Many a times you are worried about few, some or many White heads or Blackheads. Medically these are called Comedones.

Actually, these are a form of Acne (or Pimples).

Mild form of acne contains only comedones with or without some papulopustules.

Comedones are commonly divided into:

1. Microcomedones

- Not visible by naked eye.

- seen under microscope

- all big acne starting point is this.

- i.e. why medicine need to applied on full area rather than apparent spots.

2. Closed (Whiteheads) and Open (Blackheads) comedones

Pictorial description of white and Blackheads  

3. Sandpaper Comedones

- very small , almost confluent closed comedones

-mainly on forehead

- difficult to treat;shows delayed response to treatment

- may become red in initial stages of treatment

4. Macrocomedones

Macrocomedones are >1mm

- Blackheads/more commonly whiteheads >1mm in size

- may be a cause of slow and poor response to treatment

- can be a cause of flare up during treatment

- gentle cautery is done usually to remove.

5. Missed Comedones

- visualised by stretching the skin with a good light at an angle;

-another cause for applying creams to full area.


Comedones are treated in its mild form by topical creams like retinoids , benzoyl peroxide, Salicylic acid etc.

Resistant acne or a rapid response may need oral treatments  like antibiotics, retinoids; chemical peels, Radiofrequency/cautery/ mechanical removal of comedones.

A flare up is expected response sometimes in first 4-8 weeks of treatment;

All treatment must be taken under supervision of dermatologist.