Do You Have Whiteheads, Blackheads, Pustules, Milia Or Cysts?

Updated: 9/6/14. Skin Fact: All blemishes are not equal. Learn the differences and treat them accordingly.

Whiteheads/Closed Comedones Little clogged bumps under the skin that aren’t red or sore, just little white-ish, clear or flesh colored bumps under the skin also known as “clogged pores.” Most people get them on the chin, sides of the mouth or hairline, but they certainly can be found elsewhere such as the cheeks. They are also very common in darker skin tones such as in African-American skin.

What you can do: Since these have no infection (meaning, they are not generally sore), using harsh acne products will only make them worse by causing dry skin cell build up trapping the oil in the skin longer. Exfoliate! By keeping off surface dead skin cell buildup, this will help them to purge naturally, however a good deep pore cleansing facial is also very beneficial for removing the impurities within the pores. Once you get the pores cleaned out, exfoliating products work deep within the skin to keep them clean.

Read: How To Manually Extract Clogged Pores And Blackheads From Your Skin

They can be caused from heavy pore-clogging oils like Mineral Oil and Petrolatum so be sure to avoid these ingredients. Also, limit the use of facial oils. While cleansing oils and skin oils used in place of moisturizer are popular to use, this will only add to trapped pores making them worse. A great cleanser to use is AHA/BHA Cleansing Gel which destroys the oil and bacteria deep within the pores. Exfoliate with gentle products like BHA Clarifying Serum, Mint Buffing Beads and Triple Berry Smoothing Peel.

Blackheads Large pores that contain oil that has oxidized with air causing it to turn black…

What you can do: Although there is no way to permanently get rid of blackheads, my best advice is to get regular monthly deep pore cleansing facials followed by home use of a well-formulated salicylic acid product like BHA Clarifying Serum to keep the pores clean long after the facial. Long term use of Retin-A can help but it has to be used regularly and for years before you can really see a difference.  Avoid the ingredients Isopropyl Myristate and Isopropyl Palmitate in your skin care products as these can contribute to the formation of blackheads and clogged pores.

Read: My 3-Step Plan For Reducing Blackheads

Pustules Red, inflamed blemishes that contain pus and known as your traditional “zits” that are most likely to cause post-breakout red or dark scars IF you don’t properly know how to care for them.

What you can do: You MUST NOT touch these until you can see a whitehead. Then you can carefully extract the infected pus and immediately spot treat with our Night Time Spot Lotion. Our Daytime Blemish Gel works very well, too.

Read: How To Get Rid Of A Blemish Fast

Papules A red, painful blemish that has not quite reached the surface. It’s the stage past a closed comedone (whitehead) where bacteria has caused inflammation resulting in an infected blemish. A papule will then usually turn into a pustule.

What you can do: The main symptom of a papule is inflammation and irritation so the goal is not to dry it out with acne products but rather to calm down the inflammation by using topical cortisone cream (found at the drug store), ice compresses followed by Anti-Cyst Treatment. These will all reduce the inflammation until the whitehead reaches the surface and it can be gently extracted.

Milia Hard, white, raised bumps that feel like a little ball under the skin; most commonly found around the eyes and the apples of the cheeks, but can appear elsewhere.

What you can do: All the acne spot treatments in the world will never get rid of these. They may be caused from heavy pore-clogging oils like Mineral Oil and Petrolatum, but for many people, they are genetic or caused from smoking. The only way to remove these is to get them manually extracted by an esthetician or dermatologist. If you try to do it yourself, you’ll probably end up scarring yourself so it’s best to put your skin in the hands of a trusted professional. Once you get them removed, regular exfoliation is really essential to keep them from coming back—or at least as quickly. AHA Smoothing Serum 17% works extremely well to keep the skin exfoliated so milia doesn’t form underneath dry skin cells. It’s also important to use gentle, low-foaming cleansing gels to deep clean without drying out the skin. See my recommendations for non-drying, sulfate-free cleansers.

Cysts Hard, painful bumps that develop deep within the skin and can linger for weeks.

What you can do: Do not pick! Despite being sore, you’ll never get that infection out and if you attempt to, you’ll most certainly have a scar that will linger for months. The rule is: If a whitehead does not forms (which they never do if it’s a true cyst) then hands off! You have only two options. Use Anti-Cyst Treatment (a true miracle of a product) or schedule an appointment to get a cortisone injection by a dermatologist.

