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Blackheads- Causes, Symptoms, Diagnosis, and Treatment

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Blackheads are a common skin condition mainly involving the face, particularly the nose, neck, arms, back, chest, and shoulders.

Medically reviewed by

Dr. Ekansh Shekhar

Published At December 29, 2022
Reviewed AtDecember 29, 2022

What Are Blackheads?

Blackheads are a kind of acne called acne vulgaris. They are open bumps on the skin filled with excess oil and dead skin. They may look as if dirt is in the bumps, but they do not signify poor hygiene or dirt on the skin. They frequently occur on the face, particularly on and around the nose. They can also appear on other body parts, such as the back, chest, neck, arms, and shoulders. Blackheads affect almost everyone during their lives. However, they are more frequent among teenagers and young adults undergoing hormonal changes. Blackheads are not contagious and cannot spread from one person to another through skin-to-skin contact.

What Causes Blackheads?

Blackheads are open comedones that occur when a hair follicle or sebaceous gland becomes inflamed due to the following reasons:

  • Increased sebum production by the sebaceous gland.

  • Abnormal keratin build-up.

  • Increased hormones can cause increased sebum production during teenage, menstruation, or while taking birth control pills.

  • The build-up of the bacteria Propionibacterium acnes on the skin causes acne.

  • Certain drugs, like corticosteroids, lithium, or androgens.

What Are the Symptoms of Blackheads?

The other common symptoms of blackheads include:

  • The main characteristics of blackheads are dark, open bumps on the skin. They appear black due to the oxidation of debris, like oil, dirt, dead skin, and bacteria. They are easy to spot because of their dark color.

  • They are not painful like pimples and do not cause discomfort like whiteheads.

How Are Blackheads Diagnosed?

Blackheads are often easy to recognize from their appearance, so seeing a healthcare professional to diagnose them is not needed.

How Are Blackheads Treated?

Over-the-Counter Medications: Various non-prescription medications can treat blackheads. They work by killing bacteria, removing excess oil, and forcing the skin to shed dead skin cells. These drugs contain ingredients such as:

  • Salicylic Acid: This is available as a cleanser or lotion. It effectively removes the top layer of damaged skin. In addition, the acid dissolves dead skin cells to prevent the hair follicles from clogging.

  • Azelaic Acid: Barley, wheat, rye, and various grains naturally contain azelaic acid. It kills microorganisms on the skin and helps reduce swelling.

  • Benzoyl Peroxide: This over-the-counter product is a leave-on gel or wash. It works by targeting the surface bacteria which aggravate acne. However, these formulations may irritate the skin.

  • Retinoids (Vitamin A Derivatives): Retinoids break up blackheads and help prevent clogged pores. There may be a slight change in skin color or peeling. Using retinoids every alternate day or simultaneously as a moisturizer can lessen these side effects.

If the blackheads do not go away with over-the-counter medications, the healthcare provider may recommend stronger prescription medications, like:

  • Prescription-Strength Retinoids: Prescription-strength retinoids are stronger than non-prescription retinoids. These medications contain vitamin A, keep plugs from forming in the hair follicles and promote a more rapid turnover of skin cells.
  • Oral Antibiotics: Oral antibiotics help reduce the blackhead-causing bacteria.

  • Microdermabrasion: This procedure involves using a special instrument to sand the top layers of the skin. Sanding the top layers of the skin removes clogs that contribute to blackheads.

  • Chemical Peels: These peels use a mild chemical solution to eliminate clogs and dead skin cells that cause blackheads. While mild peels are available over the counter, dermatologists or other medical professionals perform stronger chemical peels. Over time, the skin's top layers get shed, revealing smoother skin underneath.

  • Laser Skin Resurfacing: This procedure directs short, concentrated, pulsating tiny light beams at the blackheads to reduce the oil produced by sebaceous glands and kill bacteria.

Home Remedies: A few home remedies may help get rid of blackheads, such as:

  • Tea Tree Oil: Tea tree oil is known to prevent or stop the growth of bacteria.

  • Sugar or Salt Scrubs: They scrape away the dead cells on the skin's surface.

  • Green Tea: It is an excellent antioxidant. Wet green tea leaves effectively reduce oil production in the skin.

A dermatologist should remove deep blackheads. They use a small instrument with rigid metal loops on the ends called a blackhead or comedo extractor and apply even pressure to the blackheads. These tools safely remove the entire blackhead and reduce the risk of returning.

How Long Does a Blackhead Take To Go Away?

Blackheads can go away on their own. It typically depends on how deep the blackheads are in the skin. Blackheads close to the skin's surface are more likely to go away naturally. However, deeply embedded blackheads are less likely to resolve on their own. A dermatologist can help get rid of these deeply embedded blackheads. In the meantime, be patient and do not try self-medication. Blackheads can take six to eight weeks to go away completely. Apply the products that suit the face because certain cosmetic products may cause the skin to break out. Contact a dermatologist if the blackheads do not go away even after two months of at-home treatments or if they worsen or become painful. The dermatologist may prescribe medications or recommend in-office procedures, such as microdermabrasion, chemical peeling, or laser treatment.

How Are Blackheads Prevented?

