Comedonal Acne: What It Is, Why It Happens, and How It's Treated
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
Comedonal acne is a breakout of small, noninflamed bumps called comedones, which form when pores clog with sebum and dead skin cells. It is typically the mildest form of acne. Unlike pimples, comedones are not tender or swollen. It is treated with topical retinoids or salicylic acid, oral medicines if needed, and procedures such as comedone extraction. [1]
What the research says
Acne is extremely common, and topical retinoids work. A JAMA review reports that acne vulgaris affects about 9% of people worldwide and roughly 85% of people aged 12 to 24. In one randomized trial of 207 patients, tretinoin 0.025% gel alone cut acne lesion counts by 63% at 12 weeks. (Eichenfield et al., JAMA, 2021) [2]
Guidelines back specific first-line treatments. The American Academy of Dermatology guideline made 18 evidence-based recommendations and 5 good practice statements. It strongly recommends benzoyl peroxide and topical retinoids, and conditionally recommends salicylic acid and azelaic acid. (Reynolds et al., Journal of the American Academy of Dermatology, 2024) [3]
Retinoids help both kinds of comedones. A systematic review of topical treatments for mild-to-moderate acne found that tretinoin and adapalene significantly improved both open and closed comedones. (Althwanay et al., Cureus, 2024) [4]
What Is Comedonal Acne?
Comedonal acne looks like many small bumps on the skin, often on the face, that are not inflamed. The bumps are pores or hair follicles clogged with sebum, a natural oily substance, and dead skin cells. [1]
It differs from pimples, or inflammatory acne. Pimples are discolored (red, purple, brown or 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 are not tender or swollen. [1]
The name is pronounced "KO-meh-DOH-nul AK-nee." It is very common, most often affects preteens and teenagers, and is also seen in many adults. It can occur together with other types of acne, such as inflammatory papules (small raised inflamed bumps) and pustules (inflamed bumps filled with pus). [1]
Key Terms to Know
Comedone: a small bump formed when a pore or hair follicle clogs with sebum and dead skin cells.
Sebum: the natural oily substance your pores release.
Keratin: the protein that helps make your hair, skin and nails.
Androgens: a group of hormones.
Noncomedogenic: describes a product that does not clog pores.
Dermatologist: a doctor who specializes in skin care.
Isotretinoin: an oral prescription acne medication (brand name Accutane).
What Are the Types of Comedonal Acne?
Comedonal acne has two types of comedones, depending on whether the clogged follicle is covered by skin or open at the surface. [1]
Closed comedone (whitehead): a small white or yellowish bump. The plugged follicle is covered with skin, so its contents are not exposed at the surface.
Open comedone (blackhead): a small dark speck that looks like black or dirt. The plugged follicle has a widened opening, and exposure to air turns the tip of the content black (it oxidizes).
Where Does Comedonal Acne Appear?
Comedonal acne usually appears on the forehead and chin, but it can also affect the nose, cheeks and back. [1]
What Are the Symptoms of Comedonal Acne?
Signs on your skin include: [1]
Bumpy skin texture: bumps of varying sizes, rough-feeling skin, and bumps that seem to have a solid core.
Flesh-colored bumps: bumps that mostly match your skin color and are not discolored or inflamed.
Small dark spots: open comedones (blackheads) look like specks of black or dirt.
White or yellowish bumps: closed comedones (whiteheads) with a slight white or yellow color.
What Causes Comedonal Acne?
Comedones form when pores or hair follicles become clogged with dead skin cells and sebum. [1] This clogging can happen with: [1]
increased sebum production
abnormal formation of keratin
increased hormones (androgens)
increased amounts of a skin bacterium that causes acne
What Increases Your Risk?
Several factors may raise your risk: [1]
Family history: acne tends to run in families.
Damaged pores or follicles: for example, from popping comedones or pimples.
Excess or fluctuating hormones: common during puberty or pregnancy.
High humidity: living in a humid climate can worsen clogged pores.
Oily or greasy personal care products: oils add to what clogs pores.
Diet: consuming a lot of milk products, sugars and fats may raise risk.
Can Comedonal Acne Cause Complications?
Without treatment, comedonal acne can turn into inflammatory acne, which can be painful and more noticeable. [1] Acne can also affect self-esteem and mental health, so reach out to a healthcare provider if it makes you feel negatively about yourself. Your mental health matters as much as your physical health. [1]
How Is Comedonal Acne Diagnosed?
A healthcare provider can diagnose comedonal acne by looking at your skin. You can see your primary care physician or a dermatologist. [1]
How Is Comedonal Acne Treated?
Comedonal acne is typically the mildest form of acne, but it can be hard to treat because the comedones are "stuck" within the follicles. Several treatments can reduce the number and size of comedones, and a provider can help you build the best plan. [1]
Topical Treatments
Products you apply to the skin include salicylic acid, retinoids, azelaic acid, benzoyl peroxide and glycolic acid. [1] Guidelines strongly recommend benzoyl peroxide and topical retinoids for acne in general. [3]
Oral Medications
If comedonal acne does not respond to topical treatments, your provider may prescribe oral medicines: [1]
Birth control pill: hormonal therapy.
Spironolactone: hormonal therapy.
Antibiotics: fight acne-causing bacteria.
Isotretinoin (Accutane): a powerful oral acne medication.
Procedures
Your provider may recommend procedures to remove the clogging material: [1]
Comedone extraction: sterile instruments manually remove clogs; done by a dermatologist or licensed esthetician.
