How To Treat Subclinical Acne: 7 Tips From Derms + What Causes Those Bumps
If skin concerns typically fall under a categorical umbrella, consider acne a giant, shady parasol. There are so many types of bumps—ranging from inflamed zits to cysts to whiteheads—not to mention a bunch of monikers that, when you break them down, are really cut from the same cloth.
Here's one that people often misunderstand: subclinical acne. Let's unpack what this subgroup really means, what it looks like, and how to treat the pesky bumps.
What is subclinical acne?
Essentially, it's a fancier word for congested skin. "This is not a term we use in dermatology," says board-certified dermatologist Hadley King, M.D. "But I see that it is occasionally used in lay media." Although, the term subclinical can spark some confusion: Many hear "sub" and think it refers to those painful, cystic pimples that live underneath the skin, when these types of bumps really align with noninflammatory acne—also known as comedonal acne, whiteheads, or sebum plugs.
"They are nonpainful and usually do not lead to scarring or skin discoloration," says Ife Rodney, M.D., a board-certified dermatologist and founder of Eternal Dermatology. "[In dermatology], you'll hear the term comedonal acne rather than subclinical acne." The flesh-colored bumps never seem to come to a "head," but they can progress into pimples or pustules if they become inflamed—which can happen if they're left untreated.
And while this type of acne can crop up anywhere you have pores, Rodney says they tend to appear on the forehead, chin, and nose (where people tend to accrue the most oil), as well as the chest, back, or shoulders.
Subclinical acne has a slew of causes (they're simply clogged pores, which can happen for many, many reasons), but here are a few common culprits:
- Comedogenic products: "Often heavy products with oils can worsen or cause this type of acne," board-certified dermatologist Jennifer Herrmann, M.D., tells mbg about closed comedones. This refers to skin care, yes, but also makeup and hair care products, too—anything that touches your skin on the regular.
- Not cleansing correctly or enough: If you aren't diligent about face-washing (or forget to cleanse certain areas, like around the hairline), all the dirt and grime from the day can accumulate in your pores and lead to buildup.
- Genetics: "Genetics is the most common cause," says Rodney. "Some people are more prone to subclinical acne than others." In other words: It simply may be out of your control.
- Lifestyle factors, like diet and stress: It's worth evaluating your diet, as what you consume internally can show up on the skin. In terms of stress, an uptick in cortisol (that's the stress hormone) has been linked to increased oil production, which can contribute to clogged pores.
How to treat it.
Considering subclinical acne can lead to inflammatory pustules down the line, it's important to get a leg up on treatment. Plus, a cluster of comedones can cause textural issues, like bumpy, uneven skin.
1. Use salicylic acid.
This beloved BHA is oil-soluble, which, according to Rodney, means it can "penetrate deep into the sebaceous glands (oil glands) and hair follicles to break up the pore-clogging debris" (aka, exactly what causes those comedones to form).
King seconds the advice: "It exfoliates the surface of the skin and penetrates into pores to remove oil. This helps to prevent pores from becoming clogged and can help remove clogs that have already formed." Slather on a cleanser, mask, or leave-on treatment with the BHA—just be mindful not to overexfoliate, as this can cause those bumps to form.
2. Try benzoyl peroxide.
Or you could opt for benzoyl peroxide, which can kill acne-causing bacteria and help break up pore-clogging agents, like dead skin cells. That said, it's like a one-two punch for inflammatory acne (your angry pustules, cysts, and pimples) as well as comedonal acne (like blackheads or subclinical acne). Again, you can find benzoyl peroxide in a number of skin care products, from cleansers to treatments (check out our picks here).
3. Apply retinoids.
"Topical retinoids have a comedolytic effect, meaning that they help to prevent and treat clogged pores," King explains. "This is because they increase the turnover of skin cells and reduce the tendency of cells and keratin debris to clump together." You'll need to consult a derm for a prescription-strength product, or you can snag an OTC retinol (here are our favorites).
4. Stick to noncomedogenic products.
Since subclinical acne really just means clogged pores, you'll want to avoid pore-clogging ingredients. Of course, everyone's skin is different, so you may face congestion from certain formulas others may swear by. (Example: Some people hail coconut oil for its moisturizing and skin-softening capabilities; others find it way too heavy for their skin.)
It may take a bit of detective work to decipher which products you should probably avoid, but it's certainly something to keep in mind. Don't forget about makeup and hair care products, too!
5. Properly cleanse your face after sweating and wearing makeup.
6. See a dermatologist.
It's always helpful to see a professional who can I.D. your bumps and give you a more targeted plan of action. Plus, says Rodney, a derm can offer more medical-strength treatments, like a chemical peel or microdermabrasion, to help unclog all that debris.
7. Don't pick!
As tempting as it may be to pop or squeeze the comedones, do try to keep finicky fingers at bay. "[Picking] prolongs healing time and increases the risk for inflammation, infection, scarring, and discoloration," says King, making the irritated hair follicles only look more raised. Again, you may want to see a derm who can safely perform extractions.
Subclinical acne is really just another way to describe clogged pores before they become inflamed, just like whiteheads, sebum plugs, and closed comedones. And while it can have a host of causes (the most common being heavy, comedogenic products and genetics), there's a lot you can do to manage this acne subgroup.
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