How do blackheads develop?

Blackheads are a type of acne that develops when hair follicles become clogged. Get rid of blackheads with medication, home care and alternative therapies.
Blackheads are a type of acne that develops when hair follicles become clogged. Get rid of blackheads with medication, home care and alternative therapies.

Blackheads are a type of acne that develops on the skin when hair follicles become clogged with skin, bacteria, and sebum. They appear black and may make you feel like your skin is dirty. Some people are self-conscious and try to remove blackheads on their own. However, instead of popping blackheads and risking scarring, you can benefit from consulting a doctor for medical treatment.

What are blackheads?

Blackheads are a mild type of acne where small black bumps appear on the skin when the hair follicle becomes clogged. Sometimes people think the skin is dirty, but extra washing does not help reduce blackheads . 

Symptoms of blackheads

Blackheads can appear on their own, or they can develop with other forms of acne. Symptoms of blackheads include:

  • Small black or yellowish bumps
  • Often found on your face
  • May be widespread across your back, chest, arms, and legs
  • May appear with whitehead, papules, pustules, cysts, nodules

Cysts, papules, and nodules may feel tender and painful, but blackheads usually do not hurt.

Causes of blackheads

Blackheads develop when a hair follicle becomes clogged with skin debris, bacteria, and sebum. The secretions plug the hair follicle and become what is called a comedone. Blackheads are open comedones, and these secretions turn black as they are exposed to air and oxidize.

Acne and blackheads can develop for many reasons. These include:

Who can get blackheads?

Acne and blackheads are very common. Anyone can develop acne, and people of all ethnicities and ages can have blackheads. Most people will experience acne at some point in their lives, and it’s even common to develop acne as an adult. But most acne develops during puberty. 

People who take certain medications like barbiturates, corticosteroids, or lithium, or who start and stop hormone medications, may also develop acne. 

Diagnosis of blackheads

You may not need to see a doctor to diagnose your blackheads. However, if you have other pustules, whiteheads, lumps, or cysts, or if the blackheads are widespread, you may need to speak to your doctor.

Your doctor or dermatologist will need to take your medical history and examine your skin to diagnose your blackheads and acne.

Treatments for blackheads

Some people want to try blackhead removal at home, but it’s not ideal to try on your own as you may damage your skin. You can treat mild acne or blackheads at home with over-the-counter skin care products and healthy hygiene practices.

Medications

You can manage your skin with over-the-counter cleansers and blackhead removal products. Some treatments can include :

  • Salicylic acid cleanser
  • Benzoyl peroxide
  • Niacinamide
  • Sulfur-based mask
  • Retinol products
  • Azelaic acid
  • Clay mask

If your blackheads persist or they become widespread, your doctor may prescribe medications, including:

  • Prescription-strength salicylic acid cleansers and creams
  • Prescription-strength benzoyl peroxide
  • Tretinoin

If you have inflammatory acne that is moderate to severe and widespread, your doctor may also recommend antibiotic treatment. Sometimes doctors may recommend birth control if your acne is hormone-related. 

Home care

While you may feel your skin looks unkempt, overwashing does not help blackheads. Washing your skin too much can lead to irritation, which can make your condition worse. Exfoliants are a great way to help remove dead skin cells clogging up the hair follicle. However, too much exfoliation can also irritate the skin and make your blackheads worse .

Some lifestyle and self-care practices you can do at home include:

  • Wash your face only twice a day
  • Exfoliate your skin with a salicylic acid scrub once or twice a week
  • Treat the blackhead area with benzoyl peroxide
  • Use a sulfur or clay mask once or twice a week
  • Use a gentle, oil-free moisturizer 
  • Don’t wear too much makeup
  • Remove all makeup at night before bed

It can take some time for your products to work, so keeping a consistent skincare routine is essential. Diet may play a role in acne for some people. It may be important to pay attention to any changes in your diet and speak to your doctor if a particular food causes a reaction.

You can try to extract blackheads with a blackhead removal tool, but it doesn’t always work, and it can lead to scarring. Ask your dermatologist to show you the best steps to do it correctly.

Alternative therapies

Other skin treatments for blackheads and acne may include:

Research suggests these may work, but the results are inconsistent.

Other alternative therapies may involve nutrition, supplements, and natural ingredients. These may include:

These may help address acne, but there isn’t enough clear evidence yet.

Side effects of blackhead treatment

You can generally treat blackheads at home with over-the-counter products. Some products may have some side effects. You might experience:

  • Dry or tight skin from salicylic acid
  • Redness, itching, and irritation from retinol
  • Stains on your clothing from benzoyl peroxide
  • Scarring from improper blackheads removal
  • Mood changes, weight gain or loss, and menstrual changes from hormonal medications
  • Sensitivity to sunlight from skincare products and antibiotics

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Medically Reviewed on 2/23/2021
References
SOURCES:

Advances in Dermatology and Allergology: "Significance of diet in treated and untreated acne vulgaris."

Johns Hopkins Medicine: "Acne."

Molecules: "Treatment Modalities for Acne."

National Health Service: "Acne."

National Health Service: "Acne – Treatment."