Treating Whiteheads

Let’s talk about whiteheads.  Pimples.  Zits.  Blemishes.  No matter the name, they are a nuisance to everyone from time to time.  Whiteheads are different from blackheads and are sometimes easier to get rid of/treat.  We know many people will pop whiteheads in hopes of they will go away just like that, but is that the smartest thing to do?  Learn the answer in the article below.

A Dermatologist’s Pro Tips For Getting Rid of Whiteheads

Once and for all.

It’s time to get rid of whiteheads once and for all. The pesky pimples’ white heads—that’s where the very original name comes from—are agonizingly noticeable and tend to pop up at the most inconvenient times. To figure out how to fight these blemishes, we enlisted the help of Dermatologist Dr. Nava Greenfield of Schweiger Dermatology Group. Read on to find out how to get rid of whiteheads and prevent new ones from popping back up.

What exactly is a whitehead?

“A whitehead is a buildup of keratin (substance produced by skin cells) and oil from sweat glands inside a hair follicle,” says Dr. Greenfield. Whiteheads and blackheads are both comedones, which are small bumps or blemishes on the skin usually causes by a clogged pore, but they do differ. “Whiteheads are also called closed comedones because the pore does not extend to the skin surface,” explains Greenfield. “Blackheads are open comedones because they are open, and allow the keratin and sebum to oxidize which turns it black.”

Should you extract whiteheads at home?

You can, but unless you know exactly what you’re doing, it’s not recommended. “If the technique is not sterile, you can cause an infection in the skin,” says Greenfield. “Also, pimple popping can easily lead to scarring which is hard, time consuming, and costly to treat.” Your best bet is contacting a dermatologist. They have three important things: the tools, the knowledge, and the degree. The only three things you have are your fingers, an insatiable need for instant gratification, and the free trial version of the Headspace app. “Our goal as a dermatologist is to treat the acne without leaving any scars,” says Greenfield.

What are some non-popping at home remedies for whiteheads?

It starts with prevention. “You can try a salicylic acid spot treatment when you see one developing,” says Greenfield. “Sometimes they can help prevent and acne papule from enlarging and can help them resolve.” If you see a whitehead forming, try grabbing one of the products listed below to catch the pimple in the earliest stage.

The Ordinary: Salicylic Acid 2% Solution, $4.90,

Orgins: Super Spot Remover Acne Treatment Gel, $17.00

Peace Out: Acne Healing Dots, $19.00

What products can you recommend for whiteheads?

“I recommend retinoid and glycolic acid washes and moisturizers, Retinoids balance sweat gland productions and stabilize cell turnover on the face which helps control white production,” says Greenfield. If you’re using retinoids to fight whiteheads in the winter, Dr. Greenfield urges users to pack on the moisturizer since retinoids are very drying. It’s best to ask your dermatologist for a prescription retinoid, but here are a few over-the-counter options.

Obagi: Retinol 1.0, $61.00

NeoStrata: Retinol & NAG Complex, $48.00

Jack Black: Deep Dive™ Glycolic Facial Cleanser, $22.00

Mario Badescu: Glycolic Foaming Cleanser, $16.00

So you’re going to pop your whitehead at home anyway. (We get it, no judgement.) How should you prepare?

Be clean! “Clean it [the whitehead] with an antibacterial like rubbing alcohol,” says Greenfield. “Clean your hands and sterilize any other instruments that you will use.”

What’s the process of popping a whitehead? What’s the best after care?

The process is fairly straightforward. “Opening up the skin with a needle and using a comedone extractor to remove the contents of the pore,” explains Dr. Greenfield. In regards to after care, “wipe away any debris left over and hold gentle pressure with a gauze pad for up to approximately one minute.”



What Microneedling Does

Microneedling has become a very popular treatment in aesthetician’s and dermatologist’s offices over the last couple years because of the alleged benefits to your skin that it brings. However, not many people know a lot about microneedling because other treatments sometimes overshadow this procedure. We think the future is bright for microneedling! It is a relatively simple procedure that helps fight your acne scars, large pores, and more. Learn about what it’s like to try microneedling in the article below.

