Whiteheads

Whiteheads, or closed comedones, are a form of acne caused by a plugged hair follicle beneath the skin that remains closed at the surface. The pore becomes blocked with a mixture of sebum and keratin, forming a small, white or flesh-colored bump. They are non-inflammatory and differ from blackheads, which are open comedones that oxidize on contact with air. Whiteheads commonly appear on the face but can also occur on the chest, back, and shoulders.

Causes and risk factors include hormonal changes during puberty and other life stages, genetics, and use of oil-based cosmetics or skincare products. Certain medications and conditions that increase sebum production can contribute. Handling the skin aggressively or squeezing lesions can worsen inflammation or lead to scarring.

Diagnosis is usually clinical, based on appearance. In rare cases, distinguishing whiteheads from similar lesions such as milia or inflammatory acne may require examination by a clinician.

Treatment focuses on reducing clogged follicles and preventing new ones from forming. For mild cases, topical therapies such as retinoids (for example adapalene or tretinoin), benzoyl peroxide, and salicylic acid are commonly used, often in combination. Avoid picking or squeezing. Professional extraction by a dermatologist or trained esthetician may be considered if needed. For more persistent or widespread acne, topical antibiotics (such as clindamycin) may be added to a regimen; in moderate to severe cases, systemic therapies such as oral antibiotics or isotretinoin may be necessary under medical supervision.

Prevention includes regular gentle cleansing, noncomedogenic moisturizers and makeup, and avoiding known comedogenic products. Whiteheads may improve with treatment but can recur, requiring ongoing management.