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The Difference Between Blackheads <br> And Whiteheads — And How To Treat Them

The Difference Between Blackheads
And Whiteheads — And How To Treat Them

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Here’s the 411 on these annoying but oh-so-common skin imperfections 

Upsetting, frustrating, annoying—these are just some of the words you may use to describe acne. One you’d never think of: uncommon. In fact, according to the American Academy of Dermatology [1], acne impacts nearly 50 million Americans per year. Odds are you’ve experienced what it’s like to have a whitehead or a blackhead. But do you truly know the difference between the two? If not, read on for some helpful info from Jerry Tan, M.D., an adjunct professor of dermatology at the University of Western Ontario and an Acne Store advisory board member. Being able to identify which kind of acne eruption you’re dealing with is essential to getting whiteheads and blackheads off your face for good.

What’s are whiteheads and blackheads?

Both blackheads and whiteheads are types of acne spots, but they’re less “angry” and irritated than their inflamed counterparts like nodules, cysts, papules, and pustules. To explain how blackheads and whiteheads develop, Tan starts with a quick little anatomy lesson: “To moisturize your skin, oil glands underneath the skin produce a waxy substance called sebum and then send it up to the surface through a little tube called the follicular canal,” he explains. But—and here’s where things can go wrong—if some debris is blocking the pore opening, the oil has nowhere to go. “It’s kind of like a manhole cover,” says Tan. The sebum just builds up and builds up, and then mixes with dead skin cells and bacteria to form a pimple.

Do I have blackheads or whiteheads? What’s the difference?

You know that whiteheads and blackheads appear different, but do you know why? It comes down to how much of that opening the manhole cover blocks. In whiteheads the opening is closed completely, hence why they’re also known as closed comedones. Explains Tan, “Appearance-wise, they show up as little white bump on the skin, a lot like the end of the grain of uncooked rice.” A blackhead, or open comedone, occurs when that manhole cover is partially open and allows air to reach the oil and other gunk in your pores and oxidize it, which turns that portion of it dark gray black.

When a blackhead isn’t a blackhead

It’s common—especially for people with fairer skin—to think they have blackheads when they actually have sebaceous filaments. “These are thin hair-like structures that lines the pores and helps the oil travel up to the surface,” explains Tan. Because they can appear gray or black against light skin, they do a pretty good impression of a very tiny blackhead. But technically these aren’t actually a part of the acne family, and you definitely shouldn’t squeeze them. They’re also totally natural and benign, so no need to worry if you have them.

Squashing blackheads and whiteheads is about taking a preventative approach to acne overall.

The best products for blackheads and whiteheads

Squashing blackheads and whiteheads is about taking a preventative approach to acne overall. Tan recommends avoiding any dietary triggers you’ve identified like dairy (keep a journal to track what exacerbates your breakouts) and using proven acne-busting ingredients like benzoyl peroxide, salicylic acid, lactic acid, or glycolic acid.

But the best way to get rid of blackheads and whiteheads is to exfoliate, exfoliate, exfoliate. Exfoliation helps to unclog pores by sloughing away dead skin cells and debris before they get a chance to do their damage. Tan recommends using chemical exfoliators like beta hydroxy acids (salicylic acid is one) as well as topical retinoids. “I tend to recommend products that are gentle and can be used regularly as opposed to harsher products meant for occasional use like face scrubs with gritty ingredients or at-home peels,” Tan says. “Scrubs and peels are more likely to further inflame existing acne and lead to more redness, irritation, and even scarring.”

Is it OK to squeeze whiteheads?

For those blemishes that you just must get rid of stat, Tan wants you to resist the temptation to squeeze with your fingers. Instead, try a comedone extractor. These dual-side blackhead and whitehead removal tools often have a pointy end, which allows you to create a tiny exit hole so the contents of the pimple can easily escape. “The other end looks like a spoon with a hole in the middle of it,” Tan explains. “As you gently push it into the area around the clogged pore, the contents should pop out.” Being gentle during the process is key, you don’t want to leave more marks or scars. If you’re unsure how to best extract, see a qualified aesthetician.

Reach for comedone extractors post-shower when your skin has been softened by the warm water. “The lesions might be a little bit more ready to pop at that time,” Tan says. And proceed with caution: “These tools can work on both whiteheads and blackheads, but you must use the sharp end to create a little opening in the pore.” If the pimple is still blocked and you keep pushing it into your skin, there might not be anywhere for the stuff inside to go, so it might end up traveling deeper into the skin, creating an even bigger problem.

Can I use those pore strips to extract blackheads?

Pores strips have been seen as a path to clear skin since a 1998 study provided some evidence that they may help with blackhead extraction. [2] Since then, however, many doctors, including Tan, have come to think of their function as more cosmetic than anything else. “You’re usually only removing some of the contents—it’s not actually clearing out the whole pore,” he says. Translation: The effect is temporary, and the pore will eventually fill up again as the material that is removed is just the normal part of the small hairs and columns of sebum.

That said, Tan sees a value in them. First, they actually do remove sebaceous filaments, which are harmless but can make pores more noticeable. Plus, Tan sees that they perform what he calls a “very psychological role” in making you feel like you’re helping your skin, which might scratch that itch to pick at your face. Of course, there’s that satisfyingly voyeuristic effect too. Tan points out, “They give you a clear perspective into the jungle of your pores.”

 

References:

[1]: https://www.aad.org/media/stats-numbers

[2]: https://www.tandfonline.com/doi/abs/10.3109/09546639909055910

Jerry Tan, M.D.

Dr. Jerry Tan is a member of the Acne Store Board of Dermatologists and an adjunct professor of dermatology at the University of Western Ontario and in private practice in Windsor, Ontario. He is the principal of Windsor Clinical Research Inc., a research site for clinical trials, and the Healthy Image Center, a cosmetic dermatology treatment facility. Dr. Tan graduated from Queen’s University in medicine and trained in dermatology at the University of British Columbia and the University of Michigan. In 2009, he was awarded the Canadian Dermatology Foundation Lectureship Award for excellence in dermatology research. In 2019, he was named Dermatologist of the Year by the Canadian Skin Patient Alliance.

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