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Home > Skin & Beauty > Skin Conditions > What Causes Whiteheads and How to Get Rid of Them

What Causes Whiteheads and How to Get Rid of Them

September 17, 2021
7 min read
By Akanksha Shah Sanghvi, MD, Clinical Dermatology

In this article:

  • Causes of Whiteheads
  • Symptoms of Whiteheads
  • Treatment for Whiteheads
  • Diagnosing Whiteheads
  • Risk Factors
  • When to See a Doctor
  • Final Word

Acne is a frequent skin problem prevalent in up to 85% of teenagers at least once during adolescence. (1)

whiteheads treatment modalities

Of the different types of acne, whiteheads are among the most common and are characterized by the appearance of tiny white bumps on the skin. These are typically seen on the face, shoulders, back, and upper arms, especially in teenagers.

Whiteheads, similar to other forms of acne, develop due to clogging of skin pores with dead skin cells, oil, and debris. They have a characteristic white appearance because they are closed comedones, that is, the clogged pore is covered with a thin skin layer.

Causes of Whiteheads

Whiteheads are generally a result of increased sebum or oil production, which in turn leads to a higher risk of clogging of pores. A number of factors can increase oil production or contribute to debris entrapment in the skin pores, including:

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  • Hormonal changes, especially during puberty, pregnancy, menstruation, and menopause
  • Genetics
  • Use of oil-based cosmetics, skin care products, and hair products
  • Excessive stress
  • Anxiety
  • Exposure to air pollution
  • Extreme weather conditions such as high humidity

Symptoms of Whiteheads

Whiteheads appear as small bumps on the skin with a white tip. These may be seen on the face, chest, shoulders, back, neck, or arms.

Treatment for Whiteheads

Several treatment modalities are available for whitehead management. You can consult your doctor or dermatologist on the following treatments to determine which is best suited for your skin:

1. Benzoyl peroxide

benzoyl peroxide can help treat whiteheads

Benzoyl peroxide kills acne-causing bacteria and also aids in the removal of dead skin cells. It is one of the most common treatments for inflammatory acne, as it can be used for longer periods than antibiotics. (2)

There are a variety of prescription and over-the-counter products containing benzoyl peroxide that you can try to treat whiteheads.

2. Retinoid creams

Retinoids are keratolytic, which means they help dissolve dead skin cells, therefore aiding in unclogging skin pores. You may be prescribed gels, creams, or lotions containing retinoic acids or tretinoin. (3)

3. Topical products containing alpha and beta hydroxy acids (AHAs and BHAs)

Alpha and beta hydroxy acids are generally used as mild chemical exfoliants. They help remove the dead skin cell layer to reveal new, rejuvenated skin. Moreover, they are antibacterial agents that help control acne formation.

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The AHAs and BHAs commonly used for whitehead treatment are glycolic acid, lactic acid, salicylic acid, and their derivatives. Salicylic acid is the most commonly used hydroxy acid as it is highly efficient in exfoliating the skin and preventing clogging of pores.

Salicylic acid can be found at 0.5%–2% (4) strength in topical over-the-counter products such as creams, gels, toners, and moisturizers. It is suggested to use these products 2–3 times daily.

Lactic acid is another commonly used hydroxy acid. Depending on its pH, concentration, and bioavailability, it may be used at home as a mild exfoliant, moisturizer, or chemical peel agent. (5)

4. Niacinamide creams

Niacinamide is commonly used for symptomatic treatment of acne since it helps reduce the redness and swelling. This anti-inflammatory medication can be procured as a topical cream. For severe acne, your doctor may prescribe oral niacinamide supplements.

5. Comedone extraction

comedone extraction for whitehead removal

Performed by an expert, comedone extraction involves the removal of the contents of acne using specialized, sterilized tools. (4)

Avoid performing extraction at home since you may push the contents of the acne deeper into the skin and increase the risk of infection. (6)

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6. Microdermabrasion

Microdermabrasion refers to a clinical skin exfoliation procedure that uses a specialized tool. When performed correctly by an expert, microdermabrasion can unclog the pores effectively and therefore aid in the treatment of whiteheads and other forms of acne.

7. Chemical peels

Chemical peels are skin exfoliation treatments that use high-strength alpha or beta hydroxy acids and therefore should be performed by an expert in a clinical setting.

This treatment helps remove the outer skin layer that contains dead skin cells and dirt, revealing a new, fresher, smoother skin layer. Moreover, chemical peels can help control oil production and therefore prevent the formation of whiteheads and other forms of acne.

8. Yellow peels

Yellow peel is a retinol-based treatment that is applied to the skin and left for a few hours before rinsing it off.

