Blackheads vs whiteheads: what is the difference

Blackheads and whiteheads are the same thing at the start: a pore plugged with oil and dead skin cells. The difference is the opening of the pore. The American Academy of Dermatology (AAD) says a whitehead forms when the plug seals the opening, and a blackhead forms when the buildup widens the opening and turns dark in the air. Both are the mildest form of acne. This guide explains how each one forms, why one is dark, which one is worse, and how doctors say to treat them. For how acne starts in general, see what acne is. It is part of the guide to the types of acne.

The difference in one table

	Whitehead	Blackhead
The pore's opening	Sealed over the plug	Widened and open to the air
What you see	A small raised bump, white or skin-colored	A dark dot, usually flat
Medical name	Closed comedo ("closed pore")	Open comedo ("open pore")
Red or swollen	No	No
Treatment the AAD recommends	A retinoid, plus a benzoyl peroxide wash	The same

The AAD gives the medical names and their meanings: a whitehead is a closed comedo, which means closed pore, and a blackhead is an open comedo, which means open pore. "Comedones" is the word for both together.

How a whitehead forms

The AAD says a whitehead forms when extra oil and dead skin cells build up and plug the opening of a pore. The plug stays under a thin layer of skin, so it shows as a raised bump that is white or the same color as your skin.

NIAMS, part of the US National Institutes of Health, describes whiteheads as plugged hair follicles that stay beneath the skin and make a white bump. The NHS says whiteheads are small bumps, usually the same color as your skin, and that some may have white pus.

How a blackhead forms

A blackhead starts with the same buildup inside the pore. The AAD explains that as the buildup grows, it widens the opening of the pore, and you see a blackhead. The NHS describes blackheads as black and brown spots that are usually flat but may be raised.

Why blackheads are black

The AAD explains the color as a chemical reaction. When the buildup inside the pore reacts with oxygen in the air, the black color appears. The AAD compares it to a cut apple turning brown. NIAMS gives the same explanation: the air changes the color of the oil, called sebum, at the surface.

This matters for how you treat blackheads. The AAD's page on acne types says the black dots are not dirt, so there is no reason to scrub them. It warns that scrubbing will only make acne worse.

Where they show up

Blackheads and whiteheads form where pores are plugged, and certain habits make them more likely in certain places:

• Hairline, forehead and back of the neck. The AAD says oily shampoos, conditioners and styling products can cause whiteheads and tiny bumps in these areas.
• Cheeks, chin and forehead. The AAD says makeup that clogs pores often causes many tiny bumps here, with whiteheads that rise just above the skin.

If you suspect a product, the comedogenic checker looks up the ingredients on its label. The forehead and chin acne and pimple on the nose pages cover those areas in more detail.

Which one is worse

Blackheads and whiteheads sit at the same level. The UK NICE acne guideline groups both as non-inflammatory lesions, meaning spots without redness or swelling. It places any number of them in its mild to moderate band. Red, swollen spots and nodules are what move acne into the moderate to severe band: 35 or more inflamed spots, or 3 or more nodules.

The risk the two share is scarring from picking. The AAD says picking at whiteheads can lead to more whiteheads and acne scars, and that squeezing a blackhead can cause an infection or a permanent scar.

When a plug becomes a pimple

A blackhead or whitehead can turn into a red, sore pimple. MedlinePlus explains that if bacteria become trapped in the plug, the body's immune system may react and a pimple forms. The AAD says the bacteria that normally live on everyone's skin can multiply quickly in the trapped oil, and swelling follows.

The AAD's names for the next stage are papule, a small red bump without pus, and pustule, a red bump with pus and often a white or yellow center. The types of acne guide lays out every stage from the plug to the deep nodule.

Why squeezing is risky

Squeezing feels like the quickest fix, and the AAD explains why it often makes things worse. When you squeeze, you can push some of what is inside the pore deeper into the skin. That increases swelling and can lead to acne that looks worse, more pain, and scars. You can also carry bacteria from your hands into the skin.

