Blackheads 101: Causes, Prevention and Treatment Options

• Blackheads develop due to a buildup of natural oils and debris within pores
• They can be treated with over-the-counter products and professional treatments
• Blackheads can be prevented by adhering to an effective daily skin care routine

What Are Blackheads?

Blackheads are hard plugs that develop within hair follicles, or pores, due to a buildup of natural sebum (oil), dead skin cells and debris. 

Blackheads along with whiteheads are referred to as comedones; these are noninflammatory lesions unaccompanied by pain, redness or inflection.   

Anyone can develop blackheads, however science has established that acne is highly prevalent among adolescents and that comedonal acne is the most dominant form versus inflammatory. One study of adolescents established that 61% of participants fell within this category. 

Comedonal acne should be promptly treated as it is a precursor to inflammatory acne.

How to identify them

Blackheads form just beneath the skin’s surface, creating a slightly bumpy appearance. They typically appear in clusters and can be identified by a darkened tip.

Blackheads can be confused with sebaceous filaments, which are thin hair-like structures that line pores. These filaments contain a mixture of oil and dead skin cells and are yellowish to white in color. Their role is to help moisturize skin by transporting the sebum up to the skin’s surface; this is a natural process common to all people.

Blackheads vs. whiteheads

Blackheads and whiteheads are both types of comedones. The only difference is that blackheads (open comedones) have a darkened head due to exposure to air; whiteheads (closed comedones) have a thin layer of skin covering the plug which prevents it from darkening.

» Learn more about the difference between blackheads and whiteheads

What Causes Blackheads to Appear?

Blackheads can develop due to a range of causes with the main instigators being genetics,  hormonal fluctuations and lifestyle.

Blackheads form when oil and dead skin cells become trapped within pores. When sebaceous glands are stimulated, they produce excess amounts of sebum which can worsen symptoms.

Puberty, pregnancy and menopause all cause wild swings in hormonal levels which have been shown to stimulate sebaceous glands.

Science has also established a link between acne and genetic factors, specifically the function and activity of sebaceous glands as well as inflammatory response.  Heritability estimates are in the range of 50%–90%. 

Those with naturally oily skin are more at risk of developing blackheads. 

The absence of a consistent skin care routine or one that omits proper skin care products can also contribute to the development of blackheads, as this allows for oils and debris to build up on the skin.

Affected areas

Sebaceous glands are located all over the body except the palms, soles and top of the feet. Blackheads can develop wherever these glands are but typically form where there are the most sebaceous glands. 

On the face

Blackheads on the face typically occur within the T-zone, the area comprising the forehead, nose and chin.

A higher concentration of oil-producing glands are found in this area resulting in an increased risk of blackheads. Other surrounding areas affected by blackheads, to a lesser degree, include the ears and neck.

Other body areas

Blackheads can also be found on the chest, back and shoulders. Wearing tight-fitting clothes can cause blackheads and acne to develop in these areas when moisture becomes trapped. Humid environments that cause recurrent sweating can also contribute to their formation.

How To Treat Blackheads

It’s important to treat blackheads as early as possible; the more oil builds up, the greater the likelihood that bacteria will multiply and lead to inflammatory acne. 

Mild cases of blackheads can be treated with at-home topical solutions. When used carefully and as instructed, comedone extractors and pore strips can also be effective in clearing clogged pores. You can also try some at-home remedies by creating your own exfoliating scrub. 

For widespread blackheads, opting for professional blackhead extraction ensures the treatment will be performed safely. Other treatments include microdermabrasion, chemical peels and laser therapy. 

Over-The-Counter Treatments

Over-the-counter (OTC) treatments work to exfoliate skin and clear pores of buildup; these products are geared toward those with mild to moderate symptoms.

Creams, masks and other topical products

Face masks are popular skin care products that can help remove impurities from the skin and  target specific skin concerns. For treating blackheads, clay is a smart choice as it is known for its absorbent and detoxifying properties.

Other options include peel-off masks, which remove buildup from pores. However, these types of masks can irritate and damage skin especially when used too often.

Exfoliating products are very effective in both treating and preventing blackheads. 

With consistent use, they work to remove excess oils and skin debris from skin to maintain clear pores either through chemical exfoliants or with natural exfoliants made with fruit seeds and fibers, walnut and cocoa bean shells or jojoba wax beads. 

Salicylic acid, a chemical exfoliant, can successfully remove blackheads; it dissolves the bonds that hold dead skin cells together and deeply penetrates to rid pores of blockage. It can also control oily skin. Glycolic acid is another chemical exfoliant that exfoliates and sloughs off dead skin cells. 

Exfoliants can be found in scrubs that wash off or serums that are left on the skin to gently exfoliate throughout the day.

Additionally, creams formulated with active ingredients to target blackheads can be used under a daily moisturizer. Since they are only applied to the affected areas, they can be ideal for dry or sensitive skin to minimize irritation.

Ingredients to look for

Salicylic and glycolic acid are two agents that can effectively clear away clogged pores. Benzoyl peroxide is another strong choice as it is a keratolytic that can loosen and break down the outer layer of skin to clear away debris. It’s effective at drying up blackheads and has antibacterial benefits to help prevent inflammatory acne from developing.

You can safely use benzoyl peroxide with salicylic or glycolic acid at low concentrations to achieve better results; using higher concentrations can cause dryness and irritation. 

Charcoal and clay are two ingredients you can find within gently formulated creams and masks formulated to clear blackheads; they help purify the skin and remove oil buildup from pores.

