Whiteheads are a type of acne lesion, known as a closed comedone, which forms when a pore is blocked by oil, dead skin cells, and bacteria. Finding these small, raised bumps around the mouth can be frustrating due to the area’s sensitivity and visibility. Many bumps that appear white or pale around the lips are not true acne whiteheads, but rather common, harmless skin variations or other dermatological conditions. Identifying the nature of the bump is the first step toward effective management and prevention.
Differentiating Common Lip Bumps
Many white or pale bumps on or near the lips are not closed comedones, but are instead normal structures or benign cysts. One of the most common variations is Fordyce spots, which are enlarged sebaceous (oil) glands. They appear as tiny, painless white, yellow-white, or flesh-colored dots. These spots are present in 70% to 80% of adults and typically cluster along the vermillion border, the thin line separating the lips from the surrounding facial skin.
Another possibility is Milia, which are small, firm, dome-shaped white bumps resulting from trapped keratin. Milia are tiny cysts, not acne, and are not associated with inflammation or redness. In contrast, a true whitehead is a small, raised bump that is part of the acne process and usually forms on the surrounding skin rather than the lip itself. True whiteheads are caused by an overproduction of sebum and dead skin cells in a hair follicle, creating a visible plug.
Specific Causes of Perioral Acne
When the bumps are confirmed to be true whiteheads, the cause often relates to the unique environment around the mouth, leading to perioral acne. A frequent trigger is occlusion from heavy or waxy products, known as acne cosmetica. The use of thick lip balms, petroleum jelly, rich moisturizers, or high-coverage makeup can clog the pores in the skin surrounding the lips. These products create a physical barrier that traps sebum and dead skin cells, encouraging whitehead formation.
Hormonal shifts are a significant factor, causing oil glands to become overactive and increase sebum production. This acne tends to appear in the lower third of the face, including the chin and perioral region, often flaring during menstrual cycles, pregnancy, or stress. Habits like frequent lip licking or touching the face can transfer bacteria and irritants to the area, contributing to breakouts. Irritation from dental products, particularly toothpastes containing fluoride or harsh foaming agents, can also trigger perioral dermatitis, which is often confused with acne.
Immediate At-Home Care and Prevention
Managing and preventing perioral whiteheads begins with gentle habits and product changes. Use non-comedogenic skincare products, which are formulated not to clog pores, and wash your face twice daily with a mild cleanser. Be meticulous about rinsing after brushing your teeth, as residue from irritating toothpaste ingredients can linger around the mouth and trigger breakouts.
Avoid manipulating the bumps, as squeezing or picking a whitehead can push bacteria deeper into the skin. This action increases the risk of infection, inflammation, and potential scarring. For mild breakouts on the surrounding skin, use over-the-counter topical treatments containing salicylic acid (BHA) or benzoyl peroxide. Salicylic acid dissolves the plug of oil and dead skin cells, while benzoyl peroxide targets acne-causing bacteria and reduces inflammation.
When to Seek Professional Treatment
While many mild whiteheads respond to consistent home care and product adjustments, specific signs indicate it is time to consult a dermatologist. If the bumps do not improve or continue to worsen after four to six weeks of dedicated at-home management, professional evaluation is warranted. A dermatologist can accurately distinguish between true acne, Fordyce spots, milia, perioral dermatitis, or other conditions like cold sores.
Seek prompt care if the bumps become intensely painful, severely swollen, or show signs of infection, such as redness or crusting. For persistent or moderate-to-severe cases, a dermatologist can prescribe stronger, targeted treatments. These options may include topical retinoids, which normalize skin cell turnover, or oral medications, such as antibiotics, to reduce inflammation and bacteria.