The peel helps remove the superficial layers of the skin, allowing fresh new rejuvenated skin to grow underneath. This treatment also stimulates new collagen formation and thus tightens the skin to remove fine lines and wrinkles.

9. Hydra facial

Hydra facial is a special skin care treatment to unclog pores and remove acne-causing agents from the skin. Additionally, this noninvasive procedure can improve acne scars and hyperpigmentation.

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10. CO2 laser

A CO2 laser treatment is generally used to treat acne scars, but it is also recommended to exfoliate the skin surface to reveal rejuvenated skin. In addition, the use of ablative lasers, such as in CO2 laser, stimulates collagen synthesis, aiding in smooth skin development.

CO2 lasers can be used all over the skin surface. Areas with acne scars may be targeted to fade the scars and blend them with the surrounding skin.

undergoing laser treatments can help fade whiteheads

11. Erbium:YAG laser

As opposed to the CO2 laser treatment, erbium:YAG laser employs a nonablative laser to treat acne scars, wrinkles, and open pores. It helps get rid of whiteheads and gives the skin a smoother appearance by stimulating collagen synthesis without damaging the skin.

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This treatment delivers laser energy to the skin in tiny dots over the targeted area and requires a very short recovery time.

Diagnosing Whiteheads

Whiteheads can be easily diagnosed with a physical examination of the face, chest, neck, upper arms, and back, in general the areas with the highest number of sebaceous glands.

To determine the cause of the lesions, your doctor may ask about your medical history, skin type, and skin care routine.

Risk Factors

Here are a few things that can increase your likelihood of developing whiteheads:

  • Teenagers undergo puberty-related hormonal changes, making them more prone to acne. Among this high-risk group, boys are more commonly affected than girls.
  • Adult acne is more prevalent among females than males.
  • Excessive intake of sugar and junk food on a regular basis is linked to a higher incidence of acne.
  • Using skin products that contain harsh chemicals can strip the natural moisture from your skin and thereby trigger sebum overproduction, paving the way for acne.
  • Scrubbing your skin too much or too vigorously can trigger or worsen acne. (7)

When to See a Doctor

consult a doctor regarding treatments to deal with whiteheads

Whiteheads are a common cosmetic problem that generally does not require any medical attention. However, you must consult your doctor if the whiteheads are frequently recurring or are associated with the development of cysts or nodules.

In addition, make sure to pay an emergency visit to the doctor if the medication you are using for whiteheads or acne causes faintness or inflammation in the face, eyes, tongue, or lips.

What you may ask your doctor
  • What can I do if the whiteheads increase?
  • How often should I exfoliate my skin?
  • What treatment modality is best suited for me?
What your doctor may ask you
  • Describe your skin care routine.
  • When did you first notice the appearance of whiteheads and what areas do they affect?
  • What factors, such as periods or stress, have you noticed to have an effect on your whiteheads?

Final Word

Whiteheads are a common form of acne and appear as small, closed lesions on the skin surface. While they are rarely a serious medical problem, people often seek treatment for whiteheads due to cosmetic reasons.

There are a number of treatments that you can try to improve your whiteheads. These include over-the-counter, prescription, and in-office treatments. Consult your dermatologist to identify the reason behind your whiteheads so you can prevent their recurrence.

Continue Reading Continue ReadingRemove Whiteheads: 4 Home Remedies and 8 Preventive Tips
References
  1. Lynn DD, Umari T, Dunnick CA, Dellavalle RP. The epidemiology of acne vulgaris in late adolescence. Adolescent health, medicine and therapeutics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769025/. Published January 19, 2016.
  2. Acne: Overview. InformedHealth.org [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK279211/. Published September 26, 2019.
  3. Leyden J, Stein-Gold L, Weiss J. Why topical retinoids are mainstay of therapy for acne. Dermatology and therapy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574737/. Published September 2017.
  4. Tan AU, Schlosser BJ, Paller AS. A review of diagnosis and treatment of acne in adult female patients. International journal of women’s dermatology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986265/. Published December 23, 2017.
  5. KK; GTRMPJSV. Long term topical application of lactic acid/lactate lotion as a preventive treatment for acne vulgaris. Indian journal of dermatology, venereology and leprology. https://pubmed.ncbi.nlm.nih.gov/17656910/.
  6. Wise EM, Graber EM. Clinical pearl: Comedone extraction for persistent macrocomedones while on isotretinoin therapy. The Journal of clinical and aesthetic dermatology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225139. Published November 2011.
  7. Kraft J, Freiman A. Management of acne. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3080563/. Published April 19, 2011.
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