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. 

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.

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.