How Are Blackheads Treated?

Blackheads, also called open comedones, are a type of acne. Blackheads develop if oil and dead skin build up on your skin and clog your pores.

If you squeeze one, you most likely find more blackheads to tackle, leaving your skin pinched, blotchy, and irritated from poking and prodding. While squeezing a blackhead is satisfying, touching the area can damage the skin barrier and cause inflammation and scarring.

Instead of squeezing blackheads, different treatments can help get rid of them. Usually, antibiotics, retinoids, and chemical exfoliators are first-line treatments. If those therapies fail, a dermatologist may recommend microdermabrasion, comedo extraction, chemical peels, or laser therapies.

What Are Blackheads?

Blackheads are a type of acne. Your skin is constantly sloughing off and clogging your pores while also secreting sebum, a kind of oil, that mixes with these dead skin cells, Rachel Nazarian, MD, a dermatologist based in New York, told Health. 

Also known as your skin's natural exfoliation, that process helps protect you from the external environment. However, as a result, you may notice dark pores crop up on your nose, cheeks, chin, and ears.

Those dark pores are blackheads, open pores that fill with sebum and dead skin. Blackheads are clear and greasy. However, when the pores are open to oxygen, they turn black.

What Causes Blackheads?

Generally, acne occurs if something builds up on the skin and clogs the pores. The types of acne vary depending on what clogs the pores. With blackheads, excess oil and dead skin clog the pores.

Anyone can develop blackheads. Still, certain factors increase your risk, such as:

• Hormones: Changing hormones during puberty, the menstrual cycle, and pregnancy can increase the risk of blackheads. For example, during puberty, levels of androgens, male sex hormones, rise. Androgens cause glands that make sebum to widen.
• Genetics: Your risk of blackheads may increase if one or more of your family members has acne.
• Certain medications: Corticosteroids and lithium may alter your hormones and increase your risk of blackheads.
• Age: While anyone can develop blackheads, adolescents are likelier to have it than others.

How To Treat Blackheads

A dermatologist may advise different treatments, including topical and oral medications, to reduce the build-up of oil and dead skin clogging the pores. Generally, people see improvements in their skin within six to eight weeks.

Antibiotics

Although acne is not an infection, antibiotics may help in moderate to severe cases. A dermatologist may advise antibiotics, either topical or oral. Antibiotics, like doxycycline and erythromycin, can reduce bacteria on the skin and inflammation. 

Usually, people with blackheads do not use antibiotics for long periods. However, you should always finish a complete round of antibiotics for them to work. 

Also, dermatologists often advise using antibiotics with other treatments, like benzoyl peroxide. On their own, antibiotics may lose their effectiveness.

Retinoids

Retinoids, either topical or oral, are a class of treatments derived from vitamin A. Examples of topical retinoids include tretinoin, tazarotene, and trifarotene. In contrast, isotretinoin is an oral retinoid that treats severe cases. Retinoids unclog pores, enhance cell turnover, and even out skin texture, explained Dr. Zeichner.

A dermatologist may advise gradually adding a topical retinoid to your skincare regimen and treating blackheads. For example, you may start by applying a low dose every other day. Eventually, you will use the product daily. 

Also, one of the side effects of retinoids is sun sensitivity. A dermatologist will likely advise that you be proactive about wearing sunscreen daily.

Keep in mind that you will want to avoid layering an acid, like salicylic acid, with a retinoid. Both products exfoliate the skin and might cause irritation and inflammation. Instead, stagger your application. For example, try using your products with acids during the day and save your retinoids for nighttime.

Cleansers and Exfoliators

Physical exfoliation can help smooth and brighten your complexion. However, physically exfoliating your skin will not reach the keratin and sebum inside your pores. Therefore, that method will not effectively treat blackheads, said Dr. Nazarian. 

Instead, use chemical exfoliators with ingredients that target blackheads by loosening and dissolving the grime in your pores. Opt for products that contain benzoyl peroxide, azelaic acid, or salicylic acid.

For example, "[salicylic acid] removes excess oil and exfoliates dead cells from the skin's surface to dry out pimples and clear out the pores," Joshua Zeichner, MD, an associate professor of dermatology at the Icahn School of Medicine at Mount Sinai, told Health. 

A dermatologist may advise using one of those chemical exfoliators with an antibiotic or topical retinoid. However, make sure that you stagger their application.

Also, products with ingredients like resorcinol and sulfur break down blackheads.

Microdermabrasion

You can perform microdermabrasion at home or receive the treatment in a dermatologist's office. Both options exfoliate the skin to treat blackheads. However, a dermatologist can penetrate the skin deeper than at-home options.

Using a device, a dermatologist removes the top layer of your skin. Then, they will gently apply moisturizer to the affected areas. The entire process takes about 30–40 minutes.

Typically, people receive five to 16 treatments. After each session, you must take extra care of your skin. After-care includes gently moisturizing your skin and protecting it from the sun. You may notice your face swells or gets pink or red.

Comedo Extraction 

Although dermatologists warn against popping blackheads, they can safely do so to get rid of them. With comedo extraction, a dermatologist uses sterile tools to remove blackheads.

Typically, people receive comedo extraction when other treatments fail. However, comedo extraction does not cure blackheads. So, you'll need to maintain a good skin care regimen with other treatments to prevent future acne. 

Chemical Peel

Chemical peels help reduce fine lines and wrinkles. Also, dermatologists use chemical peels to remove blackheads.

There are different types of chemical peels. For example, if you receive a deep peel, you will receive general anesthesia. Then, the dermatologist will gently apply the chemical peel in sections. Lastly, the dermatologist will apply surgical dressings to the affected areas.

In contrast, you do not need anesthesia for a medium peel. After applying the peel, a dermatologist will advise using a cool compress and gently cream on the face.

Laser Therapies

If used with other treatments, laser therapies may effectively treat blackheads. However, only certain types of lasers remove blackheads. For example, visible and infrared light does not treat blackheads. 

In contrast, photo pneumatic therapy uses intense pulsed light (IPL) laser with a vacuum to remove oil and dead skin cells, reducing blackheads.

Some evidence suggests that the best results take multiple sessions to achieve. Also, laser therapies may cause mild side effects like stinging and burning. Rarely, lasers cause long-lasting pain, burns, and blisters.

How To Prevent Blackheads

To prevent blackheads, try some of the following tips:

• Do not touch your face: As much as it might be super tempting, do not try to squeeze the blackheads out yourself, Debra Jaliman, MD, a dermatologist based in New York, told Health. Popping blackheads may cause bacteria to enter your skin and cause an infection.
• Use products that will not clog your pores: Opt for oil-free and non-comedogenic products. Non-comedogenic means that the product will not clog your pores, said Dr. Zeichner. 
• Stay consistent: Consistency in your skin care regimen is as helpful as the products that treat blackheads. For example, retinoids and salicylic acid help get rid of blackheads. However, you need to continue using them to prevent your pores from refilling, noted Dr. Nazarian.
• Avoid tight-fitting hats: Although headbands and caps do not cause blackheads, they might worsen acne. 
• Keep your hair out of your face: Another likely culprit of blackheads could be your hair. The oil that builds up on your hair can block the pores, especially if you have a fringe or bangs, added Dr. Zeichner.
• Take your makeup off nightly: If you wear makeup, never fall asleep without removing it. 

A Quick Review

Blackheads are acne that develops if oil and dead skin build up on your skin and clog your pores. Different treatments can help get rid of blackheads, including antibiotics, retinoids, and chemical exfoliators. Most blackheads go away within six to eight weeks. If your blackheads last longer than eight weeks, consult a dermatologist.