Dr. Eric Schweiger - acne treatment centers

Blackheads vs. Whiteheads

Know Your Acne Classifications

When you’re fighting acne, it’s important to know the difference between whiteheads vs. blackheads, as well as all of the other different forms of acne. The main two categories of acne are “inflammatory” and “non-inflammatory” acne. Non-inflammatory acne lesions are blackheads and whiteheads, officially “open and closed comedones.” Whiteheads are literally white on the surface, while blackheads are dark. Inflammatory acne is what is traditionally thought of as pimples and cysts, they are red and inflamed bumps on the skin. Inflammatory acne lesions are the type that can lead to scarring.

Blackheads vs. Whiteheads

Blackheads (open comedones) look black in color because the substance inside the follicle has been exposed to air and has oxidized. Blackheads occur when the opening of the follicle is wider than typical. Whiteheads (closed comedones) contain the same sebum and dead skin cells as blackheads, but the substance has not been exposed to the air, so it stays white.

Treating Whiteheads and Blackheads

There are some over the counter treatments that will help treat and fight blackheads and whiteheads. One ingredient that’s proven to be effective is salicylic acid. Salicylic acid is a “keratolytic agent,” meaning it’s a peeling agent that helps remove the top layer of the skin. Salicylic acid also helps shed cells inside the hair follicles, which in turn prevent the pores from clogging and keeps them free of debris. Salicylic acid helps clear out whiteheads and blackheads. Salicylic acid concentrations approved for use in over the counter treatments for acne usually fall between 0.5 percent to 2 percent. The negative side of salicylic acid is that it can cause stinging and skin irritations, such as peeling skin and redness. Benzoyl peroxide is another great ingredient to help treat both whiteheads and blackheads. Benzoyl peroxide is available at all concentrations over-the-counter, which means that over-the-counter treatments are able to provide this effective acne treatment without a prescription. Benzoyl peroxide works by killing the P. acnes bacteria that causes acne through exposing it to high levels of oxygen. Benzoyl peroxide also unclogs the pores, so that blackheads and whiteheads do not develop. However, there are many different factors that contribute to the formation of acne, and benzoyl peroxide influences only one of them.

Antibiotics for Whiteheads and Blackheads

Antibiotics are commonly used in the treatment of inflammatory acne. They can be used topically in the treatment of mild to moderate inflammatory acne or taken by mouth for the treatment of moderate to severe inflammatory acne. Antibiotics work in a few different ways to reduce acne. The main mechanism that antibiotics use to treat inflammatory acne is to decrease the amount of P. acnes bacteria around the pore. Antibiotics also work by reducing the concentration of free fatty acids in the sebum; free fatty acids promote inflammation and may cause comedones (whiteheads and blackheads).

The Best In-Office Procedure to Fight Blackheads and Whiteheads

The Isolaz® is an in-office procedure that is used to clear out your pores and kill the P. acnes bacteria that leads to acne. There are two components to the Isolaz® treatment, a gentle suction that cleans your pores, and a light that simultaneously destroys the P. acnes bacteria. A 2008 study showed that acne continued to improve for three months following a series of Isolaz® treatments[i]. The same study showed a decrease in both inflammatory (pimples) and non-inflammatory (blackheads and whiteheads) acne and reported that 82% of patients were moderately to very satisfied with their treatment.
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