Acne Scars Most blemishes will leave a purple or red mark once the blemish is healed. Post-Breakout Fading Gel works well to get the blemish scar to go away quickly.

Read: Get Control Of Cystic Acne—Before It Scars Your Skin!

Read: 11 Causes for Acne And Blemishes

Read: How To Break Your Skin Picking Habit

Which skin care products are best for you? See our nine skin types or take the Skin Type Quiz and get products recommended.

Need expert advice from a licensed esthetician? Schedule a virtual consultation to get customized advice in person, over the phone or online via Skype or Face Time.

For more expert advice check out the blog. Also sign up for our skin tip e-newsletter, follow Renée Rouleau on Twitter and Instagram and join the discussion on our Facebook page. You’ll be your own skin care expert in no time. Get the #ReneeRouleauGlow!

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Comments:

  1. You forgot papules. I get those a lot. I actually have all of the above acne but I frequently get papules more than I do cysts

    Posted By: Molly  | 

    Reply
  2. Renée Rouleau

    For simplicity sake (and because we couldn’t fit a sixth one in the header!) we kept it to the five. But since you mentioned papules, let me talk about those.

    Papules: It’s the next stage past a closed comedone (whitehead) where bacteria has caused inflammation and infection resulting in a painful, red blemish. The main difference between a papule and a pustule is that pustule is the next stage where dead bacteria and dead skin cells rise to the surface causing yellow pus.

    What you can do: The main symptom of a papule is inflammation and irritation so the goal is not to dry it out with acne products but rather to calm down the inflammation by using topical cortisone cream (found at the drug store) and ice compresses followed by a soothing mask like Renee Rouleau Azulene Gel Mask. These both will reduce the inflammation.

    Posted By: Renée Rouleau  | 

    Reply
  3. I am plagued most often by whiteheads, especially around the mouth/lip area – very painful, pustules and cysts. That said, the severity and frequency of all of the aforementioned have been greatly reduced since using your product line, Renee. :)

    Renee – two questions:

    1. Would you talk about why whiteheads/pimples form on the mouth/lip area?

    2. Are cortisone injections very painful? And, does one have to undergo a series of injections, or just one? I don’t think I’m at the point where my cystic acne is so severe to warrant cortisone injections, but, since you have mentioned them, I thought I’d ask.

    Posted By: Marcy  | 

    Reply
  4. Renée Rouleau

    Hi Marcy,

    Answer to #1
    The real cause is truly unknown as to why you get them in that area. We suggest to cut out your dairy (a previous blog post discusses that) but could also be hormonal.

    Answer to #2
    Yes, it will be slightly painful as they are injecting a needle into a very painful cyst. Once they inject the cortisone, it should be gone within 24 hours. One injection for one cyst.

    Posted By: Renée Rouleau  | 

    Reply
  5. What about small, red, raised bumps, which aren’t painful? What are these?
    I have a few on my cheek.

    Posted By: Marcy  | 

    Reply
  6. Two more things:

    I read up on cortisone injections. Apparently, the pimple disappears, but is replaced by a sort of dent which can take months to heal and fill in.

    Also, you recommend cortisone cream for papules, but it contains petrolatum and mineral oil, which you recommend one should avoid using on the skin.

    I would appreciate your comments re: the aforementioned.

    Posted By: Marcy  | 

    Reply
  7. Renée Rouleau

    It’s really hard to say without seeing it. If they are always there and never go away, then it’s some sort of skin growth and should be looked at by a dermatologist.

    Posted By: Renée Rouleau  | 

    Reply
  8. Lydia Noel

    As for papules, you can look for one that doesn’t contain that. But a one or two time use probably won’t be a problem.
    -Lydia

    Posted By: Lydia Noel  | 

    Reply
  9. Hi, Renee. The red bumps are some sort of inflammation. I put some ice on them last evening, and they calmed. :) Also, thank you to Renee and Lydia for responding to both of my inquiries.

    Posted By: Marcy  | 

    Reply
  10. Lydia Noel

    Excellent! Ice works, too! -Lydia

    Posted By: Lydia Noel  | 

    Reply
  11. Can a cystic pimple at some point develop a head? Which most likely means it wasn’t a cystic pimple to begin with. I ask because I have been treating what I thought was a cystic pimple for the past two weeks with the Anti-Cyst Treatment. However, instead of getting smaller, the pimple appears to be getting larger, not to mention more painful.

    What do I do?

