Acne: macrocomedones

LAST UPDATED: Aug 02, 2021

Introduction

Macrocomedones can be regarded as a variant of acne if found in isolation, or part of a more classical acne vulgaris if found with other signs of acne.

This chapter is set out as follows:

Clinical findings
Images
Management

Clinical findings

Macrocomedones are effectively large whiteheads
They are more frequent on the face than the chest

Clinical Images

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Management

Macrocomedones are best treated by gentle cautery, using a topical anaesthetic, given by someone familiar with the technique

Patients with associated moderate-severe acne, needing isotretinoin, should get the macrocomedones treated before commencing isotretinoin otherwise a severe inflammatory response can develop

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