Carina Jahn/Blaublut Edition/August

In movies about a woman trying to get pregnant, there?s always that scene in which the protagonist looks around and sees nothing but infants in strollers, swollen bellies, signs advertising DJ school for toddlers. I have a similar obsessive streak, but in my movie, I?d be faced with a sea of Rihannas, Cate Blanchetts, Pharrells?flawless visage after flawless visage. I?d stroke my own imperfect cheek and weep.

My skin problems began in puberty with a case of cystic acne that haunted me right up until last year, at age 25. (Aczone, my friends: Ask your doctor about it.) Even though I?ve now got my blemishes more or less under control, I?ve been left with enlarged pores and scars around my cheeks and mouth. For this, I?ve tried all manner of over-the-counter peels, exfoliants, and ?miracle? witchy cures (apple cider vinegar shots, anyone?) to no avail.

Then, via the wonderful world of Instagram, I caught wind of the microneedling craze. Microneedling is a process that?s exactly what it sounds like?tiny needles penetrating the skin hundreds of times?usually at the hands of a wand-wielding dermatologist or licensed aesthetician. Popularized in the 1990s by a Canadian plastic surgeon after he found he could fade surgical scars with an inkless tattoo gun, it?s used to treat all kinds of textural woes, from acne scars to enlarged pores. According to Mary L. Stevenson, MD, an assistant professor of dermatology at NYU Langone Health, the counterintuitive process, also known as collagen induction therapy, is thus: The needles create wounds that trigger an ?inflammation cascade,? the same natural healing process that occurs when scar tissue is formed after, say, a scraped knee?rendering skin, to crib from Ernest Hemingway, ?strong at the broken places.? But because the needles are so short (0.5 to 4 mm, tinier than a garden ant), the process is very controlled. While clinical assessments of microneedling are in their relative infancy, the results are promising: A 2015 study in the Journal of Clinical and Aesthetic Dermatology showed ?a noticeable enhancement in skin appearance, post-acne scars, and patient satisfaction? in all 10 patients after six bimonthly sessions. And while lasers are more prone to causing accidental hyperpigmentation in darker skin tones, microneedling does not.

Advertisement – Continue Reading Below

While microneedling isn?t exactly new, it?s only in the last couple of years that at-home devices have flooded the market. Most DIY treatments involve running a small manual device (think a spiky paint roller) over the skin. Experts agree that at-home rolling should never be done with needles exceeding 0.5 mm?the risk of infection is too high?yet those same experts will tell you that at that particular length, little damage is being done to the skin, and therefore little actual collagen-building is being triggered. Which isn?t to say that at-home rolling is useless. According to Stevenson, DIY devices might increase the effects of certain topical treatments, while Manhattan-based dermatologist Joshua Zeichner, MD, notes that if you?re looking to reduce post-acne hyperpigmentation, the exfoliation ?likely may give some effect. You?ll notice I put in three qualifiers.?

After a few weeks experimenting with a 0.3 mm at-home roller, I notice that my skin feels softer but not markedly changed. I want my pores teeny and my acne scars gone?now. And so, on the recommendation of superstar dermatologist Dendy Engelman, MD, I make my way downtown to Jeannel Astarita, the founder of Just Ageless NYC Medical Spa.