    Posted By: Marcy  | 

    Reply
  12. Lydia Noel

    Generally speaking, cysts don’t come to a head. So it was probably a papule which turned into a pustule. But a lot of people have great luck with using our Anti Cyst Treatment for those.

    Posted By: Lydia Noel  | 

    Reply
  13. I am hoping you can shed some light on this. I have a couple of large pores on either cheek that never form a head. Yet, ever so often, I squeeze the skin around these pores and a long thread like pus like substance comes out. What could this possibly be? Thanks!

    Posted By: Nikki  | 

    Reply
  14. Lydia Noel

    It sounds like you have a clogged pore that keeps filling up with oil. Since you can get it cleaned out with squeezing it, then regular monthly deep pore cleansing facials and using a Glycolic Acid serum at home will help keep those pores cleaned.

    Since it’s a large pore with a wide opening, it will probably always keep “filling up” if you don’t keep it cleaned out. Hope this helps!

    Posted By: Lydia Noel  | 

    Reply
  15. Can the estheticians at RR extract milia?

    Posted By: Stephanie Haynes  | 

    Reply
  16. Lydia Noel

    Yes, we can. Depending on how close to the surface they are will depend on how easy it will be to get them out. When you call to schedule, let them know you have milia so they can schedule a little extra time for extractions.

    Posted By: Lydia Noel  | 

    Reply
  17. I have little bumps on my chin. When I squeeze them, it’s just like squeezing a white head, although they never really come to a head. But they don’t go away! I know they’re not cysts, so what are they?

    Posted By: Lexi  | 

    Reply
  18. Lydia Noel

    Is it in the crease of the chin? If so, that’s the way the pores form within that crease. Everyone has them but deep pore cleansing facials and home use of Glycolic Acid will help.

    If it’s not necessarily in the crease, then they might be leftover old oil from previous breakouts. Again, the same advice as above.

    Posted By: Lydia Noel  | 

    Reply
  19. Renee-

    I started using your products recently and my skin has never looked better! I tend to get alot of milia, and I’ve had several treatments at the dermotologist to extract them. Do you have a product that will minimize them?

    Posted By: Teresa Williams  | 

    Reply
  20. Renée Rouleau

    One of our Glycolic Serums and/or Triple Berry Smoothing Peel is your best bet. It speeds up cell turnover to prevent the dead skin cells from blocking the oil.

    Posted By: Renée Rouleau  | 

    Reply
  21. I started using 1 week back and i have strted seeing results in 1 week time .

    Posted By: mendy  | 

    Reply
    • Renée Rouleau

      Which product are you referring to? So glad that you’re getting results with our product.

      Posted By: Renée Rouleau  | 

      Reply
  22. my large portion of jaw area have become hard ,red, above al this there are many pus secreting heads on then i dnt know what it is and its lasting from more thanone and ahalf month i am helpless what should i do????????? plese do reply

    Posted By: ankit  | 

    Reply
    • Renée Rouleau

      Take a look at our Anti Cyst Treatment. Using that on the jaw area works very well to PREVENT breakouts as well as treat them. Use it every night on that area and watch them clear up!

      Posted By: Renée Rouleau  | 

      Reply
  23. My husband has infected pores on his face and scalp if I press on the skin yellow pus comes from all the surrounding pores it is like the underlying skin is infected he has been in antibiotics for 6 months but it hadn’t changed the doctor has advised that this is the only treatment and it is indefinite. Is there anything else we can try also what do you think this is called ? The doctor says it is just acne

    Posted By: Julie  | 

    Reply
    • Renée Rouleau

      It’s really hard for me to comment on it without seeing it. If the antibiotics aren’t working for the acne, then it’s time to try a new strategy. We have a new skin consultation service called My Skin Prescription (visit http://www.myskinprescription.com ) which can be done over Skype or Apple Facetime. Check it out and see if that’s something he would be interested in. It would be great for him to do this. Otherwise, have him look at our nine skin types and it will suggest products for his skin. I would guess he’s a skin type #3 but hard to know without all the details.

      Posted By: Renée Rouleau  | 

      Reply
  24. Hi their I’ve had well what I thought to be a milk spot right under my eye side of it but very close is really starting to bug me :( just want it gone. It looks like it has pus in it? :/ I squeeze it and it comes out with this stuff but doesn’t smell, comes back too it just never goes I’ve had it for about 10 years and I’m 26! It actually hurts to try and squeeze it too. Please help lol :/

    Posted By: Tara  | 

    Reply
    • Renée Rouleau

      Have you been to a dermatologist yet? I think that’s the way to go.

