Solar or senile comedones arise on the face of the middle-aged and elderly. They affect areas that have been exposed to sunlight over a long period of time, particularly the cheeks, which may become yellow and leathery (solar elastosis).
The comedones may be open (blackheads) or closed (whiteheads). There may also be larger cysts.
Solar comedones are not related to acne vulgaris and do not usually become inflamed. They are however very persistent.
Solar comedones in association with elastosis (yellowish thickening and furrows) is also known as Favre-Racouchot syndrome. It may affect the skin around the eyes, the temples and the neck. It is thought to be due to a combination of sun exposure and heavy smoking.
- 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 cautery, diathermy or laser treatment. They may recur and require further treatment from time to time.