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

• Whiteheads are clogged pores that have been closed over by skin
• They are largely caused by high levels of the hormone androgen
• To treat, use products containing benzoyl peroxide, salicylic acid and AHAs
• Prevent whiteheads by washing your face twice daily and exfoliating 2-3 times a week

Whiteheads vs Pimples

A pimple begins as a pore that has been clogged by oil and dead skin cells. Naturally occurring oil in your skin, called sebum, is produced by sebaceous glands inside the pore. When sebum is trapped inside, it starts to build up. If bacteria on the surface of the skin is also trapped in the pore, it becomes inflamed and a pimple develops. Whiteheads are not necessarily inflamed but left untreated, it can develop into pimples.

How to identify them

The term ‘whitehead’ specifically refers to a clogged pore that is closed over by skin – as opposed to a blackhead, which remains open. Whiteheads appear as white bumps that are sometimes yellowish in color. They’re small and firm and are sometimes not easily extracted.

Don’t confuse whiteheads with acne

Large quantities of whiteheads are symptoms of a mild form of acne vulgaris, a chronic inflammatory disease of the skin. However, acne does not always entail whiteheads while the occasional appearance of a whitehead does not mean that you have acne.

What Causes Whiteheads?

Whiteheads are often caused by the hormonal changes that occur at puberty. During puberty, the hormone androgen is produced in higher quantities. Increased androgen levels lead to excess oil production by the sebaceous glands.

Fluctuations in hormones due to menstruation, menopause and disorders, such as polycystic ovarian syndrome, can also lead to whiteheads and other forms of acne. Since whiteheads affect some people more than others, genetics and the immune system may play a role in their development.

Affected areas

Whiteheads tend to appear on areas of the body where the skin has more sebaceous glands. These include the face, chest, back and shoulders.

Whiteheads on your face

Your nose, chin and jawline are the areas of your face most prone to visible whiteheads. The pores and sebaceous glands of your nose are larger than those on the rest of your face, so when they get clogged, it tends to be more noticeable.

Hormonal acne often occurs on the lower third of the face, making your chin and jawline prime target areas for whiteheads to appear.

How to Treat Whiteheads

Whiteheads can usually be treated with a combination of over-the-counter treatments formulated with the right active ingredients. A rigorous skincare routine is also key to treatment and prevention of this condition.

Over-the-counter treatments

Scores of whitehead treatments can be purchased over-the-counter (OTC) in the form of gels, masks, patches and cleansers work in different ways to resolve the root causes that lead to whiteheads. These skin care products can exfoliate your skin, reduce oiliness, dissolve sebum and even improve skin cell turnover. It’s important to be discerning when you shop – be sure to choose products with active ingredients that are proven to work.

Effective active ingredients

Active ingredients scientifically proven to be effective treatments for whiteheads include benzoyl peroxide, salicylic acid and alpha hydroxy acids (AHAs) like glycolic and lactic acid.

Active ingredient	How it works	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 the growth of new skin	Mild irritation, stinging; increased photosensitivity

Benzoyl peroxide

Available in a variety of strengths, benzoyl peroxide treats whiteheads by releasing oxygen into the clogged pore. This kills the bacteria that causes acne and thus prevents the whitehead from developing into a pimple. Benzoyl peroxide may bleach hair and fabric so use with caution, especially if you apply it before going to bed.

It’s wise to start with a lower concentration of benzoyl peroxide. Higher concentrations are not necessarily more effective but may irritate your skin. Benzoyl peroxide is often used in tandem with salicylic acid to treat whiteheads.

Salicylic acid

Salicylic acid is ‘lipophilic’ or fat-soluble, meaning that it can dissolve the oily debris that causes whiteheads. This treatment has been proven effective as a peeling agent. It’s also available OTC as an ingredient in creams, lotions, gels and cleansers.

Alpha-hydroxy acids (AHAs)

AHAs act as a chemical exfoliant. They weaken the lipids that hold dead skin cells together so the uppermost layer of skin dissolves, exposing healthier skin below. By facilitating the removal of dead skin cells, AHAs like glycolic acid can treat whiteheads and with regular use, prevent them from occurring in the first place. Lactic acid is another AHA that works in much the same way to exfoliate your skin except it offers the additional benefit of lightening hyperpigmentation.

