Whiteheads: advice for eliminating them.

White spots: which cosmetic treatments should be used to target them?

White spots, or pustules, are circular vesicles filled with pus, a clear fluid. They take the form of a white bump surrounded by red, inflamed skin. This type of spot is characterised by its significant size and high sensitivity to touch. The pustules can form on various areas of the body, including the face, where they cause significant aesthetic discomfort. When they appear on the face, white spots are usually caused by an outbreak of acne or rosacea, most often driven by hormonal fluctuations, causing an increase in sebum production, coupled with bacterial colonisation. To fight the infection, the immune system produces pus, a fluid composed of blood cells and neutrophils that accumulates in the blocked pore and forms the pustule.

Various cosmetic treatments can help combat white spots and achieve a smoother skin texture.

Applying a succinic acid treatment.
Still relatively unknown in cosmetics, succinic acid is an interesting active ingredient for combating pustules. It has antimicrobial properties and can specifically act against Cutibacterium acnes, which is implicated in the pathogenesis of acne. This molecule is also a good anti-inflammatory, capable of reducing the redness surrounding pustules. This was indeed demonstrated in a recent clinical trial conducted with 43 people suffering from acne. After applying a cosmetic lotion containing 2% succinic acid, 4% niacinamide and a phytocomplex for 56 days, the researchers observed an increase in the diversity of the patients' skin microbiota, with a decrease in the relative abundance of C. acnes (from 66.43% to 58.11%). Furthermore, a reduction of 52.12% in inflammatory lesions and 18.33% in erythema was observed.
Use of green tea extract.
Matifying, anti-inflammatory and antibacterial, green tea extract also presents a good alternative for combating whiteheads. Its effectiveness against pustules was studied in a trial involving 30 women suffering from severe acne. Over two weeks, they underwent ten sessions of sonophoresis accompanied by the application of a gel containing green tea extract, bamboo extract and 5% lactic acid. Sonophoresis is a technique that uses ultrasound to increase skin permeability and facilitate the diffusion of molecules. On average, the severity of acne decreased from 21.50 to 14.73 using the international GAGS (Global Acne Grading System). Moreover, out of the 30 women, 25 transitioned from severe acne to moderate acne.
Invest in certain essential oils.
The daily application of a drop of tea tree essential oil or rosemary essential oil on each pustule can also help to make them disappear. These essential oils are indeed known for their antibacterial properties, which allow them to help curb the infection, and anti-inflammatory properties, useful for reducing the redness and inflammation of the skin associated with pustules. However, caution is advised: like most essential oils, they should not be applied directly to the skin in their pure form and must be diluted in a carrier oil beforehand.
Turning towards a treatment with benzoyl peroxide.
Indispensable in the case of acne, benzoyl peroxide is a bactericidal agent, anti-inflammatory and comedolytic. It thus acts on three parameters involved in the pathogenesis of whiteheads. Benzoyl peroxide can indeed reduce the proportion of bacteria C. acnes and decrease skin inflammation. Moreover, it has exfoliating and sebostatic activities allowing it to neutralise hyperkeratinisation and hyperseborrhoea. Benzoyl peroxide is a very well-documented molecule, whose effectiveness against acne has been demonstrated in numerous studies. This compound is found in both cosmetic care and dermatological treatments.

Eliminating whiteheads: the importance of a consistent and tailored skincare routine.

Alongside treatments specifically targeting whiteheads, it is important to adopt a skincare routine that is suited to your skin type. While it is not necessary to have a complicated routine composed of numerous products to combat pustules, certain categories of care are considered essential by many dermatologists. These include the cleansing - moisturising - sun protection triptych.

Step 1: Cleanse the skin.
Practised once or twice a day, skin cleansing removes impurities, sweat, and sebum that accumulate throughout the day or during the night. This prevents the clogging of pores and thus the formation of whiteheads. Moreover, by leaving the skin clean and clear, cleansing improves the absorption and effectiveness of subsequent treatments. It is generally advised for individuals with whiteheads to opt for a cleanser that is soap-free, abrasive-free, alcohol-free and has a high rinseability.
Step 2: Hydrate the skin.
Skin hydration is a crucial step in a skincare routine, even for oily skin or skin with whiteheads. Indeed, poor hydration can damage the skin barrier and may trigger a reactive hyperseborrhea, which is a rebound effect in sebum production. Therefore, the use of a light, non-comedogenic moisturiser, formulated for acne-prone skin, is important in combating pustules.
Step 3: Protect the skin from the sun.
Often overlooked, the daily application of sun protection is nevertheless essential in the case of white spots. Indeed, UV rays can intensify skin inflammation and exacerbate imperfections. Therefore, using a non-comedogenic broad-spectrum sunscreen every day is necessary to protect the skin while avoiding further clogging of the pores.

Although it may be tempting, it is not advisable to pierce a white pimple, as this could spread the infection to the rest of the face and lead to the appearance of other pustules.

Which dermatological treatments help to eliminate whiteheads?

If you do not notice an improvement in your skin after six to eight weeks of regular use of cosmetic products targeting pustules, if these multiply rapidly or become a significant source of insecurity, it is time to consult a dermatologist. They can offer you stronger treatments tailored to your situation. Oral antibiotics, for example from the tetracycline family, or topical ones, such as erythromycin, are generally prescribed as a first step. In the case of oral antibiotics, they are sometimes combined with benzoyl peroxide or topical retinoids.

Topical retinoids, whether adapalene or tretinoin, are indeed often used to combat pustules as they possess a noteworthy keratolytic effect which allows them to remove dead cells accumulated on the surface of the epidermis and thus unclog the skin's pores. In cases of severe or persistent acne, an oral treatment based on isotretinoin may be considered. It should be noted that due to its teratogenic nature, isotretinoin is strictly contraindicated for pregnant women. Those of childbearing age must imperatively use reliable contraception.

Another option in the case of recurrent pustules: the continuous intake of spironolactone, a diuretic with anti-androgenic properties. By regulating and reducing the production of androgens, this molecule helps to decrease sebum secretion, which aids in combating whiteheads. However, this therapeutic option is relatively recent and has not yet had much follow-up.

Finally, the "Sebacia" laser is increasingly establishing itself as a long-term solution for eliminating pustules. This process is based on the targeted destruction of sebaceous glands. For this, a solution containing gold and silica microparticles is applied to the skin. These penetrate the sebaceous glands and accumulate within them. The microparticles then absorb the energy delivered by the laser radiation emitting at 810 nm, which destroys the sebaceous glands. This treatment not only eliminates skin lesions but also prevents their recurrence by ensuring that the sebaceous glands still at rest do not become inflamed in the future.