How Acne Can Be Divided Into Blackheads and Whiteheads

Understanding and Identifying Acne Types

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Acne, commonly referred to as pimples, is the most common skin disease treated by physicians. It is a chronic condition that affects more than 85 percent of adolescents and young adults. One study showed that two-thirds of teenagers with acne wanted to talk to their physician about their acne, but only one-third actually did.

Types of Acne

Not all acne is the same. Simplistically, acne can be divided into red bumps and blackheads or whiteheads.

This division is important because each type is treated differently. Blackheads and whiteheads, known medically as comedones, can be more numerous on the face and shoulders than red bumps filled with pus.

Good, consistent skin hygiene can help improve this condition. Therefore, knowing more about what causes comedones and how to treat them is a step towards clearer skin.

What are Blackheads?

Blackheads, also known as open comedones, are follicles that have a wider than normal opening. They are filled with plugs of sebum, keratin, and sloughed-off cells and have undergone a chemical reaction resulting in melanin oxidation. This gives the material in the follicle the typical black color. Blackheads are often found on the nose, but can also be found in other areas of the face and body.

What are Whiteheads?

Whiteheads, also known as closed comedones, are follicles that are filled with the same material as blackheads, but have only a microscopic opening to the skin surface.

Since the air cannot reach the follicle, the material is not oxidized, and remains white.

Skin Care for Blackheads and Whiteheads

The key to skin care for acne is consistency. An overnight cure has not been found. But using good skin care methods aids in the daily, steady improvement of follicle health.

Since acne is not caused by eating certain foods, restricting the diet is not helpful. Since it is also not caused by "dirty" skin, excessively scrubbing does not help and can even make the skin more irritated and actually worsen acne.

Oil-based makeup should not be used since it can contribute to the buildup of oil in the follicles. Water-based makeup labeled as non-comedogenic can be used safely.

Treatment of Blackheads and Whiteheads

Treatment of whiteheads and blackheads takes time. Most treatments take several weeks to months before a noticeable change is seen.

Benzoyl Peroxide

Benzoyl peroxide has an antibacterial effect and may also decrease the chemical reaction that changes the lining of the hair follicle. This may help reduce the plugging that causes comedones. Benzoyl peroxide may be used for a mild case of comedones or to help prevent the formation of others.


Topical retinoids are commonly prescribed medications for blackheads and whiteheads. Types of retinoids include tretinoin (Retin-A, Avita, Renova), adapalene (Differin), or tazarotene (Tazorac).

Retinoids are derivatives of vitamin A and works by increasing cell turnover and reducing the "stickiness" of the sloughed cells. They help expel the plugged material returning the pore to normal. Retinoids can be irritating, so specific instructions on how to use it can be found here.


Prescription topical antibiotics or oral antibiotics might be used if some of the blackheads and whiteheads are infected, but antibiotics do not help with comedones that are not infected.

Isotretinoin (Accutane)

Isotretinoin (Accutane) is used for severe cystic acne and has many side effects. It is very effective for comedones when used properly, but is not usually prescribed for mild acne of either type.


Extraction may be used by a health care provider, aesthetician or facialist on open comedones. Some people are interested in extracting their blackheads and whiteheads to release the contents within these growths. Many stores sell comedone extractors for this purpose. Comedone extractors are most often metal, and one end has a small loop. For blackheads, the opening of the extractor is placed around the blackhead, and pressure is then applied downwards and laterally. Whiteheads often need to be nicked beforehand. If you decide to extract your blackheads and whiteheads yourself, make sure to do so properly. Instruments should be sanitized, and extraction should be done gently and carefully. If you have any doubts about on performing the extraction, find an experienced facialist or aesthetician to do so for you.

No Need to Suffer

Whiteheads and blackheads are types of acne that affect many people. There are good treatment options available, so there is no need to suffer from this condition in silence. A primary care provider can initiate treatment for acne and follow mild to moderate cases. Severe cases or those resistant to treatment should be seen by a dermatologist.


Mayo Clinic. Acne.

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