# Closed comedones (whiteheads): why they're so stubborn and what actually clears them URL: https://dermalguide.com/articles/closed-comedones-whiteheads/ Part of: https://dermalguide.com/acne/ Published: 2026-10-18 · Updated: 2026-10-23 > Why closed comedones take months to clear, how to use a retinoid without wrecking your skin barrier, whether retinol can cause bumps, and when to see a dermatologist. ## Short answer Closed comedones are pores blocked by oil and dead skin under a closed surface, so they show as small skin-coloured or white bumps, usually on the forehead and chin. A topical retinoid is the first-line treatment; adapalene 0.1% is sold without a prescription in the US. Expect six to eight weeks before clear improvement, and keep going afterwards, because new comedones keep forming. ## What this means for you ### Start with what you notice Confirm the bumps are blocked pores under a closed surface, then give a retinoid enough time. ### The ingredient names, translated Closed comedones are tiny clogged pores that haven't opened. A retinoid such as adapalene works best, but it's slow: give it at least two months. Start gently, because irritated skin is harder to clear. If nothing improves, a dermatologist can prescribe stronger options or remove them safely. ### How to decide - Skin-coloured or white, with no dark plug and clustered on the forehead or chin, is a closed comedone. - If the surface looks unbroken and you cannot find an opening, do not try to extract it. - Start with the gentlest retinoid you can use comfortably. Irritated skin is harder to clear, not easier. - Do not judge the change until at least two months have passed. ### What to expect Expect six to eight weeks before clear improvement, and expect to keep going after that, because new comedones keep forming while you use the product. If nothing changes at all after two months, a dermatologist has stronger options and can remove them safely. General guidance, not a test of these products: [Comedonal acne (DermNet)](https://dermnetnz.org/topics/comedonal-acne); [How to treat different types of acne (American Academy of Dermatology)](https://www.aad.org/public/diseases/acne/diy/types-breakouts); [Guidelines of care for the management of acne vulgaris (J Am Acad Dermatol, 2024)](https://doi.org/10.1016/j.jaad.2023.12.017); [Differin (adapalene 0.1%) Drug Facts label](https://otclabels.com/lib/otc/otc-meds/differin/); [Yentzer BA, McClain RW, Feldman SR. Do topical retinoids cause acne to 'flare'? J Drugs Dermatol. 2009;8(9):799-801 (PMID 19746671)](https://scholarlyworks.lvhn.org/medicine/2174); [Pimple popping: why only a dermatologist should do it (American Academy of Dermatology)](https://www.aad.org/public/diseases/acne/skin-care/popping); [Hair care products and breakouts (American Academy of Dermatology)](https://www.aad.org/public/diseases/acne/causes/hair-products); [Acne: overview (NHS)](https://www.nhs.uk/conditions/acne/); [Sebaceous filaments (Cleveland Clinic)](https://my.clevelandclinic.org/health/diseases/24571-sebaceous-filaments). Each product's label source is linked on its product page. ## What are closed comedones? A comedone is a hair follicle blocked by a plug of oil (sebum) and skin cells. [DermNet](https://dermnetnz.org/topics/comedonal-acne) explains that when the follicle opening stays open you get a blackhead; when it's completely blocked you get a closed comedone, often called a whitehead. The [NHS](https://www.nhs.uk/conditions/acne/) describes whiteheads as firmer than blackheads and notes they won't empty when squeezed. What they're like: - small, skin-coloured or whitish bumps, often easier to **feel than see** - clustered on the **forehead and chin** (DermNet), and along the hairline when hair products are involved ([AAD](https://www.aad.org/public/diseases/acne/causes/hair-products)) - not red or sore, unless they become inflamed - **macrocomedones** are a larger variety, more than 2–3 mm across (DermNet) ## Why are closed comedones so hard to get rid of? There are a few reasons: - **There's no opening.** Unlike a blackhead, nothing can work its way out on its own, and surface products have a closed pore to deal with. - **They form slowly.** A comedone builds up over weeks before you see it, so even an effective treatment takes weeks to show. - **They keep forming.