Dermabrasion or microdermabrasion: tools resurface the top layer of skin to remove dead skin and debris.
Chemical peels: special chemicals exfoliate the skin and help unclog pores.
See a licensed professional for these procedures, and try not to pick, squeeze or pop comedones. Doing it yourself can lead to acne scars, damaged pores or follicles that cause more comedones, infection, inflammatory acne and more noticeable blemishes. [1]
How Long Until You See Results?
With proper and persistent skin care and treatment, you may start to notice a difference in 8 to 12 weeks, but it may take many months for comedonal acne to clear. [1] This fits the 12-week timeline used in clinical trials of topical acne treatments. [2]
What Is the Outlook for Comedonal Acne?
Comedonal acne can be a long-term condition that comes back repeatedly over many years. Things you cannot control, such as hormone changes and genetics, play a strong role. Taking care of your skin can still help minimize future breakouts. [1] Helpful habits include: [1]
Avoid touching your face throughout the day, so oil and dirt do not build up in pores.
Choose oil-free, water-based, noncomedogenic products for cleansers, moisturizers and makeup.
Wash and moisturize every morning and night, including after you exercise.
Do not go to bed with makeup on.
Wash your face gently and do not scrub.
Wear sunscreen daily to protect your skin from sun damage.
When Should You See a Healthcare Provider?
See your provider if your treatment plan is not giving the results you want. It can take time, and several tries, to find the right treatment and routine. Tell your provider if you get side effects from medications. [1]
A reassuring note: Comedonal acne can be frustrating, but with the right treatment and skin care it is manageable. If you are struggling to see results or feel overwhelmed, talk to a dermatologist. Your mental health matters as much as your physical health.
Conclusion
Comedonal acne is a breakout of small, noninflamed bumps that form when pores clog with sebum and dead skin cells. It appears as rough, flesh-colored bumps, small dark specks (blackheads) or white or yellowish bumps (whiteheads), most often on the forehead and chin. It is typically the mildest form of acne, but it can be stubborn, so care combines topical products such as retinoids and salicylic acid, prescription medicines when needed, and professional procedures. Untreated, it can turn into painful inflammatory acne, and picking at it can cause scars and infection. It can be long-term, but steady skin care and treatment can minimize breakouts, and you may see a difference in 8 to 12 weeks. [1][2][3][4]
Frequently Asked Questions
What is comedonal acne?
Comedonal acne is a breakout of small bumps called comedones that form when pores or hair follicles clog with sebum and dead skin cells.
Is comedonal acne inflamed?
No. The bumps are not inflamed, unlike pimples. They mostly match your skin color and are not tender or swollen.
What are the two types of comedones?
Closed comedones (whiteheads) and open comedones (blackheads).
Why are blackheads black?
An open comedone has a widened opening, and exposure to air makes the tip of the content turn black because it oxidizes.
Where does comedonal acne usually appear?
Usually on the forehead and chin, but it can also affect the nose, cheeks and back.
What causes comedonal acne?
Pores clog with sebum and dead skin cells because of increased sebum production, abnormal keratin formation, increased androgen hormones and more acne-causing skin bacteria.
Can diet or skin products affect comedonal acne?
Diet and skin products may. Oily or greasy personal care products and diets high in milk products, sugars and fats may raise risk.
What happens if comedonal acne goes untreated?
Untreated comedonal acne can turn into inflammatory acne, which can be painful and more noticeable.
What topical treatments help?
Salicylic acid, retinoids, azelaic acid, benzoyl peroxide and glycolic acid are commonly used.
When are oral medications used?
If topical treatments do not work, a provider may prescribe hormonal therapy (the birth control pill or spironolactone), antibiotics or isotretinoin. Isotretinoin can cause severe birth defects, so it must never be taken during pregnancy, and in the U.S. it is only prescribed through a strict safety program (iPLEDGE).
Can I pop comedones at home?
No. Only a licensed professional should do extractions. Doing it yourself can cause scars, infection, inflammatory acne and more comedones.
How long until I see results?
You may notice a difference in 8 to 12 weeks with persistent care, but it may take many months to clear.
Will comedonal acne come back?
Comedonal acne can. It is often a long-term condition that returns over many years, but good skin care can minimize breakouts.
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References
Cleveland Clinic Staff. Comedonal Acne: Causes & Treatment. Cleveland Clinic. November 10, 2025. https://my.clevelandclinic.org/health/diseases/comedonal-acne
Eichenfield DZ, Sprague J, Eichenfield LF. Management of Acne Vulgaris: A Review. JAMA. 2021;326(20):2055-2067. PMID 34812859. https://doi.org/10.1001/jama.2021.17633
Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024;90(5):1006.e1-1006.e30. PMID 38300170. https://doi.org/10.1016/j.jaad.2023.12.017
Althwanay A, AlEdani EM, Kaur H, Kasapoglu M, Yadavalli R, Nawaz S, Nath TS. Efficacy of Topical Treatments in the Management of Mild-to-Moderate Acne Vulgaris: A Systematic Review. Cureus. 2024;16(4):e57909. PMID 38725769. https://doi.org/10.7759/cureus.57909
Medical disclaimer
This article is for general information only and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions about a medical condition. Never disregard professional medical advice or delay seeking it because of something you read here. Acne treatment is highly individual: what works for one person may not work for another, and only a licensed healthcare provider can recommend the right plan for your skin.
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