“Will my whiteheads ever go away?” What is a whitehead and thoughts about extraction

What is a whitehead?

Milia is the technical term for whiteheads. Some people think the term is pronounced Amelia, but it is not. (One milia equals “a milia,” and that is where the mispronunciation comes from.) Milia are found when dead skin has grown over a pore that has become congested (filled with oil and debris).

Whiteheads need to be professionally extracted—even more so than pustules. Why? Because even though you can see the whitehead on the surface of your skin, it takes someone who really knows whether or not it can be extracted. Just because you can see the milia doesn’t necessarily mean it is ready to come out. 

I am 50 years old and have pretty good skin. It is best described as combination skin—a little drier along the cheeks and under the eyes but a little oilier around the forehead and nose. I do not have breakouts to speak of.

I do have a few spots that might be whiteheads, but I’m not sure. They are relatively hard to see (unless you are really looking for them), but they are almost like tiny cysts under the skin. They are white, but the clog itself is like a little hard bead, not a fluid. [This, by the way, is a great description of a whitehead.] 

I do not typically try to extract these myself. Over time some go away. I do not know if they can be extracted during a facial or if a dermatologist would be required. Like I said, though, they are few and small so it’s not a big problem.

The way she described her little white bumps is a good description of a whitehead. This, in a nutshell, is a whitehead. It is like a seed or bead nestled inside a closed pore. Some are easier to see than others, but sometimes they really can’t be detected.

Because there is skin grown over the opening of the pore, the debris (oil) can’t just come out if you squeeze like a blackhead will. An opening has to be made (in the salon, a lancet is used) in order for the actual extraction to take place. Then if you don’t have knowledge about what is extractable and what isn’t, you may go after a whitehead that won’t come out no matter how hard you try. What comes next is possible capillary damage (couperose) and almost definitely a small infection.

Don’t self-extract your whiteheads. Have your aesthetician do this delicate work!

Since the whiteheads are few, small, and hard to see, I would leave well-enough alone. If you go in for a facial, see what the aesthetician thinks, and if possible have them extracted. Know that if you are prone to whiteheads, they will more than likely return.

I’ve recently had several new clients come in due to whiteheads and their desire to have them removed. I go into every facial with the hope to get rid of any and all milia a client has in their skin, however my wishes (and the client’s) don’t always come true.

As I’ve mentioned, although you can clearly see a whitehead, that does not mean it can be successfully extracted. One helpful tip for any clients coming in for extractions: do a clay mask once or twice right before coming in for your facial. The clay will help to bring the debris (oil in the pores) closer to the surface, which can make extraction more *successful. The clay mask will also get your pores super clean, removing superficial blackheads, creating super clean and clearer skin.

For more information, see:

• Blackheads & Whiteheads explained 
• Extractions 2.0: A How-To for those who can’t or won’t go to a professional (blackheads, whiteheads & pustules) (coming soon) I am only including this article for those of you who won’t heed my advice to leave whiteheads alone!
• “I have little white bumps under the skin—help!” (upcoming)