** DermNet notes comedonal acne treatment often needs to continue long-term, sometimes for years. Stopping when the skin clears usually lets them come back. > **Skin Realist check:** if you've been using a product for two weeks and see no change, that's normal. Judge a comedone treatment at the two-month mark, not the two-week mark. ## What actually clears closed comedones? ### A retinoid (first choice) The [American Academy of Dermatology (AAD)](https://www.aad.org/public/diseases/acne/diy/types-breakouts) says dermatologists recommend a retinoid to unclog pores, and notes that **adapalene** can be bought without a prescription. The 2024 [AAD acne guidelines](https://doi.org/10.1016/j.jaad.2023.12.017) give topical retinoids a strong recommendation. The [Differin (adapalene 0.1%) label](https://otclabels.com/lib/otc/otc-meds/differin/) says to: - use it **once daily**, as a thin layer over the whole affected area, not just individual bumps - not use it more than once a day - limit sun exposure and use sunscreen outdoors - use it from age 12; under 12, ask a doctor The AAD's guidance is to **give it six to eight weeks**. Many people find closed comedones take longer than that to clear fully, which matches the long-term treatment DermNet describes. ### Other options - **Benzoyl peroxide:** the AAD pairs a benzoyl peroxide wash with a retinoid for blackheads and whiteheads. - **[Salicylic acid](https://dermalguide.com/ingredients/salicylic-acid/):** a conditional (weaker) recommendation in the 2024 guidelines. It's gentler and can suit people who can't tolerate a retinoid. - **[Azelaic acid](https://dermalguide.com/ingredients/azelaic-acid/):** also conditionally recommended. It can be useful if you have post-acne marks as well. - **AHAs such as [glycolic acid](https://dermalguide.com/ingredients/glycolic-acid/)** are popular for closed comedones, but they aren't among the acne treatments in the 2024 guidelines or the FDA's OTC acne monograph. Treat them as a cosmetic extra, not the main treatment. From the labels we've checked, [Sunday Riley Peacekeeper](https://dermalguide.com/products/sunday-riley-peacekeeper-acne-treatment-serum/) combines salicylic and azelaic acids in one leave-on serum, and [COSRX AHA/BHA Clarifying Treatment Toner](https://dermalguide.com/products/cosrx-aha-bha-clarifying-treatment-toner/) is a fragrance-free glycolic acid toner if you want an AHA extra later. Prescription options include stronger retinoids (such as tretinoin) and other treatments your dermatologist may consider. Those are a conversation with your doctor. ## Did my retinol cause closed comedones? Is it purging? People often say a retinoid "gave them" closed comedones. Here's what the evidence says: - **The adapalene label warns about it.** It says that during the early weeks of use, acne may appear to worsen before it improves, and calls this normal. It also says irritation (redness, itching, dryness, burning) is more likely early on and usually lessens with continued use. - **A review found retinoids are unlikely to cause flares.** A 2009 review in the [*Journal of Drugs in Dermatology*](https://scholarlyworks.lvhn.org/medicine/2174) concluded it's unlikely that starting a topical retinoid causes acne to flare. It noted that some people get worse in the first week or two, but attributed this to the natural ups and downs of acne rather than the medication. So "purging" isn't well established as a separate effect, but a rough start is common and expected. Things that point to a **different problem**: - bumps appearing in areas where you don't normally get acne - **itching**, or lots of tiny bumps that all look the same (see [fungal acne](https://dermalguide.com/articles/fungal-acne-malassezia-folliculitis/)) - burning, stinging or flaking that doesn't settle - still getting worse after six to eight weeks Two other possibilities are worth considering if a cosmetic **[retinol](https://dermalguide.com/ingredients/retinol/) cream** seems to be the trigger. First, the cream's base may not suit you, regardless of the retinol. Second, irritated skin can be bumpier. We couldn't find studies showing that retinoid irritation itself causes comedones, so we can't say which is more likely; switching to a lighter base, or trying adapalene gel instead, is a reasonable test. ## How do I use a retinoid without damaging my skin barrier? The goal is to stay on the retinoid long enough for it to work, which means keeping irritation low: 1. **Start slowly.** Every other night for the first couple of weeks is a common approach, then nightly as your skin tolerates it. 2. **Use a thin layer on dry skin.** More product doesn't work faster; the label says once a day, thin layer. 3. **Moisturise.** Use a plain, non-comedogenic moisturiser, such as the fragrance-free [Laneige Balance Mode Shine Control Weightless Moisturizer](https://dermalguide.com/products/laneige-balance-mode-shine-control-weightless-moisturizer/). [Cleveland Clinic](https://my.clevelandclinic.org/health/diseases/24571-sebaceous-filaments) notes retinoid peeling is reduced by using it alongside a moisturiser. 