How to treat whiteheads on your face

Is the bump actually a whitehead?

A whitehead is a small white or skin coloured bump caused by a blocked pore whose opening has closed. The blockage contains excess oil and dead skin cells. Whiteheads are also called closed comedones. Acne consisting mainly of whiteheads and blackheads is called comedonal acne, and commonly affects the forehead and chin. A raised spot with a pus filled centre is a pustule, which is a different acne blemish even if its centre looks white.24

Which treatment should you choose?

For mild acne treated at home, choose one active treatment and follow its instructions rather than adding several at once. Retinoids are an established treatment for comedonal acne. Benzoyl peroxide can also form part of a whitehead treatment plan, but check with a pharmacist or doctor before combining it with other acne medicines. If choosing benzoyl peroxide, 2.5% is a suggested starting strength when available.156

How do you treat whiteheads?

Build the routine around cleansing, one acne treatment, moisturizer and sunscreen, rather than giving every bottle in the bathroom a speaking role.136

1. 1Cleanse gently morning and evening. Remove makeup at the end of the day, and avoid scrubbing.
2. 2Apply your chosen treatment as directed. For a treatment left on the skin, use a thin layer across the affected area rather than treating only individual visible spots.
3. 3If using a topical retinoid, apply it at bedtime according to its directions. These medicines are generally used once daily.
4. 4Use moisturizer to help with dryness, and sunscreen during the day. Retinoids and benzoyl peroxide can increase sensitivity to sunlight.
5. 5Continue the routine consistently. Do not introduce another acne treatment during the initial six to eight week trial unless a clinician advises it.

Oil free cosmetics are another option for comedonal acne. Greasy skin and hair products can contribute to acne, so consider what touches your face as well as what goes into your treatment routine.34

A benzoyl peroxide wash and gel have different directions

Benzoyl peroxide usually goes on once or twice daily, but follow your packet. For a gel left on the skin, wash your hands, gently clean and dry the area, then apply a thin layer. For a gel wash, wet the area, wash with a small amount for one to two minutes, then rinse and pat dry. Wash your hands afterwards. Keep it away from eyes, mouth, cuts and infected skin. It can bleach hair and fabrics.5

How long does clearing whiteheads take?

Fewer breakouts can appear after four to eight weeks, with clearing around 16 weeks when treatment works. Retinoids can take 12 weeks or longer to show improvement. Six to eight weeks is therefore a useful review point, not a deadline for completely clear skin. If whiteheads remain stubborn, a dermatologist can consider prescription treatment or professional comedone extraction. Comedonal acne often needs ongoing treatment, sometimes for years, rather than stopping as soon as the bumps improve.1246

Who should be careful with acne treatments?

Retinoids can cause dryness, peeling and irritation, particularly near the eyes or lips, and can worsen eczema. Adapalene is generally less irritating than tretinoin; cream formulations are generally less irritating than gels. Sensitive skin is a reason to discuss the formulation with a pharmacist or clinician, not to assume every retinoid will feel the same. If you are pregnant or trying to become pregnant, speak to a dermatologist before treating acne yourself. Some topical retinoids must not be used during pregnancy.16

Benzoyl peroxide can cause dry, peeling, itchy or painful skin. Using it less often can reduce these effects; seek advice if they persist or bother you. More product will not work faster. Stop using it and seek emergency help for throat or tongue swelling or difficulty breathing. Check with a clinician about use during pregnancy or breastfeeding, and do not add it to prescription acne treatment without advice.5

How do you treat whiteheads on your nose?

For genuine whiteheads on the nose, use the same pore clearing approach as elsewhere on the face. Treat the affected skin rather than squeezing each bump. Do not try to scrub a closed pore open: scrubbing can irritate skin and worsen acne. If you cannot tell what the bumps are, a dermatologist can assess them before you keep changing treatments.23

When should you see a doctor?

Get medical help if treatment is not improving your acne, or sooner for deep painful lumps, scarring, numerous spots or acne affecting your mental health. Hot, swollen or red skin can indicate infection and needs assessment. Redness can be harder to see on brown and black skin. Dark spots left after acne are also a reason to seek a dermatologist's help, particularly if new marks keep appearing.13