Harry is an 85 year old man who presents with “blackheads” on his face, on a background of 40 years of smoking and sun exposure.

Management of Senile Comedones

• Use sun protection
• Stop smoking
• Wash affected areas twice daily with mild soap or cleanser and water
• Apply retinoid cream to affected areas at night
• Apply light moisturisers
• The contents of the comedones can be squeezed out gently using a “comedo expressor”.

If these measures are unhelpful, the comedones can often be removed by electrocautery or laser ablation. They may recur and require further treatment from time to time.

More reading

https://www.dermnetnz.org/topics/solar-comedo/