- Blackheads occur when natural oils and debris build up within skins’ pores.
- Blackhead prevention is possible by maintaining a healthy diet, washing bed sheets regularly, wearing clean clothes and using non-comedogenic skin care products.
- Many treatment options are available for removing blackheads from the back, shoulders and chest.
Human skin contains millions of microscopic holes called pores, which are vital for the regulation of body temperature, excretion of waste and the maintenance of healthy skin.
There are two categories of pores: oil pores and sweat pores. Oil pores are larger than sweat pores, and exist anywhere there is a hair follicle on the body.
Causes of Blackheads
When an oil pore is blocked—usually due to excess oil in combination with dead skin, dirt or grime—blackheads can form. While some acne lesions are covered by a layer of skin, blackheads are exposed to the air, allowing oxygen to react with the buildup within the pore, and causing it to turn black.
Within the field of dermatology, tiny bumps on the oil pores are known as comedones. Because blackheads can only form where there is a hair follicle (oil pore) on the skin, they are common on the back, shoulders and chest, although they also form in other areas such as the ear and face.
There are many DIY treatments for blackheads on the back, shoulders and chest. If a blackhead breakout has occurred in these areas due to pores becoming blocked, there are several treatment options.:
- Skin cleansers (soap or body wash): Using an anti-acne soap or body wash can help by dissolving skin debris, thereby mitigating clogged pores.
- Exfoliants: Chemical or manual exfoliation can unclog pores and remove excess skin debris.
- Manual extraction: If executed properly, manually extracting blackheads using your fingers can be an effective treatment method.
Use an anti-acne soap or body wash
One way to prevent the outbreak of blackheads on your back, shoulders and chest is to use anti-acne soap or body wash. Common active ingredients in anti-acne soaps or body washes are salicylic acid and benzoyl peroxide.
Body washes and soaps that contain salicylic acid are recommended for treating blackheads. Salicylic acid works by dissolving debris on the outermost layer of skin and promoting the regeneration of new skin cells. This can prevent the clogging of pores.
Salicylic acid is a beta hydroxy acid. It is oil soluble, which means it can penetrate deep into pores instead of remaining on the surface of skin, like water soluble solutions. This treatment can be very effective but can take up to one week to see results. Salicylic acid is not as harsh on the skin compared to other types of treatments, such as benzoyl peroxide.
Benzoyl peroxide can be very effective for treating whiteheads, but is less effective in treating blackheads. It can also be an effective way to keep pores clean, but it is harsher on the skin than salicylic acid, potentially causing skin irritation such as peeling, dryness and redness.
Exfoliate Once or Twice a Week
Exfoliation can be an effective way to unclog pores and remove excess dead skin. There are many options for chemical-based exfoliation. Common chemical exfoliants tend to use either alpha hydroxy acids (e.g. glycolic or lactic acid), or beta hydroxy acids (e.g. salicylic acid).
Both acids work in a similar way: they cling to and help remove dead skin that may be clogging pores. The main difference between alpha and beta hydroxy acids is that the former is water soluble whereas the latter is oil soluble.
Therefore, beta hydroxy acids such as salicylic acid are able to penetrate deeper into the pores through the oil layer. This can allow for a deeper cleanse. However, for dry or sensitive skin, alpha hydroxy acid may be preferable as it has more moisturizing properties.
Physically scrubbing the back, shoulders and chest can also be an effective means to keep pores clean. This can be accomplished by using a washcloth, loofah or even mechanical skin brushes.
Although exfoliation can be an effective means to treat blackheads, it is important to only do so once or twice a week. Excessive exfoliation can cause skin irritation and potentially worsen the condition.
Use Non-Comedogenic Products
In addition to proper exfoliation and the use of anti-acne body wash or soap, it is important to ensure you are using non-comedogenic skin care products in your usual routine.
