Understanding Whiteheads and Acne Scarring: Expert Insights

January 8, 2025

What are Whiteheads?

Whiteheads, are a type of occlusive comedone caused by the buildup of sebum in clogged pores. This happens when the pores’ openings become narrowed or blocked, trapping the sebum inside. Over time, this buildup leads to small, white lumps under the skin.

Key characteristics include:

  • White Appearance: Trapped sebum appears as a lump beneath the skin.
  • Hardened Yellowish Surface: Over time, the buildup may harden and take on a yellow hue.
  • Flaky Texture: In some cases, the surface may become dry and flaky.

Improperly squeezing these whiteheads often leads to pigmentation or scarring.

How Does Scarring Occur During Acne Treatment?

Acne scarring is often linked to improper handling of whiteheads during extrusion. The following common scenarios can lead to scarring:

  1. Excess Sebum Accumulation: Large amounts of trapped sebum increase the likelihood of pore damage.
  2. Deep Sebum Buildup: Sebum that is lodged deep in the skin can be difficult to extract without injury.
  3. Severe Inflammation: Inflamed acne is more prone to rupture and scarring.
  4. Thin Skin Surface: When the skin over the comedone is delicate, it can tear or peel during extrusion.
  5. Depressions After Inflammatory Injections: The removal of trapped sebum and inflammation may temporarily leave hollow spaces.

The Risks of Improper Extrusion

Improperly attempting to extract whiteheads or inflamed acne can result in:

  • Inflammation Bursts: Pressure can rupture the inflamed tissue, spreading the damage.
  • Pore Damage: Forcing out sebum can tear the pore’s opening.
  • Surface Damage: Thin skin over the whitehead may peel off.
  • Pigmentation Issues: The resulting inflammatory response often leads to dark spots or discoloration.

In some cases, depressions left behind after the removal of sebum or inflammation can appear more prominent. However, these typically fill in over a few weeks as the skin heals naturally.

Best Practices to Prevent Scarring

To minimize the risk of scarring during acne extraction, take the following precautions:

  • Avoid Excessive Pressure: If the sebum does not come out easily, forcing it can cause more harm than good.
  • Handle Thin Skin with Care: Areas with fragile skin require a gentle approach.
  • Seek Professional Treatment: Skilled practitioners use techniques that minimize damage and scarring.

At Skinlab, staff members are trained to follow these best practices, ensuring that treatments are effective and gentle.

Written By Paul Kim

Director of Operations - APN, NSWOC, RNP

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