What is a blackhead?

If your blackhead begins to turn red, or you can't remove it with home treatments, call your doctor.
If your blackhead begins to turn red, or you can't remove it with home treatments, call your doctor.

Comedones, more commonly known as blackheads, are small, dark spots on your skin caused by a clogged pore. Contrary to common belief, the black or dark color they have isn’t from dirt — it is an oxidation of the dead skin cells that cause the clog. The oxidized skin cells then appear dark in color.

Blackheads are not commonly associated with acne, but they are one of the different types. They are acne that is non-inflammatory in nature, which is why they don’t appear to have any red tissue surrounding them when they appear.

Everyone, at some time, has found a pore that had a little black spot in it. Most of us simply squeeze it out and then forget about it. The small black spots we love to squeeze are called blackheads and can form in any pore on the body that secretes oil.

You’ve probably had someone tell you that you shouldn’t pop that pimple or blackhead. But what happens if you don’t? If it is left in place, or if you can’t get it out? Most of the time, they will go away. But sometimes, they won’t.

Learn what a blackhead is, what causes it, and what happens if it isn’t removed.

Symptoms of a blackhead

Comedones usually show up on your skin when your pores clog and the pore turn color. You might notice one forming before it turns dark as the dead skin cells collect in the pore. You may see some slight swelling around the clogged pore or notice the blackhead slowly becoming larger over time.

Causes of a blackhead

Blackheads are not caused by diet, dirt, or stress. The leading cause of clogged pores is dead skin cells. Our skin is always regenerating, new cells are created, and old ones die and fall off. The older cells may not always flake off and can sometimes block your pores.

If a pore becomes blocked, the oil that is produced by glands in the follicle cannot leave the pore. The skin cells and oil build-up and turn dark as they oxidize — and a blackhead forms.

When to see the doctor for a blackhead

Blackheads don’t usually require a trip to see your doctor. However, there can be times when you might need to see them if a blackhead is a recurring problem. If your blackhead begins to turn red, or you can’t remove it with home treatments, call your doctor. They are likely to send you to see a dermatologist who specializes in skincare and conditions.

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Diagnosis for a blackhead

Blackheads can usually be identified by their unique appearance. Your clogged pore will have a dark spot in it. It may or may not be raised, and it has an opening. A dark spot on your skin may not always be a blackhead, so if you have trouble identifying the dark spot on your skin, your doctor can perform a physical examination to determine what it is.

If your dark spot isn’t a blackhead, your doctor may take a sample of it, send it to a lab, or refer you to a dermatologist for further diagnosis.

Treatments for a blackhead

Blackheads are a form of mild acne, along with whiteheads and pimples. Breakouts are usually treated with medication that is applied topically. Some of the medications dermatologists might prescribe to you are lotions with:

  • Retinoid
  • Retinoid and benzoyl peroxide
  • Azelaic or salicylic acid
  • Benzoyl peroxide and antibiotic

If your blackheads turn into acne, the treatment is determined by the dermatologist. They might give you some of the same medications as they would for blackheads. For women with stubborn blackheads and acne, the doctor might also provide oral contraceptives or hormonal therapy. If no other medication or method works, you might be given isotretinoin, which is used to treat severe acne.

Complications from a blackhead

Blackheads are clogged pores that still have an opening. They can become irritated if you scratch or try to squeeze the blackhead out. If you don’t disinfect the area before and after you get the blackhead out, bacteria can get into the pore and cause an infection. If pores are infected, the skin can become inflamed and cause acne, which is the inflammation that results from clogged pores.

The pores can also become inflamed if the blackhead isn’t treated. Other conditions can occur as a consequence of the inflamed tissue if you pop pimples yourself. Scarring can occur if a pimple is recurring and you continuously pop it. The scars are usually pitted and sometimes remain as a dark red mark.

Hyperpigmentation can happen as the wounded skin heals. Melanin, the pigment responsible for skin color, can collect in the healing area and cause it to heal as a dark spot. If you have a pimple, blackhead, or acne and dark spots occur after it is gone, it is known as post-inflammatory hyperpigmentation.

Keloidal scars can form from acne. These are raised scars that occur if the scar tissue overgrows in the area. Keloidal scars can become quite large as the scar tissue continues to grow over time.

If you’ve been given medication for your blackheads or acne, there may be some mild side effects such as dry or irritated skin, which is usually treated with moisturizers. There are other side effects of oral contraceptives. Your doctor will discuss the effects with you if they feel you need them for treatment.

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Medically Reviewed on 2/17/2021
References
American Academy of Dermatologists Association: "Acne: Diagnosis and Treatment."

American Family Physician: "Managing Adverse Effects of Hormonal Contraceptives."

American Osteopathic College of Dermatology: "Hyperpigmentation."

American Skin Association: "Acne."

Michigan Medicine: "Keloid Scars."

National Center for Biotechnology Information: "Acne: Overview."