From Derms: These Are The Best Treatments For Whiteheads

“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:

“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:

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.

“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.

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.

Like any form of acne, there are plenty of things that can trigger whiteheads to form. To follow, a few of the most common:

“[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).

“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.

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.

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).

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.

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.

Now that you know what might be causing your breakouts, let’s get into treatment options:

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 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.

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.

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.

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.

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.

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:

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.

Still not sure if you’re dealing with whiteheads or another type of pimple? Here’s a quick refresher:

Now you know what we mean when we refer to every form of acne as “complex.” Whiteheads can be triggered by excess oil production, makeup buildup, pore-clogging ingredients, hormonal imbalances, diet, and hair care products. To manage this type of acne, opt for salicylic acid, retinol, and benzoyl peroxide treatment. Lastly, look for products designed for oily skin–here’s a full routine and the best products if you’re ready to start fresh.