4. **Don't stack actives.** US acne drug labels warn irritation and dryness are more likely if you use more than one topical acne medication at a time. Add a second only after your skin has settled, and use it at a different time of day. 5. **Protect from sun.** Follow the label's sun warning. 6. **Don't scrub.** The AAD warns scrubbing makes acne worse. > **Skin Realist check:** if your skin stings when you apply moisturiser, back off: drop to every third night or pause for a few days. You'll clear faster on a retinoid you can tolerate than on one you keep stopping. ## Can I extract closed comedones? Not at home. Closed comedones have no opening, so squeezing pushes material deeper. The [AAD](https://www.aad.org/public/diseases/acne/skin-care/popping) says squeezing at home often increases inflammation and can cause permanent scars, more noticeable acne and infection. A dermatologist can do **comedo extraction** with sterile instruments. The AAD notes it's usually offered when other treatment hasn't worked, and comedones can return afterwards, so you still need ongoing treatment. ## What can trigger closed comedones on the forehead? - **Hair products.** The [AAD](https://www.aad.org/public/diseases/acne/causes/hair-products) says oil from hair products can travel to the skin and cause whiteheads or small flesh-coloured bumps along the hairline and upper forehead. More in [forehead acne and makeup](https://dermalguide.com/articles/forehead-acne-makeup/). - **Makeup and skincare.** Look for "non-comedogenic" or "oil-free" on labels. - **Smoking.** DermNet notes comedonal acne is more common in smokers. ## Are they really closed comedones? Three things cause small, skin-coloured forehead bumps: closed comedones, fungal acne and keratosis pilaris. Clues that it may *not* be comedones include itching, bumps that are all exactly the same size, and no response to two months of a retinoid. See [forehead bumps: comedones, fungal acne or KP?](https://dermalguide.com/articles/forehead-bumps-comedones-fungal-acne-or-kp/) for a side-by-side comparison. ## When should you see a dermatologist? - No improvement after six to eight weeks of a retinoid, used consistently - Bumps that itch, or appeared suddenly - Large macrocomedones - You've been squeezing them and have marks or scars - You've had isotretinoin and comedones have come back (see [acne after Accutane](https://dermalguide.com/articles/acne-after-accutane/)) ## Frequently asked questions ### What are closed comedones? Closed comedones (whiteheads) are hair follicles plugged with oil and dead skin cells where the opening has closed over. They look like small skin-coloured or white bumps and are usually more easily felt than seen. DermNet notes comedonal acne most often affects the forehead and chin. ### How long do closed comedones take to go away? The American Academy of Dermatology advises giving treatment six to eight weeks to work. Many people need longer for full clearing, and DermNet says comedonal acne treatment often has to continue long-term, sometimes for years, to stop new ones. ### Can retinol cause closed comedones? We couldn't find evidence that retinoids cause comedones. A 2009 review concluded retinoids are unlikely to make acne flare, and the adapalene label says acne may seem worse in the early weeks before improving. Irritation or a heavy cream base are other possible reasons for new bumps; a dermatologist can help sort out which. ### Is it purging or a breakout? There's no test that tells them apart. A temporary worsening in the first weeks of a retinoid, in the areas where you usually get comedones, fits what the adapalene label describes. New bumps in new places, itching, or bumps that keep getting worse after six to eight weeks are reasons to stop and check with a doctor. ### Should I squeeze or extract closed comedones? No. Closed comedones have no opening, so squeezing pushes material deeper. The AAD warns this increases inflammation and can cause scars and infection. A dermatologist can extract them with sterile instruments if treatment alone isn't enough. ### What if they don't respond to a retinoid? They may not be comedones. Small, uniform, itchy bumps on the forehead can be fungal acne, which doesn't respond to acne treatment. A dermatologist can check with a skin scraping, and can also prescribe stronger retinoids or other options. Amazon links on this site are affiliate links. This is general information, not medical advice.