A single microneedling treatment runs between $500 and $750, and it?s rarely sold as a one-off (patients with deep scars often opt for a series of three to six treatments). But for my rosacea and acne-prone skin, traditional microneedling could spell disaster (inflammation! Exacerbated breakouts!). It turns out I?m in luck: Astarita can offer the EndyMed Intensif, a relatively new device that couples microneedling with radio frequency to treat both active acne and acne scars. Delivered via 12 highly conductive gold-plated needles, the heat kills acne-causing bacteria and lessens inflammation. (Because it?s basically two treatments in one, it?s more expensive; my treatment, which Astarita provides gratis, would normally cost $1,200.) After cleansing, exfoliating, numbing, and disinfecting my skin, Astarita starts stamping the thicker skin on my cheeks, nose, and chin, programming the needles to go to a depth of 2.5 mm, followed by my delicate undereyes and forehead at 1.5 mm. It?s no more uncomfortable than a light pinch?for the first few pulses. Then the discomfort gradually increases until tears stream down my cheeks. (Astarita explains that because the Intensif uses a slower in-out motion for its needles than straight microneedling, it?s considered marginally more painful.)

Advertisement – Continue Reading Below

But almost as soon as it begins, it?s over, and Astarita is applying postprocedure topicals?an antioxidant and a skin-strengthener. When she finally hands me a mirror, my face is a shocking shade of burgundy. It subsides to that of a particularly bad sunburn by the time I get home, and the pores on my chin?this isn?t for the squeamish?look like they?re purging sebum. In actuality, ?it?s a result of the inflammation,? Astarita texts me the next day during a check-in. ?The pores weep.? Per her advice, I slip two damp muslin cloths into the freezer and apply them periodically, feeling not unlike Norma Desmond in Sunset Boulevard?s gruesome makeover scene.

Everyone?s skin reacts differently to these procedures, but it?s typical to be red, dry, and flaky for a few days. I?d planned to work from home on the Friday following my treatment, and at the early-morning sight of my swollen, pink visage, I?m glad I did. I commence a weekend of extreme moisturizing, and by Monday, one colleague remarks upon my smooth skin (hallelujah!).

Advertisement – Continue Reading Below

Advertisement – Continue Reading Below

By the one-month mark, my pores look definitively smaller, and the scars that have bothered me for years are far less noticeable. Time will tell as to how much collagen- induced filling and tightening I?ll experience?the effects continue to develop for up to six weeks postprocedure?but for now, I?m basking in my own glow.

Not ready to commit to an in-office treatment? Here are the tools you?ll need to baby-step your way at home.


Skimping isn?t an option when it comes to needles in your face?at-home dermarollers like the Rodan + Fields Amp MD Micro-Exfoliating Roller System (1) may help with product penetration. And while in-office post-treatment topicals include injection-grade hyaluronic acid and platelet-rich plasma (via your own blood?as in the vampire facial), there are ultraeffective over-the-counter alternatives. Astarita swears by antioxidants, like SkinBetterScience Alto Defense Serum and SkinCeuticals C E Ferulic, and peptide promoters, like DefenAge 8-in-1 BioSerum (2); Zeichner recommends simple wound-healing balms, like La Roche-Posay Cicaplast Baume B5 (3). ?You may have a fantastic micro- needling procedure,? he says, ?but if you use the wrong products afterward, you may run into problems.”

1. Rodan + Fields Amp MD Micro-Exfoliating Roller System, $220; rodanandfields.comSHOP

2. DefenAge 8-in-1 BioSerum, $220; defenage.comSHOP

3. La Roche-Posay Cicaplast Baume B5, $11; amazon.comSHOP

This article originally appears in the February 2018 issue of ELLE.



Have You Heard of Baby Botox?

The newest injectable method involves a product we already are quite fond of, Botox. The name? Baby Botox. No, babies are not the recipients of treatment. Baby refers to getting a lesser amount of Botox injected into the target area. That way the area won’t appear as stiff as it would with a higher volume used. Learn more about Baby Botox in the article below.

“Baby Botox” (which doesn’t actually involve babies ? phew!), might just be the future of injectables.

Simply put, “Baby Botox” uses a lower volume of Botox (a.k.a. botulinum toxin injections) than a traditional injection to smooth fine lines and wrinkles. “Instead of using 25 units in an area, you may use 10 units,” Melissa Doft, a board-certified plastic surgeon in New York City, tells Allure. “I have many patients who ask for half the normal dose, as they do not want to look frozen but are tired of wrinkles in photos. First-time Botox patients are perfect for this.”

