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The first step to encouraging a better relationship with your acne (and working on clearing it) is to understand what’s going on within your skin. To help you out, we asked dermatologists for the 101 on one of the most common forms of breakouts—whiteheads. Let’s get into it.
Whitehead basics
“A white head (also known as closed comedones) is a hair follicle or pore that has become clogged with oil and dead skin cells,” board-certified dermatologist Lian Mack, M.D., FAAD, tells mbg.
However, it can be difficult to identify a whitehead from other forms of acne, so here are a few things to consider:
What do whiteheads look like?
“Whiteheads and papules are different, and while papules are usually raised; most whiteheads tend to be flatter,” board-certified dermatologist and assistant clinical professor of dermatology at Mount Sinai School of Medicine Jeannette Graf, M.D., explains.
Think of whiteheads as the slightly less intense version of papules. They’re actually more like a blackhead but set deeper and covered with skin (which is why they’re white, as blackheads become dark when exposed to oxygen). Here’s a quick list of traits associated with whiteheads:
- May be slightly raised or fully flat
- Less tender to the touch, if at all
- Have a white head at the center
- Often lack redness (as opposed to pustules and papules)
- May congregate in oily areas like the chin, forehead, and nose
Who typically gets whiteheads?
Because whiteheads are caused by an increase in oil production, it makes sense that those with oilier skin types are more prone to whiteheads. However, any clogged pore can be the result of oil mixing with bacteria and dead skin, so it’s not just extra sebum at play here.
Long story short, anyone can get whiteheads, but those with oily or combination skin types are most prone to them.
Where do you get whiteheads?
“Whiteheads can be common on your T-zone, as this area produces more oil than other areas of the face for people with oily or combination skin,” Graf notes. A few other common spots to see whiteheads include the hairline, nose folds, and chin.
You can also get whiteheads on the body, especially if you’re sweating with a T-shirt on. Hormonal balance can play a role in the formation of whiteheads too (more on that in a bit), and that can trigger back and chest acne in many forms.
How long do whiteheads last?
One of the better traits of whiteheads is that they’re fairly flat, painless, and tend to lack redness that other forms of acne often have—however, they might last longer. “The length of time that a whitehead persists in the skin can vary. It can take months before a whitehead resolves on its own,” Graf says.
That being said, some whiteheads can go away within a week or so—remember, everyone’s skin is unique. “If you are eager to remove a white head, see a board-certified dermatologist that can extract it or prescribe a medication to help resolve it,” Graf notes.
Are white heads painful?
Whiteheads tend to be less painful than larger, more inflamed pimples. They may even be painless, but because they can come up in sensitive areas like the nose flaps and the chin, it’s not completely unheard of to experience slight discomfort when you graze them with a finger.
What causes whiteheads?
Like any form of acne, there are plenty of things that can trigger whiteheads to form. To follow, a few of the most common:
Buildup
“[Whiteheads] can occur with poor skin hygiene, wearing makeup and powder without washing face at night, and continuously applying makeup,” Graf explains. So if you’re frequently skipping a cleanse or only splashing your face for a few seconds, you may consider being more intentional with your evening cleanse (and perhaps try double-cleansing).
Pore-clogging ingredients
“Using products that are comedogenic means that they contain ingredients that will clog your pores,” Mack says. The easiest thing to do before purchasing your next skin care or makeup item is to run it through a pore-clogging ingredients checker like this one from Acne Clinic NYC.
It’s important to note that not every ingredient on the pore-clogging ingredient scale will for sure lead to breakouts—every person and every formula is different. However, checking your products beforehand will help bring you some peace of mind and ensure what you’re using is acne-safe.
Oil buildup
At the root, whiteheads are caused by a buildup of oil—which is why they frequent the T-zone. While you can’t change your skin type, you can manage excess oil in these areas and on the face in general—more on that to come.