Preventing blackheads is difficult. But a few things can help, like:

  • Thoroughly cleanse the face with warm water and a gentle facial cleanser that does not irritate the skin.

  • Routinely use moisturizer.

  • Choose oil-free or noncomedogenic makeup or other skin care products to avoid worsening the problem. Skin products that contain oil can contribute to new blackheads.

  • Remove makeup at the end of the day, and wash your face with a gentle cleanser.

  • Keep the hands away from the face.

Conclusion

Blackheads are a common skin concern, especially among teenagers and young adults. They frequently occur on the face, particularly on and around the nose, and other body parts, such as the back, chest, neck, arms, and shoulders. While they do not cause harm, they can be annoying. Certain prescription and non-prescription medications and in-office procedures can help eliminate blackheads. In addition, a good skincare routine can help avoid blackheads. Contact a dermatologist if the blackheads do not go away even after two months of at-home treatments or if they worsen or become painful.

Frequently Asked Questions

1.

What do Blackheads look Like?

Blackheads are tiny types of acne. These look like small, open bumps on the skin filled with excess oil and dead skin cells. They look like they are filled with dirt impurities. Initially, they are white (white heads), but they can appear as tiny black spots with time.

2.

How to Keep Blackheads From Coming Back?

Here are some tips to prevent blackheads from coming back–
- Wash face twice daily.
- Use non-abrasive cleaners.
- Use alcohol-free skin products.
- Use oil-free facewashes.
- Shampoo oily hair regularly.

3.

Do Blackheads Naturally Go Away?

Depending on how deep the blackheads are, they may or not go away on their own. Superficial blackheads can go away independently by natural skin exfoliation while washing the face or bathing. This is because natural skin exfoliation causes the elimination of superficial skin and clogged pores. Natural skin exfoliation processes do not eliminate deeper blackheads.

4.

What Are Nose Blackheads?

Blackheads that occur on and around the nose are called nose blackheads. These appear as small, tiny bumps on the skin filled with oil, dirt, and dead skin cells. Following a skincare routine can prevent blackheads from occurring.

5.

What Do Blackheads Contain?

Blackheads are tiny black spots on the skin containing excess oil, debris, white blood cells, skin cells, dirt, and other impurities. Often, when removed, these appear as white material that resembles pus. They may also contain tiny hair follicles. 

6.

What Are Blackheads and Whiteheads?

White heads and black heads are both types of acne. As the name suggests, whiteheads appear as white spots, and blackheads appear as black spots on the skin's surface. The main difference between these two types is that whiteheads are in closed pores, while blackheads are in open pores. This is because blackheads are exposed to the air, and the melanin inside the blackheads is oxidized by the air, which turns the dead skin cells and natural oil black.

7.

How Are Blackheads Formed?

Blackheads form due to clogging of the opening of hair follicles in the skin. Hair follicles contain sebaceous glands, which produce oil (sebum). Clogging of the hair follicle causes dead skin cells and oil to collect, producing a bump called a comedo. If the skin over the bump has closed pores, they form white heads. When the skin over the bump is exposed to air, it forms blackheads. 

8.

How Does Differin Help Blackheads?

Differin is a gel that contains adapalene which contains retinoids used to clear skin acne. Differin gels for blackheads work by increasing cell turnover and skin exfoliation. As a result, the dead skin cells and oil are not trapped, and this prevents the hair follicles' clogging and helps to prevent the formation of whiteheads and blackheads.

9.

How Does Retinol Prevent Blackheads?

Blackheads are formed due to the entrapment of oil, dirt, and dead cells that clog the pores and hair follicles. Retinol contains vitamin A, which is important for cell turnover and helps skin exfoliation. Retinol helps to prevent blackheads as it also helps to eliminate excess oil and remove dead skin cells that clog the hair follicles. 

10.

How to Remove Blackheads?

One can remove blackheads by–
- Face cleansing and exfoliation. 
- Using face scrubs for skin exfoliation.
- Using pore strips.
- Using oil-free lotions and sunscreens.
- Using clay and charcoal masks.
- Retinoids and salicylic acid gels.

11.

What Are the Treatment Options for Blackheads?

Here are some treatment options to get rid of blackheads–
- Medications - oral antibiotics reduce bacteria that cause blackheads.
- Microdermabrasion - To remove the top layers of the skin that clog the follicles.
- Chemical Peels - To remove the layers of the skin and reduce blackheads.
- Laser Skin Resurfacing - To reduce the amount of oil produced by the sebaceous glands.

12.

How Do Blackheads Get So Deep?

Blackheads are formed due to the clogging of the hair follicles with oil, dirt, impurities, and dead cells. Initially, these occur as whiteheads that are present only in the superficial layers of the skin. With time, over weeks or months, this buildup continues to increase, causing the blackheads to become deep. If these blackheads are not removed, further buildup causes the blackheads to become deeper and more difficult to remove later. 

13.

How to Remove Nose Blackheads?

Using nose strips (pore strips) is the most convenient way to remove blackheads on the nose. Other ways include washing the face twice daily and, using face scrubs twice a week, using clay and charcoal masks. Nose blackhead treatments include chemical peels, microdermabrasion, and laser treatments from a dermatologist.
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Dr. Ekansh Shekhar

Cosmetology

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