It’s important to be aware that the use of AHAs intensifies photosensitivity, which can increase the risk of sun damage to your skin. Be sure to apply adequate sun protection after using products containing AHAs.

Follow a simple skincare routine

Combat whiteheads by washing your face every morning and evening with a cleanser that is gentle enough for daily use. If you wear makeup, completely remove it every night before you go to bed. Be sure not to scrub whiteheads as this can risk irritating them further.

Use an exfoliator on occasion to prevent the build-up of dead skin cells. Two or three times a week is recommended for most people. However, those with sensitive skin may want to only exfoliate only once a week. After washing your face, pat dry with a towel (again, avoid scrubbing) and follow up with an oil-free moisturizer.

Home Remedies and Natural Treatments for Whiteheads

Much of the literature on the Internet would have you believe that your pantry is stocked with all-natural acne treatments and remedies for whiteheads. Unfortunately, the potential of these home remedies as effective treatments is doubtful at best.

Facial steaming

A mainstay of spa facials, steaming purports to open your pores, making extraction of whiteheads easier and allowing topical ingredients to penetrate more deeply into the skin.

However, your skin can easily be scalded by hot steam and enlarged pores are more susceptible to bacterial infection. While facial steaming may help rid you of individual whiteheads, it ultimately may be more harmful than good for the overall health of your skin.

Natural astringents

Apple cider vinegar and lemon juice are two household items commonly described as natural whitehead treatments. Theoretically, these acidic substances act as an astringent on your skin to dry up pores. However, there is no evidence that either can actually treat or prevent whiteheads.

Tea tree oil

A remedy that shows slightly more promise is tea tree oil. While this product might not actually cure a whitehead, its anti-bacterial and anti-inflammatory properties may prevent the whitehead from developing into a full-blown pimple. Studies have shown that it reduces acne lesions, but the link is far from definitive.

Whitehead Extraction

Whitehead extraction is possible with the right equipment and precautions taken to avoid damaging the skin. A clogged pore or ‘comedo’ extraction tool is a small metal device with loops at one or both ends. It’s often called a blackhead extractor but can be used on whiteheads as well.

If you don’t have a comedo extractor, you can attempt to extract the whitehead with clean fingers. Whatever the method, wash your hands well with soap and hot water before extracting.

How to pop a whitehead

To pop a whitehead, use the smaller loop of the extractor tool. Center the loop around the whitehead and push into the skin with gentle, even pressure. If you are not using an extractor, push down evenly around the whitehead with clean fingers. It’s important not to use too much force. If the whitehead doesn’t come out easily, stop. Never break the skin when attempting to remove a whitehead as it increases the risk of infection.

Whiteheads buried deep

You shouldn’t try to extract a deep, painful whitehead on your own. Instead, keep your skin dirt-free with a mild cleanser and apply warm compresses several times a day to loosen up the blockage. Spread a thin layer of a product containing benzoyl peroxide on the site to eliminate acne-causing bacteria and limit the potential for inflammation.

If the whitehead gets more inflamed over time, consult a dermatologist who can prescribe a more aggressive treatment approach.

Whitehead Prevention

Avoid touching your face and follow a simple skincare routine to manage whiteheads and prevent further breakouts. While the advice to stay well-hydrated and avoid greasy foods is largely anecdotal, it certainly can’t hurt.

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

Takeaway

Almost everyone gets whiteheads during puberty but for some, the problem can continue well into adulthood. Treat and prevent whiteheads by establishing a good skincare routine including – if necessary – products with active ingredients like benzoyl peroxide, salicylic acid and AHAs.

Should you choose to extract whiteheads on own, be sure to use the appropriate tool and technique, and be careful not to break the skin.

If over the counter solutions aren’t working and your whiteheads begin to affect your quality of life, seek the advice of a dermatologist. A qualified professional can work with you to develop a prescription-strength regimen to treat your whiteheads that’s effective for your skin type.