Non-comedogenic products do not contain oily ingredients such as lanolin and cocoa butter. Using sunscreens and moisturizers that are non-comedogenic reduces your likelihood of developing blackheads, as they will not contribute excess oil into your pores.
Manual Blackhead Extraction
While it may be tempting to manually remove blackheads, if not done properly it can lead to more breakouts and cause other types of skin irritation. If you do decide to remove blackheads manually, you should do so after taking a warm shower. It is important to warm the region because this will soften hardened oil within the pores.
You can also place a warm washcloth over the region that contains blackheads. If using your fingers, gently apply pressure at the base of the blackhead.
After extraction, it is important to clean the area with a mild cleanser to avoid infection. Soak a cotton ball with toner and apply to the area to remove any lingering oil, help tighten skin and reduce the appearance of pores.
At-home removal tools
There are also at-home removal tools to facilitate blackhead extraction. These are called comedone extractors or blackhead removers and are small metal instruments with a loop at the tip. By applying pressure around the blackhead, these tools can allow for proper blackhead extraction.
It is important to note that incorrect extraction—by applying too much pressure at the wrong angle—can have a detrimental effect on hair follicles. This can cause more outbreaks and skin irritation, and it is therefore recommended to see a dermatologist for professional extraction.
It is also important to make lifestyle choices to help prevent the outbreak of blackheads on the back, shoulders and chest.
Maintain a healthy diet
An unhealthy diet can play a role in the outbreak of blackheads. It is important to avoid processed and fried foods as much as possible. Eating refined sugar and starches can lead to excess production of oil on the skin which can lead to blackhead breakouts.
A balanced low-fat diet containing fruits and vegetables can go a long way to reducing the formation of blackheads on the skin. It is also important to drink plenty of water and to exercise regularly.
Wear clean clothes
Excessive sweat on the skin can be a factor in the development of blackheads on the shoulders, back and chest. As such, it is important to wear clothes that are not too tight and allow for adequate air circulation.
Clothing that is too tight on the shoulders and back can also lead to skin irritation and eventual breakouts of blackheads. Similarly, wearing a backpack too often or with tight straps can lead to blackheads forming on the back and shoulders.
Change bed sheets regularly
Dead skin and body oils can accumulate on sheets, causing clogged pores on the back, shoulders and chest. Washing your bed sheets regularly can go a long way to reducing blackhead breakouts on the body.
When to See a Dermatologist
Seek professional treatment from a dermatologist if any of the aforementioned home treatments are not successful. This is especially important in regard to extraction techniques. If these techniques are not performed properly, they can worsen your condition and lead to further breakouts and skin irritation.
Dermatologists have proper expertise and experience to correctly treat outbreaks without compromising the hair follicles and integrity of your skin.
Blackheads on the shoulders, back and chest are caused by the blockage of oil pores in these areas. Treatment options include the use of anti-acne skin cleansers, exfoliation and manual extraction. Maintaining a healthy diet and hygienic habits also play important roles in reducing the probability of breakouts.
If breakouts of blackheads on the back, shoulders or chest persist or are severe in nature, it is recommended to visit a dermatologist for a professional consultation.
- Ea Eady, Bm Burke, K Pulling & Wj Cunliffe (1996) The benefit of 2% salicylic acid lotion in acne a placebo-controlled study, Journal of Dermatological Treatment, 7:2, 93-96, DOI: 10.3109/09546639609089537
- American Academy of Dermatology. (n.d.) How to safely exfoliate at home. aad.org/public/skin-hair-nails/skin-care/exfoliation
- Kim, S. J., Baek, J. H., Koh, J. S., Bae, M. I., Lee, S. J. and Shin, M. K. (2015), The effect of physically applied alpha hydroxyl acids on the skin pore and comedone. Int J Cosmet Sci, 37: 519-525. doi:10.1111/ics.12244
- Degitz, Klaus; Ochsendorf, Falk. (2017) Acne. onlinelibrary.wiley.com/doi/full/10.1111/ddg.13278