Comedone extractors for whiteheads: are they safe?

A comedone extractor is a small metal tool that presses blackheads and whiteheads out of pores. Comedones is the medical word for both. The tools are sold for home use, and dermatologists use them too. The question is what happens when the same tool is used at home, and what the research says about how well it works in either setting. This guide covers both. For the full plan to clear blackheads and whiteheads, see how to get rid of blackheads.

What dermatologists use extraction for

The American Academy of Dermatology (AAD) describes acne extraction as a technique "which involves using sterile instruments to get rid of blackheads and whiteheads." Sterile means free of germs. It says "When performed by a dermatologist, acne extraction is a safe way to get rid of blackheads and whiteheads."

The AAD also says when it is used: "Acne extraction is usually offered when other acne treatment fails to clear the skin. It's rarely a first choice because it takes time and can be expensive." Its treatment page calls the procedure acne surgery and says: "To avoid scarring and infection, this surgery should only be performed by a board-certified doctor who is trained and skilled in performing acne surgery."

Dermatologists also develop ways to extract comedones in hard places. A 2015 letter in the Journal of the American Academy of Dermatology described a technique for "comedone extraction from the well of the concha," the bowl-shaped hollow of the outer ear. The guide blackheads in the ear covers that area.

What the research shows

Few trials test the extractor directly. One of the clearest is a 2024 randomized trial in the journal Lasers in Medical Science, run at a hospital dermatology department in Xi'an, China, in people with dense comedones.

• Design. Each patient had one side of the face treated with a comedone extractor and the other side with a type of CO2 laser, a light-based treatment, every 2 weeks for 4 sessions. The doctors who judged the results did not know which side got which treatment.
• What the authors said about the extractor. "Comedone extractor has been widely employed by dermatologists, but the effect is temporary and may cause irritation."
• Results. After 4 treatments, comedones fell by 46.36 percent on the extractor side and 64.49 percent on the laser side. Only 37.5 percent of patients reached a 50 percent reduction on the extractor side, against 79.16 percent on the laser side.
• Pain. The laser side "showed higher comedone clearance with lower pain scores than the comedone extractor."
• Safety. "No permanent or severe side effects were observed on both sides."

This was one trial at one hospital, with trained doctors doing the extraction in a clinic. It shows what an extractor does in skilled hands: it removes a share of comedones for a while, with some irritation and pain. It does not test home use.

What the laser result means for you

The laser in that trial is an office treatment, and it has its own risks. The AAD's page on lasers and lights says "Redness and swelling are common after treatment with many lasers and light treatments," and that rarer side effects include "lingering pain, burns, or blisters" and changes in skin color or scarring. It says a board-certified dermatologist who uses lasers often can help prevent these. Both treatments in the trial were done by doctors in a clinic.

The risks of using one at home

The sources describe several risks when people squeeze or press out blackheads and whiteheads themselves:

• Pushing the plug deeper. The AAD says: "When you pop or squeeze acne, you're likely to push some of what's inside (e.g., pus, dead skin cells, or bacteria) deeper into your skin. When this happens, you increase inflammation. This can lead to more-noticeable acne and sometimes scarring and pain."
• Infection. The AAD says "squeezing a blackhead can cause an infection or permanent scar," and warns of "getting an infection from the bacteria on your hands."
• More whiteheads. The AAD says "Picking at whiteheads can lead to more whiteheads and acne scars."
• Dark spots. The AAD's tips page says picking, popping or squeezing acne will "make the acne take longer to clear and increase your risk for scarring and dark spots called post-inflammatory hyperpigmentation." These are flat marks left after a spot heals. The AAD says some can last a year or longer.
• Wider pores and blood vessel damage. A 2025 study in the Journal of Cosmetic Dermatology says squeezing the nose at home can result in "skin infections, further pore dilation, and capillary damage." Capillaries are tiny blood vessels near the surface.
• Scarring. NICE, the UK guideline body, says persistent picking "can increase the risk of scarring." The NHS says: "do not pick or squeeze spots because this can cause scars." MedlinePlus says aggressive squeezing can lead to "skin infections, slower healing, and scarring."

Whiteheads add one more problem. The AAD says a whitehead forms when oil and dead skin cells "plug the opening of a pore," so the top is closed. Pressing a loop onto a closed bump pushes against skin with no exit.

Extractors and darker skin

The dark spots that can follow picking are a larger concern for people with brown or black skin. The AAD's adult acne page says these spots "more commonly develop in people with darker skin tones," and that they show acne "is causing significant inflammation." It says a dermatologist can build a plan that clears acne and helps prevent more dark spots. If you have darker skin and are thinking about pressing out blackheads, see a dermatologist first.

If you have already used one

If you pressed out blackheads or whiteheads and the skin is now red, swollen or sore, stop using the tool and leave the area alone. Wash gently with your fingertips. The NHS says to see a GP if you have "signs of a skin infection, such as hot, swollen and red skin." Redness can be harder to see on brown and black skin, the NHS adds. A dark mark that stays after the skin heals is covered in dark marks after pimples.

What to use instead

The AAD's treatment for blackheads and whiteheads works from inside the pore: "To unclog pores, dermatologists recommend using a retinoid. You can buy one retinoid, adapalene, without a prescription. You'll also want to use a benzoyl peroxide wash." It says to "Give treatment six to eight weeks to work."

The adapalene label says to use it once a day and "cover the entire affected area with a thin layer." It warns that acne "may appear to worsen before it improves" in the early weeks, and that results may take up to 3 months. The guide how to get rid of whiteheads walks through the full routine.

Removal of any kind is temporary. The AAD says blackheads and whiteheads "can return, so you'll need to follow a skin-care plan to prevent new blemishes." A 1976 study of the oil plugs on the nose found an emptied pore "refills within 30 days." Adhesive strips have the same limit, covered in pore strips for blackheads.

What happens at a dermatologist's office

The AAD says: "During acne extraction, a dermatologist uses sterilized equipment to clean out your pores. You may need to have your skin exfoliated first." Exfoliating means removing the top layer of dead skin. The dermatologist can also treat the causes, with prescription retinoids, chemical peels or light treatments. The guide how a dermatologist removes blackheads explains each option and what to ask.

Questions to ask before extraction

• Do my blackheads and whiteheads need extraction, or should I try a prescription retinoid first?
• How many visits will it take, and what will each visit cost?
• What should I put on my skin afterward, and when can I restart my acne treatment?
• What will stop the pores from filling again?

The AAD says extraction "takes time and can be expensive," so ask about cost before you book.

When to see a dermatologist

See a dermatologist if blackheads or whiteheads remain after six to eight weeks of a retinoid, if you have many closely packed comedones, or if you are tempted to dig at your skin. See a doctor promptly for skin that is hot, swollen or painful after squeezing. Skinli gives general education and is not a doctor. If you want a plan built from a photo of your skin, the free Skinli acne plan starts there.