Blackheads, Whiteheads, What’s the Difference?
Acne comes in a variety of forms. Compared to cystic acne, the typical blackheads and whiteheads are easier to cope with, but understanding why they occur can help you determine the best way to treat them.
Blackheads, or open comedones, are the darker “plugs” of acne that occur on the surface of your skin. Large or swollen pores allow sebum, dead cells and bacteria to build up, eventually hardening into a plug that clogs the pore. Because blackheads rest directly on the surface of your skin, the melanin present becomes oxidized, resulting in the darker color that gives blackheads their name.
Whiteheads, on the other hand, are closed comedones in which bacteria and sebum harden before ever reaching the surface. This typically occurs within or directly near the oil glands, which rest in a side pocket which branches off the main channel of the pore. The hardened acne pustule may not even be able to fit into the pore’s main channel. In these cases, air cannot reach the pustule and so oxidation does not occur, leaving the blemish white.
Blackheads are generally less serious than whiteheads, since whiteheads can easily damage the inside of the pore, causing inflammation that, besides making acne more visible, requires a longer time to heal from. Topical treatments are more likely to be successful against blackheads, and they can even be manually extracted, usually without much risk. Prevention usually requires either regular exfoliation to prevent the buildup of dead cells, and/or internal treatments such as vitamin B5 or vitamin A derivatives (like Accutane) which cause your pores to tighten.
When treating whiteheads, many of the products that focus on exfoliation (removing dead skin cells) simply don’t work, since these blemishes have little or nothing to do with dead cells on the surface of your skin. Stronger drugs such as benzoyl peroxide may be required that can penetrate beneath the surface and kill acne-causing bacteria. However, this bacteria feeds off sebum, and the fact is that hardened clumps of sebum can form regardless of bacteria. Regular application of antibacterial chemicals may be enough for mild acne sufferers, but internal treatments often work better in more serious cases. Vitamin B5 and A-derivatives are effective at tightening pores because they reduce the sebum levels which otherwise causes them to swell, and reducing oil levels is still the most effective means to prevent whiteheads.
