What is a Pimple with a Hard White Ball Inside?


We've all experienced those pesky pimples that seem to show up at the worst times. You look in the mirror one morning and notice a small bump brewing on your forehead. At first, it's just a little red bump, but over the course of a day or two, it grows into a full-fledged zit with a gross pus-filled head. But then there are those other rare pimples - the ones with a hard white ball inside. What gives?

If you've ever dealt with a pimple like this, you've probably wondered what that hard white ball inside the pimple actually is. It's definitely different than the typical pus-filled pimples we're all familiar with. Keep reading to find out exactly what causes these unique pimples with the hard white balls inside of them.

What is a Pimple with a Hard White Ball Inside

What Causes a Pimple to Form in the First Place?

Before we dive into what the hard white ball inside certain pimples is, let's do a quick pimple overview and talk about how pimples form in general.

Pimples start deep in the pores when they become clogged with dead skin cells, excess oil (sebum), and bacteria. This mixture of substances, debris, and germs is known as a plug. The plug blocks the pore, which is normally open to the surface of the skin. This traps all the yucky stuff inside.

When the pore becomes blocked and a plug forms, the area swells up and becomes a bump. This is because of the skin's natural response to the blockage. To help clear the clog, the walls around the pore become inflamed. As part of this inflammatory response, the area fills with white blood cells to help fight any infection, and becomes red and swollen.

At this point, you've got an official pimple brewing under the surface.

If the plugged pore remains blocked near the skin's surface, the bump will continue to grow and fill with pus. This pus is made up of the oil, dead skin cells, bacteria and white blood cells trapped within. Eventually, this pus-filled area will rupture through the blocked pore and surface as an open, pus-oozing blemish. Fun times, right?

However, sometimes plugs can form deeper in the pore and lead to pimples filled with other material like hard white balls. Let's look into those unique cases.

Pimples with Hard White Balls - What Gives?

Pimples that contain hard white balls rather than pus have formed deep within the skin. These blemishes are also known medically as closed comedones.

Closed comedones arise from deeper in the skin structure than typical pus-filled pimples. When dead skin cells, sebum and bacteria clog a pore and cause a blockage deeper in the dermis, it triggers a reaction and causes a bump. However, because the plug forms deeper inside the skin, the contents have less exposure to air.

These closed off, airless environments favor the formation of something called keratin.

What is Keratin and How Does it Form?

Keratin is a protein that makes up the outermost layer of our skin. Keratin is produced by cells called keratinocytes deep in the pores. Under normal circumstances, these keratin proteins are transported up to the surface of the skin and make up the outer barrier.

However, when a pore gets blocked deeper in the dermis, the keratin can build up inside the closed space. Over time, these keratin proteins clump together into a hard, whitish-yellow mass. This keratin clump of dead skin cells is the hard white ball that forms inside these unique pimples.

On the surface, these bumps look like typical pimples with a red, inflamed ring. But once they are popped open, instead of finding pus, you discover a hard, pebble-like keratin ball that had formed deep down in the pore.

What Makes the Keratin Turn Into a Hard Ball?

You might be wondering how the keratin transforms from a protein into a hardened ball. Within the closed space deep in the dermis, the keratin is exposed to the pimple's inflammatory environment. This causes oxidization - a chemical reaction between the keratin and oxygen that were trapped within the blocked pore.

The oxidization process causes the keratin to harden and crystallize, turning this amorphous protein into a solid formation. Think about how an egg hardens into a solid form when cooked. The heat from cooking leads to protein denaturation and oxidization, creating a change from the raw egg's soft liquid state into a firm cooked egg.

A similar process happens within these closed off pimples, leading the keratin proteins to take on their signature hard white ball shape. The end result is an unpoppable white ball firmly wedged deep inside the pore.

Common Causes and Locations for Hard Whitehead Pimples

Hard whitehead pimples can show up randomly, but there are certain locations and triggers that make them more likely to form. Here are some of the most common causes and locations for these unique whitehead zits:


Some people are simply predisposed to developing closed comedones and hard whitehead pimples because of their genetics. So while your friend might only deal with minor blackheads, you end up with deep bumps filled with keratin balls. Genetics can make someone more prone to this type of acne.


Hormonal fluctuations are a classic trigger for whitehead pimples. That's why they frequently show up around puberty, menstruation, pregnancy and menopause. The hormonal changes that occur during these times can kick sebum production into high gear and constrict pores. This oily environment primes the skin for pore blockages deep in the dermis that lead to hard whiteheads.

Oily Skin

If you have naturally oily skin, you may find yourself as prime target for these annoying hard whitehead pimples. Excess oil can mix with dead skin cells and bacteria, finding its way deep into the pores and causing bumps filled with trapped keratin.

