Blackheads and whiteheads are both types of comedonal acne, but they have distinct characteristics and causes. Understanding their differences can help in selecting the right treatment for clearer skin.
What are Blackheads (Open Comedones)?
Blackheads consist primarily of:
- Sebum (oil produced by sebaceous glands)
- Dead skin cells (keratinocytes)
- Melanin (skin pigment produced by melanocytes)
Appearance: Small, dark or black dots on the skin surface.
Formation: Open pores filled with sebum and dead skin cells, which oxidize when exposed to air, causing them to appear black.
Location: Typically found on areas with increased sebum production, such as the nose, forehead, and chin.
Why are Blackheads black?
When a pore becomes clogged with excess sebum and dead skin cells, the plug is exposed to air. The melanin pigment within the trapped cells oxidizes upon contact with oxygen in the air, turning dark or black.
The misconception is that blackheads are dark due to trapped dirt. In reality, it is melanin oxidation—similar to how an apple turns brown after being cut and exposed to air.
Blackheads often respond well to exfoliation (chemical peels, salicylic acid, glycolic acid) and manual extraction.
What are Whiteheads (Closed comedones)?
Whiteheads are pores clogged by oil, dead skin cells, and bacteria, but the pore remains closed at the surface. Whiteheads (closed comedones) are covered by a thin skin layer, preventing oxidation. Thus, their contents remain unoxidized and appear white or skin-colored.
Appearance: Small, flesh-colored or white bumps because they’re closed and not exposed to air (no oxidation).
Location: Commonly found across the face, including cheeks and forehead.
Topical retinoids, benzoyl peroxide, exfoliation, and sometimes gentle extraction can help clear whiteheads.
Differences between Blackheads VS Whiteheads
| Feature | Blackhead (Open comedone) | Whitehead (Closed comedone) |
|---|---|---|
| Appearance | Black or dark in color | White or flesh-colored |
| Surface | Open | Closed |
| Cause of color | Oxidation by air (not dirt) | Closed under the skin surface, no oxidation |
| Texture | Firm, easily extracted | Softer, deeper, harder to extract |
| Risk of inflammation | Lower risk | Higher risk (can lead to inflamed acne) |
Treatment for Blackheads
Understanding that blackheads become dark due to melanin oxidation, and not dirt, emphasizes why topical exfoliants (like retinoids or salicylic acid) effectively treat them, reducing melanin-rich cell accumulation and preventing oxidation.
The Clifford Clinic’s 755 nm Alexandrite laser has a high affinity for melanin pigment, which makes it particularly useful in targeting blackheads (open comedones) due to their melanin-rich, oxidized contents.
Here’s why the 755 nm Alexandrite laser laser can be helpful for blackheads:
High Melanin Absorption:
The black color of blackheads is specifically due to oxidized melanin. The 755 nm wavelength strongly targets melanin, allowing selective absorption and subsequent breakdown of the oxidized melanin in the blackhead.
Selective Targeting:
The Alexandrite laser selectively heats and vaporizes the melanin-rich plug without damaging the surrounding tissue significantly. This targeted treatment reduces the appearance of blackheads effectively.
Reduced Pore Size:
By heating and removing the oxidized melanin plug, the laser may indirectly help shrink or reduce the visibility of pores, preventing future blackheads from forming easily.
Treatments with the 755 nm laser often yield rapid improvement in areas dense with blackheads (e.g., the nose or forehead), clearing them more effectively than treatments that do not specifically target melanin. It is particularly effective for patients with stubborn, recurrent blackheads that don’t respond sufficiently to topical treatments.
If you’re experiencing issues with blackheads or whiteheads, please contact The Clifford Clinic at 6532 2400, and I’ll be happy to assist you.
