- Blackheads and whiteheads are types of acne that form when oil, dead skin cells and bacteria block pores.
- Whiteheads develop under the skin’s surface and present as small white bumps; blackheads remain partially open and are a type of acne lesion.
- A variety of acne treatments are available to try at home, including over-the-counter topical skin care solutions.
- Prevention is possible with a skin care routine that cleanses and gently exfoliates.
Blackheads and whiteheads are the result of clogged pores or follicles. Our skin follicles contain sebaceous glands that produce natural oils, known as sebum. Sebum protects the skin and helps keep it moisturized. Over time, sebum can combine with dead skin cells and bacteria, leading to clogged pores.
Hormones, medication, some types of makeup and genetics are all factors that contribute to excess oil production and clogged pores.
Although the underlying causes of blackheads and whiteheads are similar, these forms of acne do differ.
What Causes Blackheads to Appear?
A blackhead, or open comedo, is the result of a clogged pore that pushes to the surface of the skin and remains open. The open comedones get their black color from the dead skin cells in the open pore reacting with oxygen in the air. The black color is often erroneously confused with trapped dirt.
Blackheads appear most frequently on the face, back, shoulders, chest, arms and neck because there are more hair follicles and oil glands in these areas.
How Do Whiteheads Differ from Blackheads?
Unlike a blackhead which remains open, whiteheads are covered by the skin and have a white or yellowish head. They are also known as closed comedones.
Whiteheads can appear anywhere on the body but commonly occur on the face, neck, chest, shoulders and upper back as there are more sebaceous glands in these areas.
Whiteheads vs. pimples
Whiteheads, blackheads and pimples are all various forms of acne. Pimples occur when a blocked pore becomes inflamed or infected. The pimple forms because blood flow increases as part of the body’s immune response to defend itself against the acne.
Blackheads and Whiteheads on the Nose
The nose is more vulnerable to blackheads and whiteheads because it is part of the T-zone. The T-zone refers to the central part of the face that includes the forehead, chin, nose and the area circling the mouth. This region has a high concentration of oil glands, which can lead to oil buildup.
Since acne feeds on excess oil, the nose along with other areas of the T-zone are particularly vulnerable to developing forms of acne.
Blackhead and Whitehead Removal at Home
There are many over-the-counter (OTC) remedies to clear up blackheads and whiteheads. Some patience and perseverance are needed, as it can take six to eight weeks for a treatment to work. If you don’t see an improvement after ten weeks, it is recommended to try a new product.
The acne treatments below work by reducing inflammation, by killing bacteria and by regulating skin regeneration and sebum production in the pore to prevent blockages. Combined, these treatments result in fewer blackheads, smaller-looking pores, less redness and more even-toned skin.
Benzoyl peroxide prevents the spread of bacteria, in addition to removing some of the oil and dead skin cells that clog pores. Benzoyl peroxide should be considered as first-line treatment in mild acne. It is available in different strengths ranging from 2.5% to 10% and in the form of lotions, gels, cleansers, creams and washes. Begin with the lowest strength and slowly increase as needed.
Sulfur has been shown to have antibacterial properties that combat acne-related bacteria. Cleansers with 3% sulfur have a keratolytic agent that helps with mild exfoliation and can reduce the irritation that is sometimes associated with topical acne treatments. The keratolytic nature of sulfur, in particular, helps break down the keratin in the skin to stop dead skin buildup and clogged pores.
Salicylic acid is a type of exfoliate that works by loosening the bond between dead and living skin cells. In doing so, it permits oils to flow freely from pores as opposed to getting trapped and causing clogs. Concentrations typically vary from 1% to 4% and work quickly.
Retinoids are medications that have vitamin A, an ingredient known to reduce inflammation, stabilize skin cell regeneration and reduce sebum production. Retinoid help prevent the accumulation of dead skin cells within the follicle that can create blockages.
Prevent Blackheads and Whiteheads from Appearing
Follow these preventative measures to help prevent blackheads and whiteheads from forming:
- Wash your face morning and evening, and after activities that cause perspiration.
- Shampoo hair regularly.
- Only use oil-free or non-comedogenic skin care products, as these will not clog pores.
- Avoid touching your face as this can cause flare-ups.
- Use gentle products and refrain from scrubbing skin abrasively.
Step-by-Step Skin Care Routine to Tackle Whiteheads and Blackheads
A recent study published in 2017 in Clinical, Cosmetic and Investigational Dermatology demonstrated the efficacy of a twice-daily, three-step, OTC skin care regimen for the treatment of acne.
Follow this regimen every morning and evening to treat and prevent new whiteheads and blackheads from forming. When following these steps, always avoid the eye area as well as contact with eyes.
- Step 1: Cleanser – Wet face. Use fingertips to massage a coin-sized amount of cleanser onto the face. Once lathered, rinse thoroughly with lukewarm water; pat dry.
- Step 2: Toner – Look for a toner containing ethoxydiglycol and witch hazel. Apply evenly to face; do not rinse off.
- Step 3: Treatment – Apply acne treatment evenly over problem areas. Do not rinse off; allow to dry.
- Do use sunscreen and makeup products that are oil-free, non-comedogenic or non-acnegenic, which are formulated to reduce pore blockages.
- Do wash makeup brushes with antimicrobial soap as makeup applicators can store bacteria.
- Do launder pillowcases and sheets often.
- Don’t pick, pop or squeeze. This leads to more bacteria being distributed, inviting more acne and scarring.
- Don’t stress out. Stress can trigger hormones and worsen acne
- Don’t wear makeup every day. At least once a week, take a day to let your skin breathe and heal.
- Don’t visit tanning salons or subject your skin to excessive sun exposure.
It’s normal to have dead skin cells and oil in your pores. However, it is important to clear clogged pores before they can develop into blackheads and whiteheads.
Blackheads and whiteheads can be successfully treated with OTC acne products. For best results, combine a twice-daily skin care regime with acne treatments that contain sulfur, benzoyl peroxide, salicylic acid and/or retinoids. Lastly, try and incorporate the key do’s and don’ts into your daily routine.
- Purdy, S., & de Berker, D. (2011). Acne vulgaris. BMJ clinical evidence, 2011, 1714. ncbi.nlm.nih.gov/pmc/articles/PMC3275168/
- Decker, A., & Graber, E. M. (2012). Over-the-counter Acne Treatments: A Review. The Journal of clinical and aesthetic dermatology, 5(5), 32–40. Retreived from ncbi.nlm.nih.gov/pmc/articles/PMC3366450/
- Das, S. & Reynolds, R.V. Am J Clin Dermatol (2014) 15: 479. doi.org/10.1007/s40257-014-0099-z
- Rodan, K., Fields, K., & Falla, T. J. (2017). Efficacy of a twice-daily, 3-step, over-the-counter skincare regimen for the treatment of acne vulgaris. Clinical, cosmetic and investigational dermatology, 10, 3–9. doi:10.2147/CCID.S125438