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Blackheads: Causes & Treatments

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Medically reviewed by
Clinical Instructor , Mount Sinai Hospital, Department of Dermatology
Last updated October 25, 2022

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Care Plan

1

First steps to consider

  • Most blackheads can be treated at home.
  • Try OTC acne creams, gels, scrubs, that contain benzoyl peroxide, salicylic acid, and retinoids.
2

When you may need a provider

  • Blackheads don’t improve after 6–8 weeks of home care, or you also have more severe forms of acne
  • You want to have blackheads removed with special tools.

Blackheads are a type of acne that has a tiny dark spot at the center. They tend to show up on your face when pores get clogged, but you can treat (and help prevent) them with OTC acne medications.

What are blackheads?

Blackheads are a type of acne that look like small, dark spots on the skin. They form when your pores become clogged with dead skin cells and oil (sebum). Blackheads, also called open comedones, do not have a layer of skin covering them. When the clog reaches the surface of the skin and reacts with air, it turns black.

Blackheads are most common in teenagers and young adults, but adults can have them as well. They often develop on the face (especially on the nose and chin) but can also show up on the neck, back, and chest.

You may be able to remove blackheads by using face washes, scrubs, and creams or gels. But some blackheads may need to be removed by a dermatologist. You should also see a dermatologist if you have blackheads with more severe forms of acne that may need to be treated with prescription medications.

Pro Tip

It’s a common misconception that if you have blackheads you shouldn’t moisturize because this would produce more oil and make more blackheads. In fact, treatments for blackheads can cause dryness and irritation, so using a moisturizer (a non-comedogenic one) is often necessary. —Dr. Lauren Levy

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:

Dr. Rx

Blackheads in your armpits or groin folds may be a chronic condition called hidradenitis suppurativa (acne inversa), where the hair follicles in the skin folds become inflamed and enlarged. See a dermatologist if you think you have this condition. —Dr. Levy

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.

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Preventive tips

Pro Tip

Using hair oils or pomades can lead to blackheads on the forehead, lateral cheeks, and shoulders/upper back if your hair is long.  Switching your hair products to those that are non-comedogenic can help with this problem. —Dr. Levy

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.
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Clinical Instructor , Mount Sinai Hospital, Department of Dermatology
Dr. Levy is a board certified dermatologist specializing in medical derm with expertise in acne, rosacea, skin cancer, psoriasis, and skin manifestations of rheumatologic disease. Her undergraduate education was completed at the University of Pennsylvania where she graduated summa cum laude and was inducted into the Phi Beta Kappa honors society. She graduated with a distinction in research from t...
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