      Posted By: Renée Rouleau  | 

      Reply
  25. Renee, I regularly breakout on my chin. I dont think im a messy eater, I am starting to cut out dairy and i see less cysts on my chin. But somehow when i squeeze the skin, i get some liquid coming out, but they are from the pores (which are not visible). What are those? I cant seem to find an answer elsewhere.

    Posted By: Vivian  | 

    Reply
  26. I have a lot of milia on my nose, I got some removed not long ago but there are still more that have not reached the surface buried in the skin. What should I do?

    Posted By: Sofia  | 

    Reply
  27. I wonder if I don’t extract my pustule, will it still leave scar? Cos it’s been 2 months already that I have the purple mark on my face. Will it also give me pit cos of pus?

    Posted By: Susan  | 

    Reply
  28. My 14 year old has tons of acne. Some days worse than others. He now has tons of whiteheads on cheeks and forehead and face is red with red bumps. We have tried everything. Went to dermotologist and they prescribed epiduo and a sulfur cleanse and an antibiotic cream and a shampoo which we saw no results. I then researched and had him try witch hazel with no help. We are now trying proactiv which he started today. What can we do because it’s really bothering him now.

    Posted By: Dawn  | 

    Reply
    • Renée Rouleau

      I suggest that you schedule your son for an appointment with us. Visit myskinprescription.com We can take a look at his skin and offer our expert advice.

      Posted By: Renée Rouleau  | 

      Reply
  29. I am 37 years old and have always battled with clogged pores on my chin and along the jawline. I’ve recently starting using a gentle gel cleanser, a 5% glycolic toner and a lightweight moisturizer but the clogged pores are still an issue. My esthetician says its best to just spot treat any pimples, but I would love to be able to keep my pores clean and prevent the issue if possible without over-drying my skin. Any suggestions?

    Posted By: Laura  | 

    Reply
    • Renée Rouleau

      If what you have are “clogged pores” then exfoliation is your best bet. However, the 5% glycolic toner you’re using isn’t going to work well enough. Salicylic acid penetrates into the pore lining far more than glycolic does. I have a great acid serum that has both salicylic and glycolic, but also lactic acid. The combination of three is really powerful in clearing clogged pores, preventing blemishes, smoothing the skin and fading discolored marks from breakouts. You can see our BHA Clarifying Serum here https://www.reneerouleau.com/products/bha-clarifying-serum

      Posted By: Renée Rouleau  | 

      Reply
  30. I really don’t wanna do a post. Its so embarrassing to be having these problems, but I can’t fix my problem without knowing what it is. So let me start by saying what ever it is, is something I had all through out my teens come and go through out my 20’s. Whatever I have is on my chest they look like little white heads except if you try to pop them they will not go away. Some how in my mind, mind you being young I figured to get them to go away I would have to try to pull them out. Whatever they are, they’re connected to small almost invisible hair and if you can pull it out. It will leave a hole and if you can’t get it out it won’t go away.

    Posted By: heather  | 

    Reply
  31. I am 19 years old and I just recently got these tiny little bumps along both my cheek bones and mid forehead I never had this issue with clogged pores. I have normal sensitive skin with redness on one cheek. I tend to get oily in summer and dry, tight in winter. I really want to get rid of it and have nice smooth skin with no visible redness. What should I do to prevent these tiny bumps any suggestions?

    Posted By: Vanessa  | 

    Reply
    • Renée Rouleau

      It would be very helpful to start exfoliating regularly with either a facial scrub (used 3 times a week) and/or an exfoliating acid serum like one of these. Take my Skin Type Quiz here to get products recommended.

      Posted By: Renée Rouleau  | 

      Reply
      • Yes I already did I’m a skin type 5. Should I use the AHA smoothing serum and the advanced retinol serum? Or the BHA clarifying serum?

        Posted By: Vanessa  | 

        Reply
        • Renée Rouleau

          If you’re a skin type #5, then go with the AHA Smoothing Serum 10%. The Advanced Resurfacing Serum is for anti-aging, not surface exfoliation, but it’s too early to use so don’t get that. Use the AHA Serum three nights on, three nights off, alternating with the Soothing Relief Serum. All are oil-free.

          Posted By: Renée Rouleau  | 

          Reply
          • Ok but I can use everything in the complete selection correct except the advanced retinol?

