Solar comedo

What is a solar comedo?

A solar or senile comedo (plural comedones) is a small skin coloured papule found on the face of a middle-aged or older person. Soalr comedones affect areas that have been exposed to sunlight over a long period of time.

The comedones may be open (blackheads) or closed (whiteheads). They do not usually become inflamed. 

Solar comedones are not related to acne vulgaris. 

Solar comedones

Solar comedones

Solar comedones

Favre-Racouchot syndrome

Solar comedones and larger pseudocysts occur in association with solar elastosis, which causes yellowish, leathery skin and deep furrows. This appearance is also known as Favre-Racouchot syndrome. It may affect the skin around the eyes, the temples and the neck. Favre-Racouchot syndrome is thought to be due to a combination of sun exposure and heavy smoking.

Favre-Racouchot syndrome

Solar comedones

Solar comedones

Solar comedones

Image from Dr S Janjua

Image from Dr S Janjua

Management of solar comedones

• Use sun protection and apply oil-free sunscreen to exposed skin
• Stop smoking
• Wash affected areas twice daily with mild soap or cleanser and water
• Apply retinoid cream to affected areas at night (this requires a doctor's prescription)
• Apply light moisturisers if the skin is dry (dryness may be aggravated by the retinoid)
• The contents of the comedones can be squeezed out gently using a "comedo expressor", an instrument which can be purchased at a pharmacy.

If these measures are unhelpful, the comedones can often be removed by electrocautery or laser ablation. They may recur and require further treatment from time to time.