Open vs Closed Comedones

October 11, 2021

Blackheads, or open comedones

Blackheads’ is a term usually meant to refer to clogged pores that are open or exposed to the air. The keratin in these pores oxidizes and turns black in color. The medical term would be open comedones . 

It’s reasonable to remove these at home gently. I usually recommend taking two cotton tips or Q tips, anchor them on either side of the pores and gently push them towards each other to extract out the keratin. This will be less traumatizing then your fingernails!

Remember, the ‘black dots’ on the nose are actually not always blackheads. There is a common  genetic trait called trichostasis that results in the appearance of blackheads on the nose and chin. These are actually open pores with sebum and a small hair follicle giving them a dark appearance. These are best managed with adhesive nasal strips such as biore.

To make blackhead removal easier, use a topical retinoid for several days before extracting. Over the counter you will find Differin. Prescription strength versions include tretinoin and tazarotene. These products loosen up and break apart the keratin and dead skin cells making them easier to extract. 

Whiteheads, or closed comedones 

The difference between these and ‘whiteheads’ or closed comedones is that with whiteheads the same keratin, oil and sebum builds up inside the pores but the pore stays closed.  Because the keratin is not exposed to the air they do not turn black. 

 

Since there is no opening of the pore to the surface, whiteheads often need the help of topical keratolytics - medications that chemically exfoliate the surface to help extract the buildup inside the pore to relieve it. Examples would be salicylic acid and retinoids. 






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