How to get rid of whiteheads on the face

Is the bump actually a whitehead?

A whitehead is a small white or skin coloured bump caused by a closed, blocked pore. Oil and dead skin cells build up inside the follicle, the opening that contains a hair and an oil gland. Dermatologists call these closed comedones. Acne made up mostly of these blocked pores is called comedonal acne, and it often affects the forehead and chin.245

A raised, inflamed spot with a white or yellow centre can instead be a pustule, which contains pus. A large, painful lump deep under the skin is not a simple whitehead and needs medical treatment. Distinguishing these matters: a routine for mild blocked pores is not enough for deep, painful acne.12

Which treatment should you choose?

For mild acne you are treating yourself, choose one active treatment and follow its directions rather than adding several at once. A bathroom shelf full of treatments is not a treatment plan; start with one product rather than assembling a committee. A retinoid plus a benzoyl peroxide wash is another approach used for whiteheads, but ask a pharmacist or doctor before combining benzoyl peroxide with other acne medicines.126

How to build your daily routine

1. 1Cleanse gently in the morning and evening. Use a mild cleanser that does not dry your skin, and wash after exercise. Avoid scrubbing and repeated washing throughout the day.
2. 2Remove makeup at the end of the day. Do not leave it on overnight or try to compensate with a harder scrub the next morning.
3. 3Apply your chosen acne treatment as directed. For a treatment that stays on the skin, use a thin layer over the whole affected area, not just individual visible bumps. This treats existing acne and helps prevent the next breakout.
4. 4If you use a topical retinoid, apply it at bedtime according to its label or prescription. General retinoid guidance is once daily, but the directions for your particular medicine take priority.
5. 5Use moisturizer and sunscreen during the day when using a retinoid. Moisturizer helps with dryness, and sunscreen protects against the increased sun sensitivity these medicines can cause.

Water based cosmetics and skin creams are also options. A suitable cleanser supports treatment, but repeatedly washing a blocked pore is not a substitute for acne medicine.34

How to use benzoyl peroxide

Benzoyl peroxide comes in products you leave on and washes you rinse off. Start with the lowest available strength. For adult acne, 2.5% is a recommended starting strength to reduce dryness, irritation and burning. Follow the packet for frequency; benzoyl peroxide is usually used once or twice daily. Using more than directed will not make it work faster.16

1. 1Wash your hands before applying benzoyl peroxide.
2. 2For a gel that stays on, gently clean and dry your skin, then apply a thin layer to the affected area.
3. 3For a gel wash, wet the area, wash with a small amount for one to two minutes, then rinse and pat dry. Follow your own product's directions if they differ.
4. 4Wash your hands afterwards.

Keep benzoyl peroxide away from your eyes, mouth, broken skin and infected skin. It can bleach hair, towels and clothing. Use sunscreen, limit time in the sun and avoid sunbeds because benzoyl peroxide increases sun sensitivity. Check with a pharmacist before adding it to an existing prescription acne routine.6

What if your skin is sensitive?

Topical retinoids can cause dryness, redness, peeling and irritation, especially near the eyes or lips. They can also worsen eczema. Among topical retinoids, adapalene is less irritating than tretinoin, and cream formulations are generally less irritating than gels. These differences can help guide a discussion with a pharmacist or dermatologist when choosing a medicine or formulation.7

Benzoyl peroxide irritation often improves when used less frequently. Ask a pharmacist or doctor about side effects that bother you or do not go away. Stop using benzoyl peroxide and seek emergency help for difficulty breathing or a swollen throat or tongue, which can signal a serious allergic reaction.6

If you are pregnant or trying to become pregnant, get medical advice before starting acne treatment yourself. Some topical retinoids cannot be used during pregnancy. Benzoyl peroxide can usually be used during pregnancy, but check first. If breastfeeding, ask a pharmacist or doctor before using benzoyl peroxide and do not apply it to the breasts.167

How long does clearing whiteheads take?

Expect weeks rather than overnight removal. Effective acne treatment can produce fewer breakouts in four to eight weeks, with clearing around 16 weeks. Retinoids can take 12 weeks or longer to show improvement. At six to eight weeks, assess whether fewer new bumps are appearing rather than expecting every existing bump to have disappeared. Persistent whiteheads can justify a dermatologist appointment at that point.127

Comedonal acne often needs ongoing treatment, sometimes for years. Clearing the current bumps does not necessarily mean treatment is finished. Continue according to the product directions or your clinician's plan, rather than repeatedly stopping and restarting whenever a bump appears.5

What should you avoid?

Do not squeeze, scratch or pick whiteheads. These actions can cause infection, delay healing and leave scars. Avoid abrasive scrubbing, greasy cosmetics and frequent touching or rubbing of the face. If your hair is oily, shampoo regularly and keep it away from your face. Oily hair products can contribute to acne, so consider what touches your forehead as well as what you apply directly to it.4

When should you see a doctor?

Get medical help sooner for deep painful lumps, scarring, lots of spots, worsening acne or hot, swollen skin that could indicate infection. Acne affecting your mental health also deserves treatment. For stubborn whiteheads, a dermatologist can offer prescription treatment or professional comedone extraction. Extraction is a medical option for persistent blocked pores, not a reason to squeeze them yourself.23