Whiteheads are a combination of oils, sebum and cellular fragments that produce firm to hard plugs within hair follicles. They are closed from the skin’s surface by cellular debris at the follicle opening. Because they are closed and have no contact with oxygen, they do not oxidize or turn brown, as blackheads do. They form a light or yellow-white lump and are called milia (or milium, singular). When bacteria is added to these plugs, the condition can lead to acne, especially cystic acne (as shown below).


Whiteheads are promoted by excessive cellular exfoliation, which quickly clog or block the follicles. Some skin specialists believe individuals with frequent and multiple blackheads and whiteheads produce sebum that is drier than normal and conducive to forming firm plugs. Sebum contributes to skin oils and people with dry sebum may have dry skin. This may be especially true of people with chronic whiteheads, but it is also possible to have dry sebum with oily skin.

The sebaceous glands normally produce sebum with linoleic acid (omega 6), an essential fatty acid. This type of sebum has a liquid viscosity. It is calming to the skin and does not promote follicular irritation that leads to plugs. When linoleic acid is not available, the sebaceous glands produce sebum with oleic acid. This oleic form of sebum is irritating to the skin and promotes plugs. Oleic sebum is much firmer than linoleic sebum and is prone to producing hard plugs rather than flowing out of the follicle. This causes blackheads and whiteheads and both of these conditions may lead to acne infections.

Patients with large numbers of whiteheads may have an inability to digest or absorb linoleic acid, which leads to sebum produced with an oleic acid form of sebum. 

To help with linoleic acid deficiency, purchase flax seed oil supplements in the 1,000mg size. Take one capsule daily as directed.  Do NOT take the supplements if pregnant or nursing.  The supplements take 2-3 weeks to have an effect and the sebaceous glands will begin producing the linoleum form of sebum.  This will reduce the volume of new plugs but may not eliminate them altogether.  The supplements usually resolve issues with dry skin and in general improve the appearance of the skin.  Flax seed oil supplements will not dissolve pre-existing plugs but will work in conjunction with home care products.


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