Besides the volume of product used, Baby Botox is about the technique, says Doris Day, a board-certified dermatologist in New York City and author of Beyond Beautiful. “If you’re very precise in where you put the product, you can use lower doses,” she tells Allure. These super targeted micro injections deliver the more natural, tailored look Baby Botox is so coveted for.

As compared to standard-size injections, Baby Botox lowers the risk of your features appearing to be frozen. Take the forehead, for example: “The risk is that you weaken your frontalis muscle, which causes your eyebrows to drop,” Darren Smith, a board-certified plastic surgeon in New York City, tells Allure. “If you’re getting micro doses of Botox, that’s a lot less likely to happen.”

Baby Botox can be used pretty much anywhere on your face, but it’s best to create subtle changes or to erase fine lines. “Something like this is especially nice for an area like the crow’s feet, which is a very delicate area where a subtle treatment is more effective,” explains Smith. “If someone has very deep folds, micro Botox probably isn’t going to cut it. I would offer this to someone with moderate to fine lines.”

Here’s everything you need to know about Baby Botox.

1. This is not a one-size-fits-all injection.

Botox often gets a bad rep for leaving patients looking a little frozen, but that’s the fault of bad technique, not necessarily the procedure itself, explains Day. “In many places where it’s not a trained aesthetic physician doing the injection, it’s really just inject by number,” she says. The problem with this is that no two faces, or even two sides of a face, are the same. “That cookie cutter, one-size-fits-all approach is what often gives these treatments a bad name,” says Day.

Baby Botox takes the exact opposite approach. The goal of the teeny targeted injections is all about personalization. “For me, the goal of Botox is to rebalance and restore the face so you look your most beautiful best,” says Day. “I’m so over that look of sameness.”

Of course, for your most tailored look you might need a bigger dose. When considering Baby Botox, keep in mind, “The lower dose of Botox may not remove all of the lines,” says Doft. “Sometimes patients will try the lower dose first, and if in two weeks they do not see enough improvement, we will invite them back to have the full dose.”

2. It can be used to prevent lines.

The subtle nature of Baby Botox makes it perfect for those hoping to prevent lines in the first place by starting treatment in their 20s. “Baby Botox is designed for patients who are on the younger end of the spectrum of Botox users who wish to prevent the formation of wrinkles,” says Doft.

The idea is to prevent wrinkles before they form by using Botox to manipulate the way wrinkle-causing muscles move, explains Day. “My goal is to watch how you animate and how your face is aging and redirect it.” In other words, Baby Botox can help you hold onto your baby face.

3. It can be a subtler way to maintain results.

Baby Botox can also be used as an upkeep strategy. “I really think of it as small maintenance doses of Botox over time instead of standard doses given at three- to six-month intervals,” says Smith. “The other term that describes this well is ‘tweakment’ ? subtle changes done over a longer period of time using lower doses of product at each treatment.”

Instead of letting your injection totally wear off after three to six months, monthly Baby Botox injections, which use about a quarter of a standard dose, can maintain the original look. Think of it as a bangs trim between haircuts.

If making monthly injection appointments doesn’t seem feasible, you might want to forego Baby Botox in favor of a traditional dose of Botox every three to six months, says Smith.

4. It’s potentially cheaper.

Using less product should mean spending less money, right? Maybe, but not necessarily.

In some practices, the cost of the actual product determines the price, but in others, “The cost of the treatment is based on the skill set, not the product,” says Day. In other words, seeing a trained aesthetic physician, who has the time and technique to give you tailored, micro injections, might actually be more costly than larger, more formulaic doses.

Before going under the needle, it’s important to understand the pricing structure so you don’t end up spending a fortune, stresses Smith. Monthly micro doses could end up costing you more than standard-size injections every three to six months. Talk to your doc about a Baby Botox strategy before getting injected.

Related stories:

Now, watch as a dermatologist explains lip fillers: