A solar or senile comedo (plural comedones) is a small skin-coloured papule found on the face of middle-aged or older individuals. Solar comedones tend to affect actinically damaged areas that have been exposed to sunlight over long periods of time.
The comedones may be open (‘blackheads’) or closed (‘whiteheads’) and are usually not inflamed.
Solar comedones are not related to comedones found in acne vulgaris.
Solar comedones and larger pseudocysts occur in association with solar elastosis, which causes yellowish, leathery skin and deep furrows. This combination of findings is also known as Favre-Racouchot syndrome and tends to affect the skin around the eyes, the temples, and the lateral neck. Favre-Racouchot syndrome is thought to be due to a combination of sun exposure and heavy smoking.
Deep linear furrows on the posterior neck due to solar elastosis, called cutis rhomboidalis nuchae, may also accompany Favré-Racouchot.
Comedones may also be removed by electrocautery or laser ablation. However, they may recur and require further treatment from time to time.
