Whiteheads 101: Why We Get Them and How to Get Rid of Them

• Whiteheads develop when pores become clogged with oil and dead skin cells
• Effective topical solutions include benzoyl peroxide, salicylic acid and alpha hydroxy acids
• Preventative measures include avoiding comedogenic skin products, gentle cleansing and regular exfoliation

Whiteheads and blackheads are two types of lesions that are categorized under the skin condition of comedonal acne. Whiteheads are plugged skin cells that have a thin film of skin over top; blackheads are exposed to air and acquire their dark color due to oxidation. Comedones are a form of noninflammatory acne.

Whiteheads vs. Pimples

Whiteheads are an accumulation of trapped sebum (oil) produced by the sebaceous glands, dead skin cells and debris. If left untreated, Cutibacterium acnes bacteria can propagate rapidly and cause inflammation and infection. Lesions then develop into red, swollen pus-filled pimples which are a symptom of inflammatory acne.

How to identify them

Whiteheads present as white or yellowish bumps under the skin and are small and firm to the touch; they are not inflamed or painful. 

Whiteheads are typically classified as a mild-to-moderate form of acne since there is no associated inflammation. However, acne is also categorized by lesion count and size; the greater the presence, the greater the severity. 

Whiteheads can also become infected and progress from tiny microdomes to large macrodomes if left untreated.  

What Causes Whiteheads?

Whiteheads develop when oil secretions and debris build up within pores and then form hard plugs. This is commonly seen when sebaceous glands become more active during hormonal fluctuations.

Puberty, pregnancy and menopause all cause hormonal changes. Fluctuations in androgen sex hormones trigger an increase in oil production.

Genetics and the immune system are thought to play a role in their development as well as some disorders such as polycystic ovarian syndrome. 

Affected areas

Whiteheads tend to develop where there is a high concentration of sebaceous glands. This includes the face, chest, back and shoulders.

Whiteheads on your face

The nose is most prone to whiteheads as the sebaceous glands in this area are larger than those on the rest of your face. 

Hormonal acne typically affects the lower third of the face, making the chin and jawline prime targets for whiteheads to develop.

How to Treat Whiteheads

Whiteheads can usually be healed with a combination of over-the-counter (OTC) skin care products that are designed to clear pores through different mechanisms of action. 

Over-the-counter treatments

Specific agents can be found in the form of  gels, masks, patches and cleansers to exfoliate, reduce oiliness and speed up skin cell turnover. 

Effective active ingredients

Active ingredients scientifically proven to be effective include benzoyl peroxide, salicylic acid and alpha hydroxy acids (AHAs) such as glycolic and lactic acid.

Active ingredient	How does it work?	Possible drawbacks
Benzoyl peroxide	Kills acne-causing bacteria; removes excess oil and dead skin cells	May irritate sensitive skin; may bleach hair and clothing
Salicylic acid	Prevents pores from clogging	Mild stinging, irritation
AHAs: glycolic and lactic acid	Removes dead skin cells and reduces inflammation; stimulates collagen production	Mild irritation, stinging; increased photosensitivity

Benzoyl peroxide

Benzoyl peroxide treats whiteheads by releasing oxygen into the clogged pore. This kills bacteria to prevent whiteheads from becoming inflamed. It’s also a keratolytic agent that can effectively break down deep-seated plugs. 

This medication is available in a variety of strengths. It’s best to start with a lower concentration as higher concentrations are not necessarily more effective and may irritate your skin. Benzoyl peroxide is also used in tandem with salicylic acid for optimal results.

Salicylic acid

Salicylic acid is known for its efficacy in acne treatment: In a recent customer preference review of OTC acne products, salicylic acid was chosen most often at 34.0%.

This acid is fat-soluble, therefore it can dissolve the oily debris that leads to whiteheads and can break down the bonds that hold dead skin cells together. Salicylic acid also decreases sebum production, leading to fewer breakouts.

It’s available OTC as an ingredient in creams, lotions, gels, peels and cleansers.

