What Exactly Are Blackheads? A Dermatologist Explains. (Plus, Tips for Removal)

by | Updated: November 10th, 2021 | Read time: 4 minutes

While you may notice those pus-filled whiteheads and worry that others notice them too, whiteheads are typically short-lived. Blackheads are a bit more complicated since they don’t expel as easily without damaging skin. If you’re wondering why they appear and how to safely evict them, keep reading! You’ll also discover how to lower prevalence and keep your skin healthy and blackhead-free.

A Young Woman Applies a Blackhead Removal Strip to Represent What Are Blackheads | Vitacost.com/BlogWhat are blackheads?

What’s happening to skin when blackheads appear? Board Certified Dermatologist and founder of AmberNoon, Erum N. Ilyas, has some answers.

“Blackheads are clogged pores that are open or exposed to the air where excess keratin, sebum and oil builds up,” Ilyas said.

The keratin in these pores oxidizes and turns black, a phenomenon known as comedones in the medical world. Whiteheads, on the contrary, are closed clogged pores, which are not open or exposed to the air. Both blackheads and whiteheads start off as the same kind of acne, but blackheads open up and change in color while whiteheads stay closed.

Whiteheads can worsen when bacteria in the pores build up, which is why they swell and get tender, whereas blackheads stay less noticeable and are not at much risk for scarring.

The triggers for blackheads and whiteheads are similar. Here are the most common causes of blackheads and how to best treat and manage them.

What causes blackheads?

The biggest cause of blackheads is hormonal fluctuations, which often occur from acute stress and for women can be related to menstrual cycles. Another culprit of blackheads is exposure to toxins in everyday life. This could come from touching your skin too often or holding your phone against your face for long periods of time.

“Holding your phone to your face allows sweat and dirt to build up between your face and your phone,” Ilyas said, “leading to acne known as mechanica.”

This similarly occurs with chin straps from helmets and baseball hats over the forehead. Contrary to instincts, blackheads are greater in size when squeezed and picked. One thing not to do when your skin breaks out is pull at and touch your skin. Instead, let it breathe and heal.

You can also get blackheads from using certain hair products, creating acne along the hairline, temples and forehead. This kind of acne is also known as pomade acne since it comes from excess exposure to pomade-containing products.

Take note, the black dots on the nose are actually not always blackheads. There is a common genetic trait called trichostasis, which results in the appearance of blackheads on the nose and chin.

“These are actually open pores with sebum and a small hair follicle giving them a dark appearance,” Ilyas explained. “They are best managed with adhesive nasal strips.”

How to remove blackheads

The best way to manage hormonal acne is awareness of hormonal patterns and good skincare practices. Eating a clean diet helps as well. This includes skin-promoting nutrients like vitamins A, C and E, healthy fats and protein while lowering intake of sugar and fat. And if you’re someone who sweats often, be wary of the excess sebum production.

Stress-busting exercises like yoga and meditation along with healthy sleep is important too. Wash your face after sweating or makeup use with products that promote fewer breakouts. And use products designed for acne-prone skin, like salicylic acid, benzoyl peroxide and retinoid-containing products.

Benzoyl peroxide can clear dead skin cells from the surface of the skin and can kill acne-causing bacteria, thus reducing buildup in the pores.

Try a salicylic cleanser, a pore cleansing wash with benzoyl peroxide for a deeper clean, or a retinoid serum. If your acne is mostly from clogged pores, salicylic acid cleansers can exfoliate to help open and unclog pores. Finding cleansers with hyaluronic acid and vitamin E is a bonus since they’re better for upkeep of healthy, hydrated and nourished skin.

“Recognizing patterns for acne distribution can often help focus on a cause or trigger to avoid aggravating more flares,” Ilyas said. For example, only use a dollop of what’s needed for hair products.

It’s reasonable to remove blackheads at home gently using microdersion, chemical and exfoliation peels and masks or manually.

“I usually recommend taking two cotton tips, anchoring them on either side of the pore and gently pushing them towards each other to extract the keratin,” Ilyas explained. “This will be less traumatizing to the skin than your fingernails.”

Nasal strips are very effective at unclogging blackheads and clogged pores manually. A tip to make blackhead removal easier is to use a topical retinoid for several days before extracting.

“Prescription strength retinoid include tretinoin and tazarotene, which loosen up and break apart the keratin and dead skin cells, making them easier to extract,” Ilyas said. If used weekly, these retinoid creams help maintain healthy pores long-term, but first speak to your dermatologist about which products are best for your skin.

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