What causes whiteheads?

Whiteheads are caused by oil and shed skin cells building up inside a hair follicle and forming a closed plug. The follicle opening stays covered by a thin layer of skin, so the material does not darken through contact with air. This is why whiteheads are also called closed comedones. Hormonal changes, oilier skin, products that clog pores, friction, and some medicines can make follicle blockage more likely. Whiteheads are a type of non-inflammatory acne lesion, although not every small pale bump is a whitehead.

Whiteheads commonly appear on the forehead, nose, chin, cheeks, chest, or back, where follicles may produce more oil. They may feel slightly raised and usually are not tender unless the surrounding follicle becomes inflamed. Clusters of similar bumps can fit with comedonal acne. Firm, pearly bumps that remain unchanged and do not seem connected to a pore may instead be milia, which are small cysts containing keratin. A clinician can distinguish these conditions by examining the skin.

Cleanse gently, avoid scrubbing, and choose non-comedogenic moisturiser, sunscreen, and makeup where possible. Do not squeeze or dig at the bumps; pressure can injure the follicle and leave persistent marks. A pharmacist or dermatologist may suggest a topical retinoid to help prevent blocked follicles, with instructions suited to your skin and any pregnancy or breastfeeding considerations. If you want professional removal, an acne extraction facial should use clean technique and careful handling rather than forceful squeezing. Improvement usually takes consistent care over time, not a single aggressive treatment.

Arrange a dermatology assessment if the bumps persist despite a gentle routine, spread to the chest or back, become painful or inflamed, or leave dark marks or scars. Seek advice sooner if a new product or medicine was followed by a sudden widespread eruption, or if the bumps are itchy and look unlike your usual whiteheads. Prompt review is also sensible for a rapidly changing, bleeding, crusted, or ulcerated spot, because that appearance is not typical of an uncomplicated closed comedone.

You could ask: Do these bumps look like whiteheads, comedonal acne, or milia? Which ingredients in my current products may be blocking follicles? Would a topical retinoid be appropriate for my skin, and how should I introduce it to limit irritation? What should I do if the bumps become red, painful, or leave marks?