Whitehead is the everyday name and closed comedone is the medical name.2
What are whiteheads?
A comedone is a plugged opening of a hair follicle. Closed comedones are small, raised bumps with skin covering the contents. They are not inflamed, tender or swollen, and several together can give skin a rough texture. Comedonal acne means acne made up of these clogged pores, including whiteheads, blackheads or both. You can also have comedones alongside inflamed pimples.134
| Blemish | What happens in the pore | What it looks like |
|---|---|---|
| Whitehead or closed comedone | Oil and dead skin cells form a plug beneath an intact surface. | A small, uninflamed white or skin coloured bump. |
| Blackhead or open comedone | The plugged pore stays open; exposed contents react with oxygen and darken. | A dark spot or bump. The dark colour is not dirt. |
| Pustule | Inflammation develops in a pore containing oil, dead skin cells and bacteria. | An inflamed, raised bump containing pus, often with a white or yellow centre. |
Whiteheads can be flesh coloured rather than white, because the name apparently skipped the colour check. Look at whether the bump is inflamed and contains pus, rather than using colour alone to decide what kind of acne treatment you need.2
What can you use for whiteheads on the face?
Retinoids are used to unclog pores. Adapalene is available without a prescription in some markets. A benzoyl peroxide wash can also help reduce acne bacteria. Other topical options for comedonal acne include salicylic acid, azelaic acid and glycolic acid. A pharmacist can help you choose an acne treatment; prescription treatment is another option when whiteheads are stubborn.456
How should you care for skin with whiteheads?
- Wash twice a day with a gentle cleanser. Do not scrub, because irritation can make acne worse.
- Choose skincare and makeup labelled noncomedogenic, meaning designed not to clog pores. Oily or greasy personal care products can contribute to clogged pores.
- Moisturize morning and night, and wear sunscreen daily.
- Remove makeup before bed.
- Do not pick or squeeze whiteheads. Picking can cause scars and more whiteheads.
How long does treatment take?
Give whitehead treatment six to eight weeks before deciding whether to seek further help for persistent blemishes. Noticeable improvement in comedonal acne can take eight to twelve weeks, and clearing can take several months. Treatment is not an instant emptying of every pore. Adult acne treatments often need to continue to maintain their effects, and comedonal acne can return over many years.457
Large closed comedones and whitehead extraction
Large whiteheads are called macrocomedones, which gives the size upgrade a considerably longer name. They are more common in adult acne than in younger people and often appear on the chin, cheeks and forehead. Large comedones can result in scarring, so persistent larger bumps deserve medical assessment rather than repeated attempts to squeeze them.7
A closed comedone needs its covering opened before the contents can be removed. Leave extraction to a qualified professional using sterile instruments. Home extraction can damage follicles, cause infection or scarring, and trigger more comedones or inflammatory acne. Professional extraction is an option for stubborn whiteheads, alongside prescription treatment.345
When should you see a doctor?
Get medical help if self treatment is not improving your acne, you have many spots, or bumps are deep, painful or leaving scars. Hot, swollen or red skin can indicate infection; redness can be harder to see on brown or black skin. Tell your clinician about medication side effects or acne affecting your mental health.46
Where this answer comes from
- 1Comedones: MedlinePlus Medical Encyclopediamedlineplus.gov
- 2Acne: Signs and symptomsaad.org
- 3Comedodermnetnz.org
- 4Comedonal Acne: Causes & Treatmentmy.clevelandclinic.org
- 5How to treat different types of acneaad.org
- 6Acnenhs.uk
- 7Adult acnedermnetnz.org
