Whiteheads around the nose: what helps and how to treat them

Is the bump actually a whitehead?

A whitehead is a small raised bump that looks white, yellowish or skin coloured. The pore is closed, which is why whiteheads are also called closed comedones. The nose is one of the common places they appear. A whitehead can be slightly tender or cause no discomfort. A swollen pimple with a white or yellow pus filled centre is a pustule, not the same thing as a closed whitehead. Blackheads have an open pore and a dark top. Deep, painful lumps are another type of acne and need a different treatment approach. Colour alone is not enough to put every bump in the whitehead category.1456

Why do whiteheads keep appearing?

Each pore opens into a hair follicle containing an oil gland. Oil normally helps keep skin soft, but a mixture of oil and skin cells can block the follicle. Bacteria trapped in the blockage can trigger inflammation. Hormonal changes, including those around puberty and periods, can make skin oilier. Heavy sweating, humidity, frequent rubbing and greasy cosmetics or hair products can also contribute. Acne can run in families, and certain medicines can trigger it. If breakouts started after a medicine change, ask your prescriber about the connection rather than changing the medicine yourself.37

Which treatment should you choose?

For mild adult acne, start with one product containing an active ingredient suited to your blemishes. Salicylic acid is particularly useful for whiteheads and blackheads. Adapalene treats both clogged pores and pimples. Follow that product's instructions rather than giving every acne treatment the same schedule.2

Retinoids are medicines related to vitamin A that help break up whiteheads and prevent clogged pores. They can cause peeling or changes in skin colour. Using a retinoid every other day or alongside a moisturizer can reduce these effects. Adapalene is available without a prescription in some markets; local availability differs. Benzoyl peroxide comes in washes and products left on the skin. Lower concentrations and wash formulations are less irritating. A benzoyl peroxide wash can also be part of treatment for whiteheads, but there is no need to start several new products together.145

How to treat the area around your nose

1. 1Cleanse gently in the morning and evening. Use a mild cleanser and avoid scrubbing the sides of your nose or repeatedly washing the area.
2. 2Remove makeup at the end of the day. You can continue wearing makeup, but choose products labelled noncomedogenic, meaning formulated to avoid clogging pores.
3. 3Use your chosen acne treatment as directed. For medication left on the skin, apply a thin layer across the affected area rather than treating only individual visible bumps.
4. 4Use moisturizer routinely. If a retinoid causes peeling, using moisturizer alongside it or applying the retinoid every other day can reduce side effects.
5. 5Keep the treatment consistent. For mild adult acne, try one active product for six to eight weeks before adding another, unless side effects require a change.

Makeup can stay in your routine, but it does not get an overnight tenancy.17

What helps prevent more clogged pores?

Choose oil free cosmetics and avoid greasy creams. Noncomedogenic products are a useful choice, not a promise that a particular formula will suit every face. Keep hair products away from your face, and wash oily hair regularly. Hair products belong in the hair routine, not in a supporting role on your nose. Avoid repeatedly touching or rubbing the area. Clean items that touch your face, including sunglasses and pillowcases, and be careful around whiteheads when shaving. Once a treatment helps, continuing it can be necessary to keep comedonal acne under control.147

How long does treatment take?

An individual whitehead can go away on its own, sometimes within seven days. Preventing repeated breakouts takes longer: effective acne medication can produce fewer breakouts in four to eight weeks, with clearing around 16 weeks. Comedonal acne treatment can take several weeks to months to produce worthwhile improvement. If whiteheads remain after six to eight weeks, a dermatologist can assess whether you need a prescription treatment or professional extraction. Extraction is a medical procedure for removing persistent clogged pores, not a reason to squeeze them at home.1245

What should you avoid?

Do not squeeze, scratch or pick whiteheads. Pressure can damage skin, introduce infection, delay healing and cause scars. Scrubbing can irritate skin and worsen acne. Acne products can cause redness, dryness or excessive peeling. If irritation develops, ask a pharmacist or clinician how to adjust the treatment rather than adding more exfoliation. Benzoyl peroxide can bleach towels and clothing, so keep that in mind during application.7

When should you get medical help?

If you are pregnant or trying to become pregnant, consult a dermatologist before treating acne yourself. Some treatments available without a prescription are not safe during pregnancy. See a doctor for deep or painful lumps, numerous spots, scarring, worsening acne or treatment that is not helping. Hot, swollen, red skin can be a sign of infection; redness can be harder to see on brown and black skin. Persistent dark marks after acne also warrant a dermatologist's advice. Get help if breakouts are affecting your mental health, even if the affected area is small.26