Comedonal acne is treated by washing the face twice daily with mild soap and water, avoiding oily cosmetics and applying topical medication to the affected area. Topical medications include benzoyl peroxide, azelaic acid, salicylic acid and glycolic acid. If these treatments are not effective, some doctors prescribe antibiotics or hormonal therapy as treatment. In drastic cases, surgery is used to remove persistent comedones.
Comedonal acne appears most often on the forehead and chin. They look like small, skin-colored bumps. Closed comedones occur when the follicle is completely blocked by debris and sebum, resulting in whiteheads. A partial blockage creates an open comedone, or blackhead. The dark color is due to oxidation, not dirt or poor hygiene.
Comedones occur because of an excess of testosterone production, overhydration of the skin from humidifiers or moisturizers or injury-related ruptures in the follicle. Other causes include acne bacteria, reduced barrier function and increased production of cell-signaling proteins. While they do not cause acne, foods high in sugar, fat and dairy further aggravate acne, as can smoking.
Less common forms of comedonal acne are microcomedonal acne, a type of acne where the lesions are so small they are invisible to the naked eye, and macrocomedonal acne, which refers to lesions larger than 2 to 3 millimeters in diameter. Solar comedones are typically found on older people and are thought to result from sun damage.