Comedones: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Comedones?
A dermatologist, a doctor who specializes in conditions of the skin, hair, and nails, can diagnose and treat comedones. Primary health care providers, such as family doctors, can also diagnose and treat acne. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What are comedones?
Comedones are small, flesh-colored, white, or dark bumps that give skin a rough texture. The bumps are one type of acne. They are found at the opening of skin pores. A solid core can often be seen in the middle of the small bump.
Comedones are called open or closed based on whether the surface is disrupted (open) or intact (closed). Open comedones are blackheads, and closed comedones are whiteheads. Acne is a common skin condition that happens when hair follicles under the skin become clogged. Doctors refer to enlarged or plugged hair follicles as comedones.
Symptoms
Comedones can be flesh-colored, white, or dark. Whiteheads are plugged hair follicles that stay beneath the skin and produce a white bump. Blackheads are plugged follicles that reach the surface of the skin and open up. They look black on the skin surface because the air discolors the sebum, not because they are dirty. Sebum is the oil that helps keep skin from drying out.
Most often, acne outbreaks happen on the face, but they can also appear on the back, chest, and shoulders. Acne causes several types of lesions, or pimples.
- Pustules, or pimples, are papules topped by white or yellow pus-filled lesions that may be red at the base.
- Nodules are large, painful solid lesions that are lodged deep within the skin.
- Severe nodular acne, sometimes called cystic acne, causes deep, painful, pus-filled lesions.
Causes and who gets it
Doctors and researchers believe that one or more of the following can lead to the development of acne.
- Excess or high production of oil in the pore.
- Buildup of dead skin cells in the pore.
- Growth of bacteria in the pore.
An increase in androgens, which are male sex hormones, may lead to acne. Hormonal changes related to pregnancy can also cause acne. You may be more likely to get acne if your parents had acne.
People of all races and ages get acne, but it is most common in teens and young adults. For most people, acne tends to go away by the time they reach their thirties, but some people in their forties and fifties continue to have this skin problem.
The following do not cause acne, but may make it worse.
- Eating certain foods. Some studies show that eating certain foods may make acne worse.
- Scrubbing your skin too hard.
How doctors diagnose it
Comedones are one type of acne. To diagnose acne, health care providers may take several steps.
- They may ask about your symptoms, including how long you have had acne.
- They may examine your skin to help determine the type of acne lesion.
- They may order lab work to determine if another condition or medical disorder is causing the acne.
Treatment
The goals of treatment are to help heal existing lesions, stop new lesions from forming, and prevent scarring. Your doctor may recommend over-the-counter or prescription medications to take by mouth or apply to the skin. Topical medications are medicines that you apply to the skin.
- Benzoyl peroxide, an over-the-counter product, kills bacteria and may decrease the production of sebum.
- Retinoids come from vitamin A and can help treat lesions and reduce inflammation.
- Salicylic acid helps break down blackheads and whiteheads.
Topical medicines come in many forms, including gels, lotions, creams, soaps, and pads. In some people, topical medicines may cause side effects such as skin irritation, burning, or redness. Talk to your doctor about any side effects that you experience. Inflammation means swelling, redness, heat, and pain.
Some people who have severe acne or acne scarring that does not respond to topical or oral medications may need additional treatments.
Clean your skin gently. Avoid rubbing and touching skin lesions. Squeezing or picking blemishes can cause scars or dark blotches to develop. Choose products labeled noncomedogenic, which means they do not clog pores.
When to see a doctor
Some people who have severe acne or acne scarring that does not respond to topical or oral medications may need additional treatments from a doctor. Acne can cause embarrassment or make you feel shy or anxious. If you have any of these feelings, talk to your doctor.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A doctor like this may recommend over-the-counter or prescription medications to take by mouth or apply to the skin.
Common questions
Are comedones the same as blackheads and whiteheads?
Yes, blackheads and whiteheads are both comedones. Open comedones are blackheads, and closed comedones are whiteheads.
Does dirt cause blackheads?
No, blackheads do not look black because they are dirty. They look black because the air discolors the sebum.
Should I squeeze or pick at comedones?
No, you should avoid rubbing and touching skin lesions. Squeezing or picking blemishes can cause scars or dark blotches to develop.
Can food make acne worse?
Some studies show that eating certain foods may make acne worse. Researchers are continuing to study the role of diet as a cause of acne.
What medicines help with blackheads and whiteheads?
Salicylic acid helps break down blackheads and whiteheads.
Sources
- MedlinePlus - Comedones
- NIAMS - Acne Types, Causes, and Risk Factors
- NIAMS - Acne: Diagnosis, Treatment, and Steps to Take
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
