follicles with widened openings. Exposure to air at the surface of your skin causes the tip of the content to turn black in color (it oxidizes).

Signs of comedonal acne on your skin include:

Bumpy skin texture: The bumps can vary in size. Your skin may feel rough. The bumps appear to have a solid core.
Flesh-colored bumps: The bumps mostly match the color of your skin — they’re not discolored or inflamed.
Small dark spots: Open comedones (blackheads) look like specks of black or dirt on your skin.
White or yellowish bumps: Closed comedones (whiteheads) may have a slight white or yellow color.

This type of acne usually appears on your forehead and chin. But it can affect other areas, like your nose, cheeks and back.

Comedones form when pores or hair follicles become clogged with dead skin cells and sebum. Sebum is a natural oily substance your pores release.

This can happen if you have:

Increased sebum production
Abnormal formation of keratin (the protein that helps make your hair, skin and nails)
Increased hormones (androgens)
Increased amounts of a skin bacterium that causes acne

Several factors may increase your risk of developing comedonal acne, like:

A biological family history of acne
Damaged pores or follicles (from popping comedones or pimples, for example)
Excess or fluctuating hormones (like during puberty or pregnancy)
Living in areas with high humidity
Using oily or greasy personal care products
Consuming a lot of milk products, sugars and fats

Without treatment, comedonal acne can turn into inflammatory acne. This type of acne can be painful. It may also be more noticeable.

Comedonal acne can also affect your self-esteem and mental health. Reach out to a healthcare provider if acne is making you feel negatively about yourself. Your mental health matters as much as your physical health.

A healthcare provider can diagnose comedonal acne by looking at your skin. You can visit your primary care physician or a dermatologist (skin specialist) for diagnosis.

Comedonal acne is typically the mildest form of acne. But it can be difficult to treat because the comedones are “stuck” within the follicles.

Several medical treatments can reduce the number and size of comedones. A healthcare provider can help you find the best treatment plan for your situation.

Products you put on your skin to treat comedonal acne include:

Salicylic acid
Retinoids
Azelaic acid
Benzoyl peroxide
Glycolic acid

If comedonal acne doesn’t respond to topical treatments, your healthcare provider may prescribe oral medicines. They may include:

Hormonal therapy, like the birth control pill or spironolactone
Antibiotics
Isotretinoin (Accutane®)

Your provider may recommend certain procedures to remove the clogging material from your skin, like:

Comedone extraction: A dermatologist or licensed esthetician uses sterile instruments to manually remove clogs.
Dermabrasion or microdermabrasion: Your provider uses tools to manually resurface the top layer of the skin to remove dead skin and debris.
Chemical peels: Your provider applies special chemicals to exfoliate your skin and help unclog pores.

Make sure to see a licensed professional for these procedures. Try not to pick, squeeze or pop comedones. Only a professional should do extractions. Doing it yourself can lead to:

Acne scars
Damage to the pores or follicles, which can cause more comedones
Infection
Inflammatory acne
More noticeable blemishes

With proper and persistent skin care and treatment, you may start to notice a difference in eight to 12 weeks. But it may take many months for comedonal acne to clear up.

See your healthcare provider if your treatment plan isn’t giving you the results you want. It can take time — and many tries — to find the right treatment and skin care routine.

If you get side effects from the medications, let your provider know.

Care at Cleveland Clinic

Comedonal acne can be a long-term condition that comes back repeatedly over many years. Things you can’t control — like hormone fluctuations and genetics — play a strong role in it. But taking care of your skin can help minimize future breakouts:

Avoid touching your face throughout the day, which can cause oil and dirt to build up in your facial pores.
Choose oil-free, water-based, noncomedogenic (doesn’t clog pores) cleansers, moisturizers and makeup.
Wash and moisturize your skin every morning and night. Do this after you exercise, too.
Don’t go to bed with makeup on.
When you wash your face, do it gently. Don’t scrub.
Wear sunscreen daily to protect your skin from sun damage.

Comedonal acne can be frustrating. But with the right treatment and skin care, it’s manageable. If you’re struggling to see results or feel overwhelmed, talk to a dermatologist. Together, you can find a plan that works for your skin — and your life.

Learn more about the Health Library and our editorial process.

Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.

American Academy of Dermatology Association. How to Treat Different Types of Acne (https://www.aad.org/public/diseases/acne/diy/types-breakouts). Last updated 9/12/2023. Accessed 11/10/2025.
American Skin Association. Acne (https://www.americanskin.org/resource/acne.php). Accessed 11/10/2025.
Gold MH, Baldwin H, Lin T. Management of comedonal acne vulgaris with fixed-combination topical therapy (https://pubmed.ncbi.nlm.nih.gov/29380941/). J Cosmet Dermatol. 2018 Apr;17(2):227-231. Accessed 11/10/2025.
Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of care for the management of acne vulgaris (https://pubmed.ncbi.nlm.nih.gov/38300170/). J Am Acad Dermatol. 2024 May;90(5):1006.e1-1006.e30. Accessed 11/10/2025.
Sutaria AH, Masood S, Saleh HM, et al. Acne Vulgaris (https://www.ncbi.nlm.nih.gov/books/NBK459173/). 2023 Aug 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Accessed 11/10/2025.
Xu H, Li H. Acne, the Skin Microbiome, and Antibiotic Treatment (https://pubmed.ncbi.nlm.nih.gov/30632097/). Am J Clin Dermatol. 2019 Jun;20(3):335-344. Accessed 11/10/2025.

Every day, people see your skin, hair and nails. At Cleveland Clinic, our expert and caring dermatology team will make sure they’re healthy and strong.

AdvertisementAdvertisement

Peptide Therapy Guide Editorial Team