Different types of acne - Senile (solar) Comedones

Key points
Senile (solar) comedones are blackheads that appear around the eyes, quite commonly in elderly patients, especially those who have had a high exposure to sunlight during their life.  Ultraviolet radiation damage to the dermis can result in distension of sebaceous follicles with keratin blockage and comedone formation.

Hints to diagnosis
Blackheads around the eyes in elderly patients who have had a great deal of exposure to the sun during their life are diagnostic of senile or solar comedones.

Suggested first-line treatment
Topical benzoyl peroxide and/or comedonal extraction.

Suggested second-line treatment
Topical retinoids.

When to refer
The GP should refer if the lesions do not respond to treatment or become widespread.