Skin Products

Certain ingredients in skin care products, makeup and hair care items can clog your pores and irritate your skin. This can set the stage for hard whiteheads to brew under the surface. Ingredients like mineral oil, coconut oil and cocoa butter are highly comedogenic, meaning they have a rating scale score that indicates their likelihood of clogging pores.

Tight Clothing and Protective Gear

Spandex workout leggings, form-fitting dresses, tight jeans, shoulder pads in clothing or equipment and bra straps place pressure on the skin for long periods. This constant friction can irritate hair follicles and lead to hard bumps of trapped keratin below the surface. Sports helmet straps and chin guards can also cause closed comedones to form.

Certain Medications

Certain drugs like corticosteroids, testosterone, or lithium are associated with increased blocked pores and whitehead pimples. The mechanisms aren't fully understood, but seem to involve increased oil production and skin cell turnover.

Chronic Rubbing or Picking

Habitually rubbing, picking or scratching at your skin can instigate the formation of hard whitehead pimples. The constant irritation drives the debris deeper into the pore, where it can trigger deep comedones filled with keratin balls.

Common Locations for Hard Whiteheads:

  • Hairline
  • Forehead
  • Chin
  • Upper Arms
  • Shoulders
  • Buttocks
  • Inner thighs

The anatomy of pores and hair follicles in these areas make them prone to blocked ducts and closed comedones. The friction and rubbing from clothing also makes whitehead pimples likely in these locations.

Are Hard Whitehead Pimples Preventable?

While you can't always avoid hard whitehead pimples entirely, there are measures you can take to reduce your risk:

  • Keep skin clean to minimize oil and debris buildup. Use a gentle daily face wash.
  • Exfoliate regularly with products that contain salicylic acid. This helps unclog pores and remove dead skin cell buildup.
  • Limit use of pore-clogging cosmetics, creams and ointments. Opt for oil-free "non-comedogenic" labeled products.
  • Shampoo regularly, especially after sweating, to keep hair and scalp oils under control.
  • Avoid excessive rubbing, picking and scratching. This drives the debris deeper into pores.
  • Wear loose, breathable clothing and protective gear when possible.
  • Speak to a dermatologist about prescription medications if breakouts are severe or consistent.

While frustrating, occasional hard whitehead pimples are normal and manageable with proper skin care. However, if you begin noticing an abundance of hard bumps and closed comedones, speak to a dermatologist to explore causes and solutions. Consistent closed comedones may signal an underlying skin condition that requires treatment.

How to Get Rid of Hard Whiteheads

So you've got a bump brewing on your face with a hard white lump inside. What's the best way to get rid of it and remove the stubborn keratin plug?

Don't Squeeze!

Although extremely tempting, picking or squeezing a hard whitehead aggressively can make it worse. Forcing out the mass will likely just push the keratin deeper into the skin instead of removing it. And all that squeezing and fingernail probing can lead to trauma and scarring.

Steam to Loosen and Soften

Instead, a better first step is to steam your skin to help open up and soften the hard whitehead. Take a washcloth soaked in hot water and hold it over the blemish for several minutes. The moisture and warmth will help loosen up the contents and bring the plug up towards the surface.


Before attempting to extract a whitehead, clean your hands and swab the blemish with rubbing alcohol. This reduces the risk of pushing bacteria deeper into the pore and causing infection. sterilizing the area is an important first step.

Use a Sterile Lancet

Next, using a sterile lancet, gently nick the very tip of the whitehead open. Lancets are sterile, puncturing devices used by doctors and nurses to prick the skin and get drops of blood. In this case, you can use one to carefully create a small opening through which you can extract the whitehead.

Apply Light Pressure

After creating a tiny opening, use a cotton swab to apply very gentle, steady pressure beside the hard whitehead. Slowly coax the keratin plug up and out through the pre-made hole. Take it slow - no aggressive squeezing! With some light pushing, the hard ball should slide up the pore and emerge.

Follow Up Care

Once removed, apply a dot of benzoyl peroxide cream to the open pore to kill any bacteria and prevent further clogging. Allow the area to close and heal naturally, keeping it clean. Avoid makeup, picking and irritating the area while it recovers.

With some diligent steaming, sterilizing and light pressure, you can successfully extract those annoying hard whitehead pimples. But if they persist, be sure to see your dermatologist.

When to Seek Medical Care for Hard Whiteheads

While dealing with the occasional hard whitehead is normal, seek medical attention if you notice any of the following:

  • Sudden onslaught of recurring hard whitehead outbreaks
  • Inability to extract the hard whitehead properly at home
  • Signs of skin infection - spreading redness, swelling, pain, heat
  • Scarring or dark spots left behind after the bump resolves
  • Hard whitehead areas that repeatedly refill after clearing

If you are experiencing any of these issues, your dermatologist can help uncover the root cause and get your skin back to healthy. They may prescribe topical or oral medications to target congested pores and prevent future hard pimples from forming. Procedures like gentle extraction, chemical peels or steroid injections can also help remove stubborn hard whiteheads.