Hormonal imbalances
Hormones impact your skin in many ways, including increasing the frequency of whiteheads. “Whiteheads (or any acne lesions) can occur as a result of hormones. Androgens (male hormones) contribute to the development of acne by stimulating the growth and secretion of oil glands, causing an increase in oil production,” dermatology nurse practitioner Jodi LoGerfo, DNP, tells mbg.
“Increased oil production is thought to provide a growth medium for bacteria to thrive (particularly C. acnes). The bacteria utilize the triglycerides in oil as a nutrient source to flourish,” she adds.
It’s important to note that hormonal imbalances can lead to other forms of acne such as cystic pimples, pustules, and papules as well.
Lastly, your hormones are directly linked to your sleep cycle, what you eat, and your mental health—so this cause isn’t entirely out of your control (more on how to balance hormones to come).
Diet
Certain foods have been shown to increase the risk of acne, including refined sugar and dairy. “Diet can impact hormonally driven acne negatively. Dairy in particular has been shown to exacerbate acne. Not all dairy, however, worsens acne in the same manner. Studies show that skim milk exacerbates acne significantly more than full-fat milk1,” Mack notes.
Hair care products
If you’re getting whiteheads around your temples or hairline, your hair care products may be at fault. Products like hair spray, dry shampoo, and even leave-in conditioners may contain sticky and occlusive ingredients that can clog your pores and lead to whiteheads.
How to treat whiteheads.
Now that you know what might be causing your breakouts, let’s get into treatment options:
Retinoids
When it comes to whitehead remedies, “Retinoids fall at the top of the list,” Mack says. “Retinoids are vitamin A derivatives that reduce oil production and promote cellular turnover,” she explains.
“This treatment works well because whiteheads are caused when sebum and dead skin cells unite to clog a pore,” she adds. You can find retinol in many over-the-counter forms such as classic retinol, retinaldehyde, and adapalene.
The benefits don’t stop there, either. “Retinols not only help improve breakouts but have the added effect of reducing the appearance of fine lines, wrinkles, and dilated pores,” Mack continues. So if you’re looking for a multifaceted acne treatment, retinoids might be your best bet.
Salicylic acid
Salicylic acid is a well-known acne treatment, and for good reason. Salicylic acid is antimicrobial, and as board-certified dermatologist Karan Lal, M.D., of Schweiger Dermatology Group once said, it can go deep into your pores and break open and closed comedones (again, since the BHA is oil-soluble).
This BHA also exfoliates the skin, which means it helps your skin slough off dead skin at a quicker rate, essentially sweeping up the excess buildup that could lead to more clogged pores.
You can use salicylic acid in the form of a serum, cleanser, or as Mack’s go-to, a mask. “MONAT’S Cold Charcoal Mask has a beta-hydroxy acid in the form of salicylic acid. Infused with mineral-rich clays, charcoal, and salicylic acid, it gently helps to unclog pores by removing dead skin cells or keratin plugs,” she explains.
Benzoyl peroxide
Next up, we have benzoyl peroxide. “It kills the bacteria, P. acnes, that lives within our hair follicles, and it also helps to break up and remove dead skin cells that clog our pores,” board-certified dermatologist Ife J. Rodney, M.D., FAAD, founding director of Eternal Dermatology + Aesthetics, once told mbg.
That means the acid can be helpful for both inflammatory acne (your angry pustules, cysts, and pimples) as well as comedonal acne (blackheads and whiteheads). However, this ingredient can be rather drying, especially for those with already dry or combination skin.
If your skin is prone to dryness but you still want to give benzoyl peroxide a shot, opt for a wash-off treatment like Glytone Acne BPO Clearing Cleanser rather than a leave-on gel.
Acne facial
For those dealing with active and stubborn whiteheads, you may want to consider getting an acne facial. During this treatment, your esthetician will use a combination of topical ingredients (like those listed above) and high-tech tools like LED light.
You can read more about acne facials here, if you’re curious.
Masks
As noted above, masks that contain salicylic acid, benzoyl peroxide, or clay can be helpful in treating whiteheads. Ready to add one to your routine? Here’s a curated list of our top picks.