Alpha-hydroxy acids (AHAs)

AHAs act as chemical exfoliants. They loosen the bonds that hold dead skin cells together so the uppermost layer of skin sloughs off. This helps open clogged pores to release trapped debris in the hair follicles. 

With regular use, AHAs such as glycolic acid can prevent whiteheads from forming; for sensitive skin, lactic acid is a gentler option.

The use of AHAs intensifies photosensitivity, which increases the risk of sun damaging your skin. To protect yourself, use products containing AHAs at night and apply a high SPF sunscreen during the day.

Follow a consistent skin care routine

Keep whiteheads at bay by washing your face every morning and evening with a gentle water-based cleanser. Avoid scrubbing whiteheads, as this can cause irritation. Follow with a toner after washing to ensure you remove any remaining residue and your skin is fresh and clean.

Use an exfoliator 2–3 times a week to prevent the buildup of dead skin cells, or once a week if you have sensitive skin. After washing your face, pat dry and apply an oil-free moisturizer.

Home Remedies and Natural Treatments for Whiteheads

Several home remedies can be used to effectively treat whiteheads. While they might not work as quickly as OTC products, they’re inexpensive and likely already in your pantry.

Antibacterial and anti-inflammatory agents

Apple cider vinegar is both an antibacterial and astringent. Mix 1 tablespoon with 1 cup of water and apply over the affected area with a cotton ball; allow to rest for 20 minutes then rinse. 

Lemon juice can be diluted in a 1:1 ratio and used in the same manner. This all-natural remedy is not only antimicrobial and anti-inflammatory, but also an astringent to remove excess oil from skin.

Witch hazel, another antimicrobial and astringent, can be applied to the face directly with a cotton ball and allowed to dry. 

Tea tree oil has antibacterial and anti-inflammatory properties that can prevent whiteheads from progressing to inflamed pimples. It can also combat oiliness. One study of 5% tea tree oil produced significant improvements in both open and closed comedones. 

Tea tree oil should be diluted with water, applied to the affected area and allowed to dry.

Whitehead Extraction

With the right equipment and proper precautions, it’s possible to safely extract whiteheads with a comedo extraction tool, a small metal device with loops at one or both ends. 

If you don’t have this tool, you can also extract whiteheads using your fingers. Whatever the method, wash your hands or tools well with soap and hot water before doing so.

How to pop a whitehead

To pop a whitehead, use the smaller loop of the extractor tool. Center the loop around the whitehead and apply a gentle, even pressure; you may also use your fingers to apply pressure to both sides of the blemish. 

Do not use force; If the whitehead doesn’t expel its contents easily, then stop. Never break the skin as this increases the risk of infection.

Deeply rooted whiteheads

For whiteheads that are large or deeply rooted, apply warm compresses several times a day to loosen the blockage. Keep the area clean with a mild cleanser and spread a thin layer of antibacterial ointment on the area to prevent infection. 

If you have difficulty dislodging the contents or if it’s inflamed, consult a dermatologist for removal to avoid potentially damaging your skin.  

Whitehead Prevention

To prevent whiteheads, follow a skin care routine with products that target whiteheads and avoid using comedogenic skin and hair products.

If you have chronic whiteheads caused by hormonal fluctuations during your menstrual cycle, a birth control prescription may be an effective solution.

If your condition worsens, see a dermatologist who can prescribe a more aggressive treatment approach.

Takeaway

Whiteheads develop when pores become clogged with excess oil and dead skin cells. They can be treated and prevented by establishing a simple, effective skin care routine that includes active ingredients such as benzoyl peroxide, salicylic acid and AHAs. 

These products work to exfoliate skin, remove excess sebum and speed up skin cell renewal.

Whiteheads can also be addressed with all-natural remedies such as diluted apple cider vinegar, lemon juice, tea tree oil and witch hazel.

Should you choose to extract your whiteheads at home, use the appropriate tool and technique. Be careful not to break the skin, which can lead to infection.

If OTC solutions aren’t effective or if your condition worsens, seek the advice of a dermatologist. They’ll work with you to develop a regimen to treat your whiteheads effectively.