What are the other Names for this Condition? (Also known as/Synonyms)

• Senile Comedones
• Sun Acne

What is Solar Comedones? (Definition/Background Information)

• Solar Comedones is a benign skin condition that develops in middle-aged and older adults from long-term exposure to sunlight (ultraviolet radiation). It is characterized by the presence of skin lesions in the form of tiny blackheads or whiteheads, collectively called comedones
• The condition is also known as Sun Acne but is unrelated to “acne”. These flesh-colored lesions appear on the sun-exposed areas of the body, mainly on the face (on the temples and around the eyes). Solar Comedones are typically asymptomatic and do not form into fluid-filled lesions

Who gets Solar Comedones? (Age and Sex Distribution)

• Solar Comedones are common skin lesions generally observed in adults over 40 years of age
• According to medical literature, nearly 6% of the individuals above 50 years of age present Solar Comedones
• Both males and females are affected, although a higher number of cases are reported in men than women
• Worldwide, there is no racial or ethnic preference observed. However, individuals living in latitudes around the tropical regions and those in higher altitudes, may be at an increased risk for the condition

What are the Risk Factors for Solar Comedones? (Predisposing Factors)

The risk factors for Solar Comedones include:

• Chronic sun exposure: Exposure to sun for a long period (usually few decades)
• People living in tropical or subtropical geographical regions
• People living at higher altitudes
• Chronic smoking is also risk factor due to the long-term effects of tobacco smoke on skin
• Rarely, radiation therapy that is used in treating cancers

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Solar Comedones? (Etiology)

Solar Comedones is caused from prolonged exposure to the sun’s ultraviolet (UV) radiation for many years, resulting in chronic skin damage.

What are the Signs and Symptoms of Solar Comedones?

The signs and symptoms of Solar Comedones may include:

• Presence of numerous tiny comedones (raised lesions with plugged pores) - whiteheads and blackheads
• These lesions appear symmetrically, predominantly on the face (particularly around the eyes, cheeks, temples, and earlobes); other sites being the neck and arms
• The lesions are not inflammatory; there is no pain, itching, or burning sensation

How is Solar Comedones Diagnosed?

A diagnosis of Solar Comedones may involve the following exams and procedures:

• Physical examination of the skin (lesion) and medical history evaluation, including history of one’s work/occupation and smoking. This is usually sufficient to arrive at a diagnosis; although in rare cases, a biopsy may be performed
• Skin biopsy: A skin tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Solar Comedones?

The possible complications due to Solar Comedones may include:

• Emotional stress due to cosmetic issues
• Premature aging of the skin, especially in smokers
• Recurrence of the condition following treatment
• Increased risk for skin cancer

How is Solar Comedones Treated?

The treatment measures available for Solar Comedones include:

• Lifestyle changes that includes spending less time in the sun and smoking cessation
• Application of topical sun protection creams (oil-free sunscreens)
• Use of moisturizing creams for dry skin
• Use of topical retinoids
• Punch excision and suture closure
• Laser resurfacing
• Electrocautery
• Extraction of comedones using an instrument known as the “comedo expressor"

Regular follow up visits with the healthcare provider is important and recommended, to early detect any malignant transformations (skin cancers).

How can Solar Comedones be Prevented?

Solar Comedones may be prevented by considering the following steps:

• Avoiding prolonged and chronic exposure to the sun
• If this is unavoidable (like due to an occupational requirement), then taking safety steps to reduce exposure to the UV rays, such as by using sunscreens with high sun-protection factor, wide-brimmed hats, and protective clothing
• Being aware of the hazards of prolonged sun exposure and taking steps to protect oneself. Modifying one’s profession to stay out of the sun during the period, when it is most intense
• Keeping oneself well-hydrated if sun-exposure for prolonged periods is unavoidable
• Cessation of smoking, including secondhand exposure to tobacco smoke is important

What is the Prognosis of Solar Comedones? (Outcomes/Resolutions)

The prognosis of Solar Comedones is generally good with adequate treatment. The condition is typically benign and non-inflammatory. However, it is difficult to prevent the formation of new Solar Comedone lesions.

Additional and Relevant Useful Information for Solar Comedones:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/