If you’re using loose clay to make your own mask, be sure to mix the clay with a bit of jojoba or grapeseed oil (or another one of these noncomedogenic options) to ensure it doesn’t overdry your skin.
Prescriptions
If you’ve tried all of the above with little to no success, prescription treatments may be a smart next step. Topical retinoids (like tretinoin, for example) can be prescribed by your dermatologist should you need them.
Other prescription options include topical hormonal acne treatment Winlevi and oral medication Spironolactone2 (used off-label for acne treatment for women). Your dermatologist will likely recommend you try OTC options first, but these medications can be helpful for those stubborn, treatment-resistant breakouts.
How to prevent whiteheads.
Once you’ve been incorporating the steps above to work on clearing your skin, it’s important to keep preventive measures in place, so here are a few ideas:
- Wash your face regularly: “To ensure it’s not your facial hygiene that is causing or aggravating comedones, be sure to wash your face both a.m. and p.m.,” Graf says.
- Reduce stress: Stress can increase your oral production and throw off your hormones, so do your best to reduce stress when you can. Here are a few tips to get you started.
- Address your diet: Experiment with taking skim milk out of your daily menu if you suspect it could be causing you to break out.
- Mind your hormones: Do your best to build hormone-balancing meals (ideas here if you’re curious), get enough sleep, and manage your stress levels—all of these combined will contribute to more balanced hormones.
- Keep your skin care routine consistent: Those topical ingredients listed above won’t do much if you don’t commit to a regimen. Not sure how to rotate them in and out? Check out this guide on skin cycling for a preplanned method.
- Use weekly masks: Adding in a clay mask or one with salicylic or benzoyl peroxide can be one quick and easy way to level up your weekly routine. Be sure not to overdo it (read: rinse off the mask when your product suggests) and follow up with a hydrating moisturizer afterward.
- Keep blotting papers on hand: Use blotting sheets throughout the day wherever you see excess oil and shine. This will help to lessen the chance of oil buildup on the skin.
- Opt for oil-balancing products: Look for ingredients like tea tree, salicylic acid, and jojoba oil in your skin care products to help balance your oil production.
- Balance the microbiome: Your skin microbiome plays a huge role in the overall appearance of your skin and in managing breakouts. Look for skin care products with pre- and postbiotics to help balance your microbiome.
When to see a doctor.
If your whiteheads are causing you to feel insecure and frustrated, it’s best to visit a board-certified dermatologist. These experts can help you navigate this complex skin condition from potential causes to the best treatments and more.
Other types of acne.
Still not sure if you’re dealing with whiteheads or another type of pimple? Here’s a quick refresher:
- Blackheads: These are flat (like whiteheads) but present darker in color. They may congregate in the T-zone as well.
- Papules: A type of acne that appears as a solid red bump. These may start as whiteheads and turn into a papule with time.
- Pustules: Papules can often turn into pustules. When the red papule forms a white, pus-filled head, you now have a tender pustule.
- Nodules: Hard lumps under the skin that feel stiff and painful to the touch. May be skin tone or slightly red.
- Cysts: Cysts are another type of under-the-skin pimple but tend to be tender or soft to the touch. This form of acne is often sensitive and may look red and inflamed.
FAQ
Can I pop a whitehead?
You should never pop whitehead pimples (or any other kind of pimple, for that matter). Doing so can lead to scarring, infection, and further breakouts in the surrounding area. Instead, opt for spot treatments, clay masks, salicylic acid serums, or retinol treatment.
Do whitehead pimples go away on their own?
Whitehead pimples do go away with time. How long they last, however, differs from person to person. Some minor whiteheads may clear within a week, while others can last up to a few months.
Why do I get whiteheads?
There’s a wide range of reasons whiteheads pop up on the skin. A few of the most common include oil buildup, the use of pore-clogging ingredients, hormones, diet, old makeup (read: not washed off completely), and sticky hair care products.