            Posted By: Vanessa  | 

  32. Ok but I can use all the products from the complete selection on skin type 5 correct except the advanced retinol?

    Posted By: Vanessa  | 

    Reply
  33. Yes hello will the AHA smoothing serum help with blackheads/whiteheads around the nose? And also under the lip and chin? Will it remove clogged pores along the hair line/ cheekbones? Or do I need something stronger such as the BHA serum? And on my mid forehead above the brows I also get little bumps that are whitehead heads and then become pustules?

    Posted By: Clarissa  | 

    Reply
    • Renée Rouleau

      It sounds like the BHA Clarifying Serum would be better for you since you get a lot of clogged pores. I would first recommend that you get a deep pore cleansing facial from an esthetician to clean those out and then the BHA serum will work deeper in the skin to keep it looking clear.

      Posted By: Renée Rouleau  | 

      Reply
      • Even though I’m a skin type 5?

        Posted By: Clarissa  | 

        Reply
      • The BHA serum will work on skin type 5? I have clogged pores on the sides of my cheeks and then turn into pimples I’ve never had this problem before! Really want to get rid of them it’s very frustrating!

        Posted By: Clarissa  | 

        Reply
        • Renée Rouleau

          I would recommend the AHA Smoothing Serum 10% for skin type #5. Because it is exfoliating the skin, it will help clogged pores. You’ll also want to consider getting a deep pore cleansing facial.

          Posted By: Renée Rouleau  | 

          Reply
          • Yes I have a question about my skin type I don’t know if I’m a skin type 4 or 5? Can you help me?
            Because I do have a small spot of redness on one cheek but I just breakout on the sides where my cheekbones are they are tiny bumps clogged pores that turn to red bumps pimples i don’t know why but nothing seems to work or get rid of them? I have normal skin and I do get oily on my t zone if that helps!

            Posted By: Vanessa  | 

  34. Hello, I have started having a bad problem with red skin (rosacea) It comes and goes ,but is very embarrassing and makes me want to wear foundation all the time to cover it. I have tried metronidazole gel and oracea orally,neither help. I have read that it is due to dry skin, so I use a moisturizer which then makes my skin oily and I get tiny white bumps all over. My forehead gets very oily and makes my hair oily and I get milia there also. Please advise, Thank you (I am 47 yrs.old)

    Posted By: celia  | 

    Reply
    • Renée Rouleau

      It sounds like you’re not using the right type of moisturizer for your skin type if you’re getting white bumps all over. It’s clearly too pore-clogging for you. But yes, rosacea can benefit from repairing your skin’s moisture barrier and using the correct home care regimen will improve this. Take this Skin Type Quiz and get products recommended. Sounds to me as though you are a skin type #5 but take the quiz to make sure.

      Posted By: Renée Rouleau  | 

      Reply
    • Yes hello what is the difference between skin type 2 and skin type 4?

      Posted By: Vane  | 

      Reply
      • Renée Rouleau

        You can look at all nine skin types here and see the differences. (Click into each.) The main difference between skin type 2 and 4 is that 2 doesn’t get that much breakouts and is concerned about aging, so it might be someone who is in their late 20 or early 30s and beyond whereas usually skin type 4 is someone under 30 where they are still getting breakouts.

        Posted By: Renée Rouleau  | 

        Reply
  35. Hi,

    I have skin type 3 and get pustules on my cheeks that leave post acne marks and I also have milia on my cheeks and jawline. i do leave the milia alone but one by one they get inflamed leaving more acne marks behind. I just started using your BHA/AHA cleanser, the BHA clarifying serum and skin recovery lotion about 2 weeks ago, when should I start seeing results usually? I know it takes time. Also should I be using any other products to heal up my acne marks or new pimples coming in?

    Posted By: Deanna  | 

    Reply
    • Renée Rouleau

      It sounds to me as though you need to get a deep pore cleansing facial to clear out blocked pores. Closed comedones (what you’re referring to as milia) can turn into blemishes, as you have discovered, so clearing those out would be super helpful. The products you are using will then be even more effective by getting into the pores and helping them to stay clean, so I would highly suggest you find someone to do a lot of extractions on your skin. As for the routine, while you did get some great products, I would suggest you try to invest in other products for skin type 3. Essentially, the more you use, the more your skin will get the full benefit. Our acne spot treatments are amazing, too. (Like the Anti Cyst Treatment dabbed onto inflamed blemishes). As for the few products you have, it’s hard to say when you should see results but I’d say give it a good 3-4 weeks but again, it’s hard for me to say without seeing your skin.

      Posted By: Renée Rouleau  | 

      Reply

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