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Whiteheads: Causes, Treatment, and Self-Care

Outbreaks of acne commonly occur on the face, back, chest, and at times the neck and shoulders. They can lead to permanent scarring.

In the United States, around 8 out of 10 adults aged between 11 and 30 years experience some kind of acne, but acne can affect people at any age.

There are various forms of acne, but this article will look at whiteheads and how to treat them.

Fast facts on whiteheads

Here are some key points about whiteheads. More detail and supporting information is in the main article.

  • Approximately 80 percent of the American population, report that they have had some form of acne during their lifetime.
  • While the cause of acne is not entirely clear, it is associated with hormonal changes. Some cosmetic products, fabrics, and perspiration may also be causes.
  • Washing the skin gently twice daily with mild soap and lukewarm water may help.


What is a whitehead?

Whiteheads on a nose
Whiteheads are formed when bacteria block the pores in the skin.

Blackheads and whiteheads are kinds of sebaceous plugs, or comedones. They are formed of dead skin cells, oil, and bacteria that block the pores in the skin. A blocked pore that stays open is a blackhead, but in a pore that closes up, a closed comedo, or whitehead, will develop.

Whiteheads are white or yellowish in color, are firm, and cannot be extracted with squeezing. They typically measure around 1 to 3 millimeters across. By contrast, a blackhead is black in color due to contact with the air and follicle pigmentation, and is extractible.

Normally, a whitehead does not become inflamed. If bacteria enter the comedo, however, it can become infected and turn into an inflamed papule or pustule.


Causes of whiteheads

Why acne happens is not entirely understood, but hormonal fluctuations have an impact. These can be due to puberty, menstruation, pregnancy, and stopping the use of oral contraceptives. High production of an oily substance called sebum that protects the skin is also a factor.

Other factors that increase the chance of acne include using certain cosmetics and other facial products, clothing, high levels of humidity, and sweating.

Acne can result when clogged pores become infected with the bacteria Propionibacterium acnes that occurs naturally in the skin.

Current research shows no association between acne and diet, poor facial hygiene, or stress. There is inadequate evidence to associate acne and chocolate or greasy foods.

However, certain medications, pressure from sports equipment, backpacks or sports uniforms, pollution, pimple popping, and hard scrubbing all appear to worsen acne. Women and girls may find their acne gets worse between 2 and 7 days before the start of menstruation.


Treatment and self-care

Treatment of whiteheads typically includes the use of either over-the-counter (OTC) creams or medications, or medications that are prescribed by a dermatologist.

Doctor looking at acne on a mans chest
OTC medication may help to treat whiteheads. Prescribed medication from a healthcare professional is recommended if this is not successful.

OTC medications include gels, lotions, creams, soaps, or pads. These may contain include benzoyl peroxide, resorcinol, salicylic acid, or sulfur.

These medications can cause unwanted side effects, such as irritation, burning, and redness of the skin.

If OTC solutions do not work, prescription medicines are available. The type of medication prescribed will depend on the type and severity of the acne.

If the acne is hormonally driven, an oral contraceptive, an antiandrogen medication, or a corticosteroid may be recommended.

If there is infection and infammation, antibiotics may help.

The last resort treatment for acne is isotretinoin, or Roaccutane.

This is an oral treatment that works on all kinds of acne, including whiteheads, but it can have severe, adverse effects. These include a potentially severe worsening of the condition at the start of treatment, with painfully dry and cracking skin.

If a woman takes this medication while pregnant, it can lead to severe birth defects. A woman cannot use isotretinoin without first signing an iPLEDGE agreement from the U.S. Food and Drug Administration (FDA). The drug must be used under close medical supervision.

Isotretinoin is not a rapid solution. A course of treatment lasts 4 to 5 months, and there is no guarantee that the acne will not return, although many patients find that even if it does come back, it will be less severe.

Self-help for acne

There are some strategies that people with whiteheads and acne can use at home to treat and prevent acne.

These include

  • Washing skin gently twice daily with mild soap and lukewarm water
  • Avoiding squeezing pimples or excessively touching the skin
  • Using caution when shaving
  • Avoiding excessive sun exposure that can lead to skin tanning or burns
  • Avoiding excessive use of cosmetics
  • Using oil-free skin products
  • Removing makeup before going to bed
  • Choosing noncomedogenic, nonpore-clogging skin products
  • Using fragrance-free water-based emollient to treat dry skin
  • Regularly washing hair and keeping hairspray away from the face
  • Wearing loose clothing made of nonsynthetic fabrics such as cotton

Acne can cause personal distress and long-term scarring. Anyone who is concerned about their acne should seek the help of a medical professional or dermatologist, as there may be a treatable underlying problem.

A healthcare provider can offer additional information and recommendation on treating whiteheads and any other form of acne.

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