Don't pick at hard bumps endlessly. Seek help for effective treatments to prevent scarring and clear your skin long-term.

When Are Hard Whiteheads Reason for Concern?

For most of us, an occasional hard whitehead pimple is just a nuisance we have to contend with. But in some cases, clusters of recurring closed comedones may signal something more serious.

Frequent crops of hard whitehead acne lesions could indicate skin disorders like:

  • Acne Conglobata - Rare, severe form of nodular acne characterized by burrowing comedones and nodules.
  • Hidradenitis Suppurativa - Chronic skin condition causing blocked hair follicles and painful bumps in folds of the skin.
  • Pseudofolliculitis Barbae - Hair follicle irritation from shaving leading to ingrown hairs, puss-filled bumps and scarring in men.

If you are experiencing recurring episodic breakouts of hard whitehead pimples, consult a board-certified dermatologist. A proper diagnosis is key to rule out underlying disorders and develop an appropriate treatment plan. Consistent closed comedones may require prescription oral or topical medications to address root causes.

Your dermatologist can determine if an underlying skin condition is at play, or if you simply need to tweak your daily skin care routine to prevent normal whitehead pimples. Don't resign yourself to continual hard whitehead breakouts - seek help to get to the bottom of what's causing them.

In Conclusion

Dealing with the occasional pimple is part of life, but those hard whitehead ones can be especially annoying. Understanding what causes that tough keratin ball inside your zit is the first step toward banishing these bumps. With diligent pore care and proper extraction technique, you can kiss those hard whitehead pimples goodbye!

Frequently Asked Questions About Pimples with Hard White Balls Inside

Pimples with a hard white ball inside can be confusing and frustrating to deal with. Below are answers to some frequently asked questions about these unique pimples:

What is a pimple with a hard white ball inside?

This type of pimple, sometimes called a closed comedone, forms when dead skin cells, oil, and bacteria clog a hair follicle deep within the pore. The contents of the clog undergo a chemical reaction that causes them to harden into a whitish-yellow keratin mass. This hard ball of keratin gets trapped deep inside the pimple. On the surface, you just see a small, red bump.

What causes these hard whitehead pimples to form?

There are a few potential causes:

  • Genetics - Some people are just prone to developing closed comedones
  • Hormonal fluctuations during puberty, menstruation, etc.
  • Very oily skin
  • Use of comedogenic products that clog pores
  • Skin irritation from tight clothing, sports equipment, habitual rubbing
  • Medications like corticosteroids

Where do these pimples with hard white bumps usually appear?

Common locations include the face (forehead, chin), back, chest, shoulders, and buttocks. Areas often covered by clothing or equipment tend to be prone to closed comedones. The pores and hair follicles in these regions are anatomically more likely to get clogged.

How do you get rid of a pimple with a hard ball inside?

DO NOT aggressively squeeze them. This forces the keratin deeper into the skin. Instead:

  • Steam the area to loosen and soften the contents
  • Sterilize the area with alcohol
  • Use a sterile lancet to gently nick open the surface
  • Apply very gentle pressure with a cotton swab to ease out the plug

How can these hard pimples be prevented?

You can reduce their occurrence by:

  • Washing skin daily with a gentle cleanser
  • Using oil-free, non-comedogenic skin products
  • Exfoliating regularly to remove dead skin cells
  • Avoiding skin irritation from frequent rubbing/picking
  • Shampooing hair regularly, especially after sweating

When should I see a dermatologist for hard whitehead pimples?

See your dermatologist if you have:

  • Sudden increase in hard whitehead outbreaks
  • Inability to properly extract them at home
  • Signs of infection - spreading redness, swelling, pain
  • Recurring hard pimples that refill after clearing
  • Scarring or dark spots left behind

Could recurring hard whiteheads indicate something serious?

Frequent crops of hard whiteheads can sometimes indicate disorders like:

  • Acne congolobata - severe, nodular acne
  • Hidradenitis suppurativa - chronic bumps in skin folds
  • Pseudofolliculitis barbae - shaving irritation leading to ingrowns

See your dermatologist if you have recurring hard pimples to rule out any underlying skin conditions requiring treatment.

What’s the best way to extract a hard whitehead pimple?

Follow these steps:

  1. Sterilize the area with alcohol
  2. Hold a warm, damp washcloth over the area to soften and open the pore
  3. Use a sterile lancet to gently nick the surface of the whitehead
  4. Apply very light pressure with a cotton swab beside the pimple, coaxing the plug out
  5. Avoid squeezing or picking at it!
  6. Dab on benzoyl peroxide cream after extracting

With proper technique, you can remove those stubborn hard whiteheads. See your dermatologist if signs of infection, scarring, or recurrences develop.

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