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Whiteheads: Causes, Treatments & Prevention

If you’re prone to acne, you’ve almost certainly noticed whiteheads developing on your face and other parts of your body at one point or another. 

Whiteheads are a small, raised form of comedonal acne. Like other types of acne, they form when the hair follicles in your skin become blocked due to a combination of dead skin cells and sebum.

Most of the time, whiteheads aren’t painful or severe, and treating them is usually a fairly simple process. However, they can be unsightly and annoying, especially when you have a large-scale breakout that affects your nose, chin, cheeks, forehead or other visible parts of your face. 

Below, we’ve explained what whiteheads are, as well as the key factors that cause whiteheads to develop. We’ve also covered what you can do to treat and prevent whiteheads, from topical treatments to prescription medications and more. 

What Are Whiteheads?

Whiteheads are comedonal acne lesions that have a white color. They’re considered a form of non-inflammatory acne, as they usually don’t cause the swelling and discomfort that’s common with more severe forms of acne.

Although whiteheads are most obvious on your face, they can also develop on your body. You may notice whiteheads developing on your chest, back and other areas.

Whiteheads generally aren’t cause for concern. However, scratching or picking at whiteheads can introduce bacteria and potentially cause an infection to develop, which may lead to more severe acne. 

How Do Whiteheads Develop?

Whiteheads develop via the same basic process as blackheads, papules, pustules and other types of acne.

All acne lesions, whether inflammatory or non-inflammatory, develop when the hair follicles in your skin (also known as pores) become clogged. A variety of things can potentially clog your hair follicles, but the two most common causes are sebum and dead skin cells.

Sebum is a type of oil secreted by your sebaceous glands. It’s an essential ingredient of healthy skin, helping to maintain your skin’s lubrication and provide a form of defense against environmental damage and infections.

While it’s essential for your skin to be protected by some amount of sebum, when your glands secrete too much sebum, it can pool up on the surface of your skin’s hair follicles and create a plug, clogging the follicle and causing a comedone to develop.

At the same time as your sebaceous glands are producing and secreting sebum, your skin is constantly replacing itself to repair damage. This process is referred to as epidermal turnover and involves replacing old, dead skin cells with new ones. 

Over time, the dead skin cells left over by this process can build up on the surface of your skin and contribute to clogged hair follicles.

Whiteheads and blackheads are both forms of comedonal acne. Whiteheads are often referred to as closed comedones, as the combination of sebum and skin cells causes a full blockage of the hair follicle that’s closed off to the outside.

Blackheads, on the other hand, are referred to as open comedones. Their black color isn’t due to dirt or poor hygiene -- instead, it’s caused by a chemical reaction called oxidation that occurs when the debris within the follicle comes into contact with oxygen in the air. 

Causes of Whiteheads

Put simply, whiteheads are caused by a buildup of sebum and/or dead skin cells inside your hair follicles. 

However, the root causes of acne aren’t quite so simple. A variety of factors can cause your skin to secrete more sebum than normal, including your production of certain hormones, your level of stress, your diet and lifestyle, and your use of certain skincare products. 

Factors that may contribute to an increased risk of developing whiteheads and other comedonal acne include:

  • Hormones. Androgen hormones, such as testosterone and dihydrotestosterone (DHT), can bind to receptors in your sebaceous glands and produce an increase in your skin’s secretion of sebum.

    This is one of several reasons why acne is so common during puberty -- a time in which your body’s levels of androgen hormones rapidly increase.

  • Genetics. Your risk of developing acne is partly genetic, meaning that if other people in your family often experience whiteheads and other acne breakouts, you might also have a higher risk.

  • Use of certain medications. Certain hormonal medications, including medications that contain testosterone, corticosteroids or lithium, or medications that cause an increase in your body’s hormone production, may cause or worsen whiteheads and other acne.

  • Diet. Although many people associate oily foods with oily skin, there’s no evidence that eating chocolate, meat or other high-fat foods causes acne.

    However, some research suggests that eating a large amount of carbohydrates may be linked to acne breakouts through its effects on blood sugar. However, research is still in its early stages and the role of carbohydrate consumption on acne isn’t well known.

  • Skincare and hair products. Oily cosmetics, skincare and hair products can all play a role in whiteheads and acne breakouts. While these products don’t affect sebum levels, they contain natural and artificial oils that can clog hair follicles and cause blockages.

  • Smoking. Research suggests that smoking may be linked to an elevated risk of acne in adults. For example, one study from 2009 found that comedonal acne is more prevalent in women who smoke than in non-smokers.

  • Stress. Although research is limited, a relatively small-scale study from 2017 found that acne breakouts might become more severe in people who report higher levels of stress than their peers.

How to Get Rid of Whiteheads

As a noninflammatory form of acne, whiteheads are usually fairly easy to treat. A wide range of treatment options are available, ranging from over-the-counter acne products to FDA-approved medications such as tretinoin and isotretinoin.

For many people, getting rid of whiteheads is equally as much about what you don’t do as it is about what you do in terms of treatments. If you’re prone to whiteheads and other comedonal acne, make sure that you avoid:

  • Squeezing or popping your whiteheads. The urge to pop whiteheads and pimples can be very powerful. No matter how tempting, it’s better to avoid squeezing or popping acne by yourself, as doing so can have unintended consequences.

    When you pop whiteheads and other pimples, you can introduce bacteria into the lesion, potentially leading to an infection. Improperly popping a whitehead could also push the blockage further into the hair follicle, worsening the acne.

