Whiteheads on your face: what they are and how to treat them

What do whiteheads look like?

Whiteheads look like tiny, raised white or flesh coloured bumps. Several together can give skin a rough texture, and the surface over the blocked pore stays intact. Whiteheads can be flesh coloured rather than bright white, because even acne naming has a small print problem. A raised, inflamed spot with a white or yellow pus filled centre is a pustule, which is a different acne blemish. Deep, tender lumps are not ordinary whiteheads either. You can have whiteheads, blackheads and inflamed spots at the same time, so the colour of a bump alone does not identify every breakout.1345

What is the medical term for whiteheads?

One whitehead is a closed comedo; several are closed comedones. Comedones are clogged pores, and "closed" means the skin surface over the blockage is intact. Whiteheads are a type of acne, not a separate condition that needs its own category of skincare. An open comedo is a blackhead. The open or closed distinction describes the pore's surface, not how severe your acne is.13

What is the difference between blackheads and whiteheads?

Blackheads darken when the material inside the pore reacts with oxygen in the air, which gives the name more drama than the chemistry deserves. The dark colour is not dirt. Scrubbing does not solve the blockage and can make acne worse.12

Why do whiteheads keep appearing?

Each pore opens into a hair follicle containing an oil gland. A whitehead forms when oil and skin cells accumulate into a plug and the pore closes over it. Hormonal changes can make skin oilier, including during puberty, periods and pregnancy. Greasy cosmetics and hair products, heavy sweating, humidity and repeated rubbing or touching can also contribute to acne. Some medicines can trigger or worsen acne. Acne is most common in teenagers, but adults get it too, and it can run in families. If bacteria become trapped in a blocked pore, the immune system can react and an inflamed pimple can develop.45

How do you remove whiteheads?

For whiteheads and blackheads, a retinoid is a recommended treatment to unclog pores. Adapalene is one retinoid available without a prescription in some markets. A benzoyl peroxide wash can also help reduce acne bacteria. Salicylic acid is another acne treatment available from pharmacies. Ask a pharmacist to help choose a treatment rather than starting several together. Picking at whiteheads can cause more whiteheads and scars. Squeezing, scratching and rubbing acne can also cause infection and slower healing. Stubborn comedones can sometimes be removed through professional extraction by a dermatologist; prescription acne treatment is another option.1245

How to build a routine for whiteheads

1. 1Wash gently morning and evening with a mild cleanser. Avoid scrubbing and repeated washing. Clean your skin after exercise as well.
2. 2Apply your chosen acne medicine according to its packet or prescription. Use it sparingly; the right amount and frequency depend on the product.
3. 3Choose noncomedogenic skincare and makeup, meaning formulas designed not to clog pores. Water based cosmetics and skin creams are also options.
4. 4Remove makeup at the end of the day rather than leaving it on overnight.
5. 5If your hair is oily, shampoo it daily and keep it away from your face. Avoid greasy cosmetics or creams and unnecessary touching of your face.

Noncomedogenic products are less likely to clog pores in most people, which is a useful idea hidden inside a word that takes up half the label.4

How to use benzoyl peroxide

Start with the lowest available strength to check tolerance. Benzoyl peroxide is usually used once or twice daily. For a gel, gently clean and dry your skin, then apply a thin layer to the affected area. 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 before and afterwards. Follow your product's directions. Keep it away from eyes, mouth, infected or broken skin. Use sunscreen and avoid sunbeds. Benzoyl peroxide can bleach hair and fabrics.6

What if treatment irritates your skin?

Acne medicines can cause redness, dryness and peeling. Benzoyl peroxide can also cause itching or discomfort; using it less often can help. Ask a pharmacist or doctor about persistent or bothersome effects. Use benzoyl peroxide with other acne treatments only with their approval. Using extra does not speed results. Stop using it and get emergency help for throat or tongue swelling or difficulty breathing.46

What about pregnancy or breastfeeding?

Benzoyl peroxide can usually be used during pregnancy, but check with your doctor. Check with a pharmacist or doctor before using it while breastfeeding, and avoid applying it to your breasts. Oral isotretinoin must not be taken during pregnancy because it causes severe birth defects.46

How long does treatment take, and when should you get help?

Give whitehead treatment six to eight weeks to work. Benzoyl peroxide usually starts working within four weeks; get advice if acne worsens or has not improved after twelve weeks. Persistent whiteheads after six to eight weeks are a reason to discuss prescription treatment or extraction with a dermatologist.26

Get medical help sooner if you have lots of spots, deep painful lumps, worsening acne or scars. Hot, swollen, red skin can signal infection; redness can be harder to see on brown and black skin. Acne that affects your mental health also deserves treatment. A doctor can assess the blemishes and offer prescription treatment or refer you to a dermatologist. You do not need to wait for scarring before seeking help.5