The 3 most important things to keep in mind when dealing with under-the-skin breakouts

Out of all the breakouts that I get, closed comedones make me especially angry. They’re like ghosts—you can kind of feel that they’re there, but it’s really hard to figure out how to get rid of them. (You feel me on this?) That’s because closed comedones, unlike all the other types of acne we so amazingly have in this world, are not fully exposed on the surface of your skin yet. They’re not quite there, but you can definitely still feel them brewing… it’s as if they’re haunting you.

“A closed comedone, AKA a whitehead, is an accumulation of dead skin cells trapped within a pore,” explains Loretta Ciraldo, MD, FAAD, board-certified dermatologist and founder of Dr. Loretta Skin Care. “It’s covered with a layer of skin at the top, which is compared to an open comedone, or blackhead, where there’s no cover of skin and we see the black buildup of dead cells.”

Because its head isn’t present on your skin, it’s more difficult to treat topically. “Since it has a covering of skin, products don’t readily penetrate into it as they do open comedones,” says Dr. Ciraldo. “Even red pimples, because they’re inflamed, tend to have blood vessels around them that more readily absorb topical acne products.” Great! That’s not to say there’s no hope in nudging pesky closed comedones into the end of their life cycle, though. For one thing, retinol can help (of course it does). “Retinoid creams can help prevent these from forming,” says Adarsh Vijay Mudgil, MD, of Mudgil Dermatology. But when you’re smack in the middle of dealing with an under-the-surface zit, dermatologists say to keep three key things in mind:

1. Properly cleanse: Making sure to cleanse your skin is the first step in clearing gunk from your skin, which allows closed comedones to breathe (and then drink up acne-banishing topicals). “Try acne cleansers and leave-on products,” says Dr. Ciraldo, who recommends salicylic and glycolic acids to unglue the dead skin cells and help prevent new comedones from popping up. “Sometimes they even resolve closed comedones,” she says. Try a cleanser like La Roche-Posay Effaclar Medicated Gel Cleanser for Acne Prone Skin ($15) or Olehenriksen Find Your Balance Oil Control Cleanser ($26).

2. Do. not. pick.: It’s so tempting to push and pick around a closed comedone to try and get it to “pop” up. I’ve been there. But this makes things worse. “If you try to pick at them to express them, often they’ll spread more under the surface of your skin,” says Dr. Ciraldo, who points out that you can get infected or develop even more acne doing this. Dr. Mudgil adds that picking can result in more inflammation and scarring, too.

3. Hit the steam: While steaming your skin isn’t always a good thing (I’m looking at you, sensitive skinned friends), it can be helpful in this situation. “At home, try steaming your face, which will sometimes open a closed comedone to help express the dead cells within it,” says Dr. Ciraldo. You can also do this at your derm’s office (they can even extract it for you).

BTW, did you know that you can get the best retinol at the… drugstore? Yep, it’s true. And here’s what dermatologists have to say on how to prevent acne from happening in the first place.