You may need to experiment with different ingredients to find which ones work best with your skin type. 

Professional Treatments

Your dermatologist may prescribe a topical retinoid such as adapalene or tazarotene. These are powerful agents that work to exfoliate dead skin cells, clear pores and speed up skin cell turnover. They also regulate sebum production.

Prescription treatments are usually reserved for moderate to severe acne, due to the strength of their ingredients and their potential side effects.

Professional treatments are also available and include chemical peels, laser therapy and microdermabrasion.

Microdermabrasion

Microdermabrasion uses a handheld device or a spray of crystals to gently exfoliate the top layers of skin. Over the course of several treatments, skin is resurfaced to slough off dead skin cells and eventually remove the blackheads.

Chemical peels

Chemical peels involve the application of exfoliating chemical solutions to facial skin and are available in varying strengths. Salicylic and trichloroacetic acid are two effective types of chemicals that work deeply to remove blackheads, target damaged skin cells and encourage skin cell renewal.

Laser therapy

A form of laser treatment, known as photopneumatic therapy is another blackhead treatment. This treatment combines the use of a laser with a gentle vacuum; the heat from the laser penetrates deep into the skin, stimulating the growth of new, healthy skin cells while the vacuum removes skin debris and excess oil.

At-Home Blackhead Treatments

If you have a mild case of blackheads, you may be able to treat them effectively at home using removal tools, pore strips and the use of natural home treatments such as facial scrubs.

Manual removal tools

Blackhead extraction tools, also known as comedone extractors, are small metal tools with  various sized loops designed to extract blackheads. Place the loop around the blackhead and apply gentle pressure to extract the plugs.

Pore strips

Pore strips are small pieces of fabric with an adhesive on what side. Place the strip over the blackheads, allow to harden for 10–15 minutes, then gently peel off to extract the blackheads.

Home treatments

As exfoliation has been shown to produce excellent results in treating blackheads, you can  create your own exfoliating scrubs with simple ingredients easily found in your kitchen. You may use these scrubs 2–3 times a week.

Before using your scrub, gently steam your face to open up pores and soften the plugs; this will allow for easier removal.

Brown sugar scrub for oily skin

Brown sugar and oatmeal provide a deep but gentle exfoliation; the vinegar provides antibacterial benefits and the lemon clears skin of excess oil.

Combine 1 tbsp. of brown sugar, 1/2 cup of ground oatmeal, 1 tbsp. of apple cider vinegar and

1 tsp. lemon juice to form a paste. Gently massage the scrub on your face, avoiding the eye area then rinse off with warm water. 

Honey, lemon and salt scrub

Lemon can effectively remove excess oils, the salt acts as a gentle abrasive and the honey leaves skin soft and moisturized. Combine 1 tbsp. of each ingredient, mix well and gently massage the scrub on your face, avoiding the eye area. Rinse off with warm water. 

Tea tree oil

Tea tree oil is an essential oil that has been shown to improve comedonal acne. In one study, comparing 5% benzoyl peroxide with 5% tea tree oil, both had a significant effect in treating blackheads with the tea tree oil producing fewer side effects. 

Tea tree oil must be diluted first before using. Add 12 drops of a carrier oil (such as grapeseed, rosehip or jojoba oil)  to every 1–2 drops of tea tree oil. To use, moisten a cotton ball with the mixture and apply to the affected area. 

You can leave it on for a few hours or overnight; rinse off with warm water.

How to Prevent Blackheads from Occurring

Preventative measures can greatly reduce your risk of developing blackheads – such as implementing a regular skin care routine with effective active agents.  

Cleanse: Prevent oil and dead skin cells from building up on your skin by washing twice a day. Choose a low pH cleanser to clear excess oils, eliminate grime and dead skin cells, and to maintain healthy skin.

Exfoliate: Regular exfoliation will prevent pores from becoming clogged with debris and will brighten and smooth your complexion.

Moisturize: Opt for an oil-free moisturizer, ideally one that contains hyaluronic acid; this agent has been shown to lock in moisture, control sebum production and balance moisture. Overly dry skin can produce excess oil to compensate, which can increase the risk of blackheads forming.

Noncomedogenic products: Choose skin care products that are labeled noncomedogenic; these are specially formulated to not block pores.

Prevent oil transfer: Regularly wash your pillowcases and bed sheets regularly to prevent the transfer of oils to your face; as well keep hair well away from your face.

When to See a Dermatologist

If you feel your acne is not responding to at-home or OTC treatments, or if it worsens, it is recommended that you consult a dermatologist for advice and professional treatment.

Takeaway

Blackheads are a form of noninflammatory acne but can develop into inflammatory acne if left untreated and bacteria accumulates. Blackheads are the result of excess oils, dead skin cells and debris becoming trapped within pores. 

Blackheads tend to form in those areas of the body that have the most sebaceous glands. This is usually the T- zone on the face as well as the chest, back and shoulders.

There are a number of effective OTC, professional and at-home treatments available to treat and prevent blackheads from forming. These work to clear pores of debris, exfoliate the top layer of skin and regulate oil production.

Treatment options will depend on the severity of your acne. Mild cases can be treated at home with home remedies and OTC products. For more severe comedonal acne, professional treatments and prescription strength retinoids have all been shown to effectively clear skin.

No matter the severity, a good skin care routine that combines regular washing with a gentle face wash, exfoliation and adequate moisturization will all work together to help keep your skin healthy and free of pore-clogging material.