Blackheads: Causes & Treatments

Symptoms

Blackheads look like small, dark spots. They often develop on the face (especially on the nose and chin) but can also show up on the neck, back, and chest.

Unlike some other forms of acne, they aren’t painful. If a blackhead becomes infected—which can happen if you pick at it—you may see redness, swelling, and yellow or white pus. Blackheads may occur along with pimples, whiteheads, and cystic acne.

Causes

Blackheads are not caused by poor hygiene. Many causes of blackheads are ones you can’t control. Some risk factors include:

• Genetics
• Puberty—changing hormones can increase your skin’s oil production
• Hormonal changes in women from menstruation, premenstrual syndrome, pregnancy, using hormonal forms of contraception)
• Anything that blocks or covers pores, such as clothing, thick skincare products, and heavy makeup
• Excessive sweating
• Humidity
• Medical conditions such as polycystic ovary syndrome
• Medications such as corticosteroids, lithium, and androgens

Pore Strips for Blackhead Removal

Pore strips are a popular over-the-counter treatment for blackheads that promise quick and visible results. These adhesive strips are designed to be applied to the nose or other areas of the face where blackheads commonly occur.

How do pore strips work? When applied to damp skin, the adhesive on the strip bonds to the top layer of dead skin cells, oil, and other debris clogging the pores. As the strip dries, it contracts and pulls this material out of the pores. Upon removal, the strip takes the extracted debris with it, potentially leaving pores clearer.

While pore strips can provide satisfying immediate results by removing some surface-level blackheads and debris, dermatologists caution that their effectiveness is limited. Pore strips only remove the top portion of a blackhead and do not address the root causes of their formation. Additionally, frequent use of pore strips may irritate the skin or enlarge pores over time.

If you choose to use pore strips, follow these tips for best results:

1. Cleanse and dampen the skin before applying the strip
2. Ensure the strip adheres well to all creases
3. Leave the strip on for the recommended time (usually 10-15 minutes)
4. Gently remove the strip, being careful not to tug too hard on the skin
5. Use no more than once a week to avoid irritation

Remember that while pore strips can be a temporary fix, a consistent skincare routine that includes proper cleansing, exfoliation, and oil control is more effective for long-term blackhead prevention and management.

Blackhead removal

It may be tempting to remove blackheads by squeezing them but this is a bad idea. Squeezing can damage the skin and allow bacteria to enter the pore, causing inflammation.

There are several types of OTC medications for blackheads. If these don’t work, see your dermatologist, who can gently remove them with special tools. Your dermatologist may also recommend prescription medication.

At-home care

Using acne products regularly may get rid of your blackheads but it takes time. It can take 6–8 weeks for the below treatments to work.

OTC medications

There are many OTC products that treat blackheads, including face washes, scrubs, gels, and creams. These contain ingredients such as:

• Salicylic acid, which unclogs pores
• Azelaic acid, which fights bacteria and clears pores
• Benzoyl peroxide, an antibacterial chemical that unclogs pores
• Retinol, a milder, OTC version of retinoids, which prevents dead skin cells from building up in your pores. Retinol can be found in products like moisturizers but is also sold as a gel (Differin).
• Blackhead-fighting masks can help deep-clean your pores. These usually contain clay or charcoal.

Steaming

Steam can help loosen the oil and dead skin cells that are clogging your pores. Never stand over a pot of boiling water. Instead, boil the water, let it cool for a couple of minutes, and then pour it in a bowl. Drape a towel over your head to trap the steam and position your face about 6 inches above from the bowl. You can stay under the towel for up to 10 minutes.

Supplies

Using a facial brush helps remove dead skin cells that can clog your pores and cause blackheads. There are electronic versions as well as simple silicone facial brushes. But they can irritate sensitive skin.

Medical care

If your blackheads don’t improve after 6–8 weeks of treating it yourself, or you also have more severe forms of acne, see a dermatologist. You may need to take prescription medication or have your blackheads professionally extracted.

Medication

• Retinoid creams and lotions. Retinoids are made from vitamin A and unclog blocked pores. Examples include tretinoin (Retin-A) and tazarotene (Tazorac). Keep in mind that retinoids can temporarily make acne worse before it gets better. It can take 8–12 weeks to see results.
• Antibiotics. If you have ongoing or severe acne, your dermatologist may recommend taking antibiotics to get it under control. These include tetracycline, minocycline, and doxycycline. Or you may be prescribed an antibiotic cream (clindamycin).

Procedures

• Extraction. Your dermatologist can safely remove blackheads using sterilized tools. While it’s possible to buy your own blackhead removal tools, it’s best to have blackheads professionally removed to avoid infection and scarring.
• Chemical peels. While they’re not used specifically for blackheads, your dermatologist may recommend a series of chemical peels, which can help remove dead skin cells. A salicylic acid or glycolic acid solution is applied to your face, which causes the top layers of skin to peel away, revealing smoother skin underneath.

Preventive tips

It’s not always possible to prevent blackheads, particularly those that are caused by hormonal changes. But certain lifestyle changes may be helpful:

• Use makeup and skin products labeled “non-comedogenic,” which means they don’t clog pores. Oil-free gel facial washes and water-based gel moisturizers are good options for people with blackheads and other forms of acne.
• Wash your face twice a day and apply a non-comedogenic moisturizer afterward.
• Always remove makeup before going to bed.
• Exfoliate your skin once or twice a week by applying a scrub (nothing with large grains, such as apricot scrubs) in gentle, circular motions.
• Try not to touch your face.