Closed comedones: causes and how to clear them

"Closed comedones" is the medical name for whiteheads. Many people meet the term when their skin feels bumpy but shows few red pimples: small, skin-colored or white bumps across the forehead, cheeks or chin that stay under the surface. This guide explains what they are, what causes them, how to tell them from bumps that look alike, and what clears them. For blackheads and whiteheads together, see the hub guide, how to get rid of blackheads.

What a closed comedone is

The American Academy of Dermatology (AAD) says: "A whitehead forms when excess oil and dead skin cells build up and plug the opening of a pore. This causes a blemish that is raised and white or flesh colored." It gives the medical name as "Closed comedo, which means 'closed pore.'" Comedones is the plural.

The FDA's rules for acne products use a similar description. A whitehead is "a condition of the skin that occurs in acne and is characterized by a small, firm, whitish elevation of the skin." The NHS says whiteheads are "small bumps. They're usually the same colour as your skin but some may have white pus."

A blackhead is the same clog with an open top. The AAD calls it an open comedo. When the top stays open, the plug meets air and turns dark. When skin closes over it, the plug stays pale and sits under the surface. That closed top is why they can be hard to see. The AAD's page on hair products says bumps like these "can be so subtle that you can feel but not see them." The guide blackheads vs whiteheads compares the two side by side.

Bumps that look like closed comedones

Several other small bumps can pass for whiteheads. They have different causes and need different care.

Bump	What it is	Source
Closed comedone (whitehead)	A pore plugged with oil and dead skin under a closed top	AAD
Milia	Tiny white bumps or small cysts made of dead skin trapped in small pockets at the surface	MedlinePlus
Pustule	A red pimple with a yellow or white center of pus	AAD
Fungal acne (Malassezia folliculitis)	Itchy bumps of the same size, caused by yeast in the hair follicles, with no comedones	Journal of Fungi review, 2025

Milia. MedlinePlus says milia "occur when dead skin becomes trapped in small pockets at the surface of the skin." It adds that "Adults may develop milia on the face" and that milia are not a true form of acne. MedlinePlus says adults may have milia removed to improve their appearance. The guide milia vs whiteheads compares the two bumps point by point.

Fungal acne. A 2025 review in the Journal of Fungi, written by dermatologists at Weill Cornell Medicine, calls Malassezia folliculitis a common condition that is often misdiagnosed as acne. It says "A hallmark feature distinguishing MF from AV is the absence of comedones," where MF is the fungal condition and AV is ordinary acne. The review says itching, no response to acne medicines and a lack of comedones should make a doctor consider it. The guide fungal acne covers it.

What causes closed comedones

Closed comedones share their causes with blackheads, which the guide what causes blackheads explains in full. In short:

• Oil. The AAD says hormones called androgens "increase the size of the skin's oil glands," which then make more oil that "can clog pores."
• Dead skin cells that stick together inside the pore instead of shedding.
• Hormone changes. MedlinePlus lists puberty, periods, pregnancy, birth control pills and stress.
• Products that clog pores. The AAD links these to whiteheads. It says that when hair care products are the cause, "you'll likely get whiteheads and tiny flesh-colored bumps called 'papules,'" along the hairline, forehead or back of the neck. With makeup, the AAD says many women get small raised whiteheads on the cheeks, chin or forehead. The AAD calls this acne cosmetica.

If your closed comedones sit along the hairline or on the forehead, check your shampoo, conditioner and styling products first. If they sit where you apply foundation or concealer, check those. The AAD says makeup can take "anywhere from a few days to 6 months" to cause blemishes, and that acne from hair products can take 4 to 6 weeks to clear after you stop using them.

How to clear closed comedones

The AAD's page on acne types gives the plan for blackheads and whiteheads: "To unclog pores, dermatologists recommend using a retinoid. You can buy one retinoid, adapalene, without a prescription. You'll also want to use a benzoyl peroxide wash."

A retinoid is a medicine made from vitamin A. The AAD says a retinoid "works to clear your pores, and can treat blackheads, whiteheads, and some pimples." The 2024 acne guideline from the Journal of the American Academy of Dermatology gives topical retinoids and benzoyl peroxide strong recommendations.

Steps that follow the sources:

1. Use adapalene 0.1 percent once a day. The Drug Facts label says to "cover the entire affected area with a thin layer." The patient leaflet adds that it "is not a spot treatment and should not be used to treat a single pimple."
2. Expect a rough start. The label says "during the early weeks of use, your acne may appear to worsen before it improves," and that irritation such as redness, dryness and burning is more likely in the first few weeks.
3. Add a benzoyl peroxide wash if you have pimples as well. The AAD says benzoyl peroxide "reduces acne-causing bacteria on your skin." The FDA allows 2.5 to 10 percent, and the AAD suggests starting at 2.5 percent.
4. Moisturize and use sunscreen. The adapalene label says a moisturizer "may help decrease dryness," and tells you to limit sun and use sunscreen.
5. Wait long enough. The label says it "may take up to 3 months of once daily use to see results." The AAD says complete clearing generally takes 3 to 4 months.

Skinli's photo plan uses adapalene 0.1 percent and benzoyl peroxide 2.5 percent, starting every other night for two weeks. It asks people to set salicylic acid aside while they use them, because the adapalene label warns that irritation is more likely when you use more than one acne medicine on the skin at a time. The guide how to start adapalene walks through the first weeks.

Salicylic acid is the other choice sold without a prescription. The AAD says it "works best on whiteheads and blackheads" because it unclogs pores. The 2024 guideline gives it a conditional recommendation, a weaker grade than the retinoids.

Why picking makes them worse

A closed comedone has no opening, so squeezing it pushes on skin that is closed. The AAD says: "Picking at whiteheads can lead to more whiteheads and acne scars, so dermatologists recommend that you treat whiteheads with an acne treatment instead of picking at them." Its page on skin care habits explains why: when you squeeze, "you're likely to push some of what's inside (e.g., pus, dead skin cells, or bacteria) deeper into your skin," which increases inflammation. NICE, the UK guideline body, says persistent picking "can increase the risk of scarring."

Tools sold for whiteheads carry the same risks when used at home. The guide comedone extractors explains what the evidence says about them.

What a dermatologist can add

If closed comedones remain after six to eight weeks of steady treatment, a dermatologist has more options:

• Extraction. The AAD says acne extraction uses sterile instruments to remove blackheads and whiteheads, and is "a safe way to get rid of blackheads and whiteheads" when a dermatologist does it. It is "usually offered when other acne treatment fails to clear the skin."
• Prescription retinoids. The AAD lists tretinoin, tazarotene and trifarotene.
• Azelaic acid. The AAD says it "opens clogged pores and helps keep them open."
• Chemical peels. The AAD says a peel "helps remove dead skin cells that are clogging your pores and excess oil."

The guide how a dermatologist removes blackheads explains each option, including what to expect. For clearing whiteheads at home step by step, see how to get rid of whiteheads.

When to see a doctor

Closed comedones are mild acne, and many people clear them without a prescription. See a dermatologist or your doctor if they have not improved after six to eight weeks, if the bumps itch and look all the same size, if you also have deep or painful lumps, or if marks or scars are forming. NICE says a referral should be considered for acne that has not responded to 2 completed courses of treatment or is leading to scarring. Skinli gives general education and is not a doctor. If you want a plan for your skin, the free Skinli photo plan starts from a photo.