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Dr. Andrew Rynne

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Suggest treatment for recurring white heads on cheek

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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 15754 Questions

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Posted on Tue, 19 Aug 2014 in Skin Hair and Nails
Question: I have recurring white head spots on my cheek which are almost impossible to "pop ", when I do the skin is broken
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Answered by Dr. Michelle Gibson James 33 minutes later
Brief Answer:
topical retinoid and topical antibiotic first line

Detailed Answer:
HI, thanks for using healthcare magic

White heads are one of the types of lesions that can be seen with acne. They do not easily burst when compared to other acne lesions such as pustules (small 'bumps' filled with pus).

Acne occurs due to four main reasons: (1) there is excess production of an oily waxy substance called sebum in the skin
(2)this causes blockage of the hair follicles
(3)there is inflammation of the skin
(4)a particular bacteria is present which also contributes to the acne.

Effective treatment would involve most or all of these.

Normally, mild treatment is started first, if there is no response then more intense treatment is started.

Initial treatment would include: (1) cleansing the face at least twice daily. There are cleansing agents that contain benzoyl peroxide, choose one with a small amount. In the initial stage of use, benzoyl peroxide irritates the face.
Benzoyl peroxide has an anti inflammatory effect, reduces blockage in some and also has a small effect on the bacteria

(2) in addition, the current consensus is that all persons with acne should use a topical retinoid and anti bacterial cream.
Topical retinoids include creams such as differin, atralin, avita, retin-A micro.

Topical antibiotics such as topical clindamycin and topical erythromycin are the most effective topical antibiotics

Summary: (1)white heads are one of the lesions seen in acne also called closed comedones
(2)cleanse twice daily either with normal cleanser or one with small amount of benzoyl peroxide
(3)a combination of a topical retinoid and topical antibiotic are recommended first line at present
Would likely need a prescription from your doctor. If this is not an option you can just use the cleansing agents.

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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