  • Scratching or picking at acne. Just like popping acne, this may worsen your acne and increase your risk of scarring. Some acne scars are permanent, making this something you’ll definitely want to avoid.

If you’re desperate to pop whiteheads or other forms of acne, contact your healthcare provider or a dermatologist. They can safely and efficiently remove acne lesions using sterile equipment that won’t put you at risk of scarring or infection. 

Over-the-Counter Treatments for Whiteheads

Because whiteheads are a fairly mild, noninflammatory form of acne, over-the-counter products are often enough to deal with small-scale breakouts. Common over-the-counter treatments for whiteheads and other forms of acne include:

  • Over-the-counter retinoids. Retinoids work by increasing the speed at which your skin produces new skin cells, helping to get rid of dead skin cells before they can accumulate and cause whiteheads to develop.

    While over-the-counter retinoids aren’t as strong as their prescription counterparts, they may be effective if you only have a few whiteheads and mild acne breakouts.

  • Benzoyl peroxide. A topical medication that’s used to treat acne, benzoyl peroxide is a good option if you have whiteheads. It’s often available combined with adapalene and is effective against both comedonal and infected acne.

  • Salicylic acid. Salicylic acid is a beta-hydroxy acid that works by peeling away the dead skin cells that can cause whiteheads and other acne. It’s available over the counter in a variety of products, including creams, cleansers and solutions.

  • Azelaic acid. Azelaic acid is a gentle exfoliant that can treat and prevent certain types of acne, including whiteheads and other comedonal acne. Like salicylic acid, it’s available over the counter in a variety of acne treatments and skincare products. 

Prescription Medications for Whiteheads

Although over-the-counter treatments are often enough for mild acne, severe or persistent acne often requires the use of prescription medication. Several prescription medications are available for comedonal acne such as whiteheads, including the following:

  • Tretinoin. A topical prescription medication, tretinoin works by speeding up your body’s skin cell turnover process and preventing excessive amounts of dead skin from building up inside your hair follicles.

    Numerous studies have found that tretinoin gets rid of acne, including several that have specifically noted tretinoin’s comedolytic (anti-comedonal acne) effects.

    Tretinoin is an active ingredient in our customized acne cream, which contains a blend of science-based ingredients to prevent acne. You can learn more about tretinoin, including how it works, its side effects and more, in our Tretinoin 101 guide.

  • Isotretinoin. An oral prescription medication, isotretinoin is one of the strongest options available for dealing with acne. Although it’s rarely used for whiteheads alone, you may need to use this medication if you have whiteheads and severe, inflammatory acne.

    Isotretinoin is highly effective, but it can cause side effects and needs to be used exactly as prescribed, meaning you’ll need to pay close attention to the instructions provided by  your healthcare provider.

How to Prevent Whiteheads

After you’ve treated whiteheads and other acne, you can reduce your risk of experiencing future breakouts by making a few changes to your habits. Try the following to prevent whiteheads and other acne from coming back:

  • If you use medication, make sure to take it exactly as prescribed. Many medications for acne can take several months to produce results, with little or no improvement during the first few weeks.

    If you’re prescribed medication for whiteheads or other types of acne, make sure to use it as prescribed, even if it doesn’t have an immediate effect. If you don’t see any results after four to six weeks, talk to your healthcare provider before making any changes.

  • Avoid skincare or hair products that contain oils. These could clog your hair follicles and cause whiteheads to develop. Try to use personal care products that are labeled as “non-comedogenic,” as these are designed specifically to avoid acne breakouts.

  • Wash your face twice a day, no more. Washing your face can help to get rid of extra sebum and reduce your risk of developing whiteheads. However, it’s also important not to wash too often, as this may irritate your skin and worsen your acne breakouts.

    If you’re prone to whiteheads and other acne, try to wash your face once in the morning and once before bed. Use a gentle, non-comedogenic cleanser and avoid scrubbing the skin too harshly, as this can cause irritation.

  • Wash your bedding frequently. The sebum that’s secreted by your sebaceous glands can build up on sheets, pillowcases and other bedding over time, increasing your risk of experiencing whiteheads and acne breakouts.

    Make sure to wash your sheets, pillowcases and other bedding frequently, especially if you’re prone to whiteheads and acne breakouts.

  • Avoid sweatbands or other clothing that covers your face. Tight-fitting clothes that cover your face can trap sebum against your skin. This may increase your risk of acne breakouts and whiteheads.

    If you’re prone to whiteheads and other acne on your body, try to replace tight clothing with looser, breathable clothing that’s less likely to trap sweat and sebum against your skin. 

  • Avoid touching your face, especially when your fingers are oily or dirty. Touching your face can transfer oils and bacteria that can worsen acne and cause infections to develop.

  • Try to quit smoking. Although it’s far from easy, quitting smoking has a lengthy list of benefits for your health, including a reduced risk of acne breakouts. If you smoke, try as hard as possible to quit, or at least reduce the amount of cigarettes you smoke.

    Our guide to quitting smoking lists techniques that you can use to make the process of quitting and staying smoke-free easier. 

In Conclusion

Whiteheads and other comedonal acne can be unsightly and annoying, especially if you often get breakouts around your forehead, nose, cheeks and chin.

Luckily, comedonal acne is usually easy to treat. Mild breakouts will typically go away with the use of over-the-counter products, while prescription medications like tretinoin can take care of persistent or severe whiteheads and other acne. 

If you’re struggling to deal with whiteheads, it’s best to talk to your healthcare provider to learn more about your treatment options. You can also talk to a licensed medical professional online and, if appropriate, receive a prescription for a suitable skincare medication. 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.