The AAD describes the safe version, done by a dermatologist. It is called acne extraction, and it uses sterile tools to clear blackheads and whiteheads. The AAD says it is usually offered when other treatment has not cleared the skin, because it takes time and can be expensive. It also says blackheads and whiteheads can come back afterward, so a daily routine is still needed.

How doctors say to treat them

The AAD's advice for both is the same. To unclog pores, dermatologists recommend a retinoid, a type of medicine that clears clogged pores. You can buy one retinoid, adapalene, without a prescription. The AAD also suggests a benzoyl peroxide wash, which helps reduce the bacteria on the skin.

The 2024 US acne guideline in the Journal of the American Academy of Dermatology gives a strong recommendation to both topical retinoids and benzoyl peroxide.

The adapalene 0.1 percent gel label sets the method:

1. Use it once a day.
2. Spread a thin layer over the whole area where acne appears. The label says it is not a spot treatment.
3. Expect it to take up to 3 months of daily use to see results.

The AAD says to give treatment six to eight weeks to work. Adapalene for blackheads and whiteheads explains how the gel works on clogged pores, and how to start adapalene without irritation gives a week-by-week start. Salicylic acid vs benzoyl peroxide compares the two most common store-bought options.

The full plan for clearing blackheads, with the methods to skip and when to see a dermatologist, is in how to get rid of blackheads.

Habits that help stop new plugs

A treatment clears the plugs you have. Daily habits decide how many new ones form. The AAD's pages on skin care, makeup and hair products give these steps:

• Choose products that do not clog pores. Use only makeup, sunscreen, skin care and hair products labeled "non-comedogenic" or "won't clog pores". The AAD says these products do not cause breakouts in most people.
• Wash twice a day. Wash your face when you wake up and before bed, and after anything that makes you sweat. Washing several times a day can irritate the skin, the AAD says.
• Remove makeup every night. The AAD says even non-comedogenic makeup can cause acne if you sleep in it.
• Keep makeup to yourself. Sharing makeup, brushes or applicators can move other people's oil, dead skin cells and bacteria onto your skin. The AAD suggests cleaning makeup brushes every week.
• Wash what your hair touches. If you use oily hair products, the AAD says to wash everything your head touched, such as pillowcases, caps and headbands, because the residue sticks to them.
• Be gentle. Apply cleanser with your fingertips, rinse with warm water and pat dry. The AAD says scrubbing can irritate your skin and make acne flare.

The same habits appear in the complete acne skincare routine, which puts them in morning and evening order.

Telling them apart from other spots

Up close, the signs are simple. A whitehead is raised and white or skin-colored, with no redness around it. A blackhead is a dark dot that is usually flat. If the bump is red and feels hard, the AAD calls it a papule, and it says many papules together can make skin feel like sandpaper. If it is red with a white or yellow center, it is a pustule. A large, sore lump under the skin is a nodule or cyst, which the AAD says needs a dermatologist.

When to see a dermatologist

The AAD says to give treatment six to eight weeks. If you still see blackheads and whiteheads after that, it suggests seeing a dermatologist, who may offer extraction or a prescription-strength treatment.

Some bumps look like blackheads or whiteheads but are something else. The AAD describes keratosis pilaris as rough bumps, plugs of dead skin cells, that appear on the upper arms and the front of the thighs. It also says hidradenitis suppurativa, a long-term skin condition in the armpits and groin, can show small black bumps that look like blackheads and often appear in pairs. Bumps like these, in places where acne does not usually appear, are a reason to have a doctor look.

A small white bump can also be mistaken the other way. StatPearls, a medical reference from the U.S. National Library of Medicine, names acne whiteheads as one of the bumps commonly mistaken for milia, tiny keratin cysts that sit closed under the skin rather than in an open or sealed pore. A whitehead responds to the same retinoid that clears a blackhead. Milia do not, because there is no pore to unclog. The guide to milia vs whiteheads tells the two apart.

To see which spots are on your own face and get a starting plan, Skinli's photo check works from one photo and two questions.