Subclinical Acne: What It Is, Treatment Options, Prevention and More

• Subclinical acne is acne beneath the outer layer of skin that has not developed into open pimples.
• It appears as flesh-colored or red bumps, mostly on the forehead or cheeks.
• There are several over the counter and prescription treatment options available.

Subclinical acne appears as red or flesh-colored bumps that form when dirt, bacteria, oil, or dead skin gets trapped in pores beneath the skin.

Treatments include over the counter washes containing salicylic acid, prescription tretinoin creams, and home remedies such as aloe vera.

Following a good skincare routine is key to preventing subclinical acne.

What is Subclinical Acne?

Subclinical acne is acne that is just below the surface of the skin. It appears as a cluster of flesh-colored or red bumps. It forms when dirt, oil, or dead skin cells get trapped in a pore beneath the skin. Subclinical acne will often develop into open pimples if left untreated.

Because it has not yet broken through the skin, most sublinical acne is classified as closed comedones, or closed pimples. A whitehead is a type of subclinical acne, because there is a thin layer of skin still present on its surface.

However, a blackhead is considered an open comedone, as it is open to the air. Blackheads get their dark color and name because the dirt and dead skin cells trapped in the pore are not obscured by a layer of skin.

Where does it appear on the body?

Most subclinical acne appears on the face, particularly the forehead and cheeks. 

This is because the oil glands on the face are prone to overactivity, which can lead to more oil getting trapped in pores – leading to the development of a closed comedone.

In addition, failure to remove makeup from your face nightly contributes to the development of subclinical acne because these particles can clog your pores.

Causes of Subclinical Acne

Subclinical acne is caused by clogged pores. However, a number of things can contribute to clogged pores.

Overactive oil glands on the face can lead to an excess of sebum – or the oil released by these glands – which can clog pores. 

Hormonal imbalances is one cause of these overactive sebum glands. In general, younger people produce more sebum and therefore may have more oil-buildup on their face.

It is also very easy for dead skin cells,dirt, and bacteria to get trapped in pores, contributing to subclinical acne development – especially if you haven’t optimized your skin care routine.

For example, failing to remove your makeup nightly, change your pillowcase regularly, or wash your face regularly can all cause clogged pores.

There is also some evidence that a diet high in dairy or added sugars can contribute to subclinical acne.

Treating Subclinical Acne

Treatments for subclinical acne work by targeting the cause, clogged pores. 

Most of them help to unclog the pores by clearing out dead skin cells, targeting bacteria, and decreasing oil production.

There are several over the counter and prescription treatments, as well as natural remedies, available.

Over the counter products

Some of the best over the counter subclinical acne treatments include:

• Salicylic acid: A 1-2% salicylic acid cleanser can gently exfoliate your face, removing dead skin cells and clearing pores
• Retinoids: Retinoid gels containing retinol or adapalene are a good spot treatment for acne, removing dead skin cells from pores and reducing inflammation
• Benzoyl peroxide: Benzoyl peroxide washes can kill pore-clogging bacteria and increase skin cell turnover, lifting dead skin cells out of pores

While salicylic acid and benzoyl peroxide can show results as soon as 4-6 weeks, it can take up to 12 weeks to see improvements using a retinoid.

Prescription treatments

If over the counter treatments are not working, you can talk to your dermatologist about trying a prescription medication. Some prescriptions ingredients or medications that are effective against subclinical acne include:

• Tretinoin: A powerful retinoid cream, tretinoin can reduce inflammation, promote skin cell turnover, and lift dirt, dead skin cells, bacteria, and oil from clogged pores
• Birth control: For acne stemming from hormonal issues, some women benefit from going on birth control to regulate hormones
• Antibiotics: To manage acne-causing bacteria, a doctor may prescribe oral or topical antibiotics

Depending on the severity of your acne, a dermatologist may want to start you on a combination of these medications.

Natural remedies

If you want to go a more natural route, or if you are only dealing with mild subclinical acne, you may want to try a natural remedy.

There are many different natural remedies available, but unfortunately many of them have no evidence to support them.

Some of the most effective natural remedies for subclinical acne are:

• Green tea extract: Green tea contains a compound called epigallocatechin gallate, which can reduce acne lesions on the face
• Turmeric: The antioxidant curcumin found in turmeric can help treat subclinical acne by clearing out the pores
• Tea tree oil: Properly diluted, tea tree oil can improve subclinical acne lesions by killing harmful, acne-causing bacteria
• Cannabinoids: Marijuana extracts like cannabidiols (CBD) may improve acne by decreasing inflammation on the skin
• Propolis: An antibacterial, antioxidant component of honey, propolis can target the bacteria that cause acne and help reduce the severity and number of lesions
• Aloe vera: Aloe vera can increase the effectiveness of retinoid creams for acne and help ease the side effects of retinoids

Prevention

There are also some lifestyle changes you can make to help prevent subclinical acne.

Eating a diet rich in anti-inflammatory fruits and vegetables, low in sugar and starches, and low in dairy may help prevent acne.

However, the best way to prevent subclinical acne is to follow a solid skin care routine.

You should wash your face morning and night using a gentle cleanser and thoroughly remove all traces of makeup each night. Each night, use a toner to help close your pores after you remove your makeup.

However, it’s important to not scrub your face too hard because this can lead to inflammation and may increase your risk of acne.

You should also wash your pillowcase regularly to remove bacteria, dirt, and dead skin cells, and sleep with your hair pulled back to limit the transfer of oils from your hair to your face while you sleep.

Takeaway

Subclinical acne is comprised of closed pimples that are beneath the skin. This type of acne usually clusters on the face, especially the forehead or cheeks.

It can be caused by hormonal imbalances, overactive oil glands, or not washing your face regularly.

Luckily, there are many treatment options including over the counter treatments, prescription medications, and home remedies.

The best way to prevent subclinical acne is by faithfully sticking to a morning and evening skin care routine.