Are the dots on my nose blackheads or sebaceous filaments?

What is the difference?

Sebaceous filaments help carry sebum, your skin's oil, from oil glands to the surface, where it helps keep skin hydrated. Everyone has them, and they are especially noticeable around the nose. Sebaceous filaments are normal parts of skin, even if pore clearing marketing would prefer a longer fault list. They do not hurt or feel uncomfortable.1

A blackhead forms when oil and dead skin cells build up inside a pore and widen its opening. The exposed buildup reacts with oxygen and turns dark. The dark color is not dirt, despite the name's enthusiasm for sounding like a cleaning problem. Scrubbing harder will not solve that blockage and can worsen acne.34

Should I squeeze a dot to check?

No. A sebaceous filament can release a waxy thread, while a blackhead can release a dark plug, but squeezing is not a safe identification test. Squeezing filaments can irritate or damage skin; squeezing blackheads can cause infection or permanent scarring. Pore strips can also pull out sebaceous filaments, and removing them can dry out skin.13

What should I do about the dots?

1. 1Cleanse gently with a mild, nondrying cleanser. For acne, wash once or twice daily, including after exercise. Avoid scrubbing and repeated washing.
2. 2If you want treatment, apply an acne product sparingly and follow its directions. Treat the affected area rather than squeezing individual dots; medicines for clogged pores are generally applied as a thin layer across that area.
3. 3Use moisturizer regularly. Choose cosmetics and skin creams labeled noncomedogenic, meaning formulated to avoid clogging pores.
4. 4Remove makeup at the end of the day rather than leaving it on overnight.

For noticeable filaments, salicylic acid dissolves dead skin cells that can clog follicles, and retinoids, medicines related to vitamin A, help prevent clogged pores. For blackheads, a retinoid is a recommended treatment; adapalene is available without a prescription. A benzoyl peroxide wash can also help reduce acne bacteria. That is acne treatment, not a reason to medicate normal filaments that do not bother you.14

Acne products can cause redness, dryness or excessive peeling. Follow the product's directions rather than increasing applications to chase faster results. Retinoid related peeling can be reduced by using the retinoid every other day or alongside a moisturizer.15

Will the dots disappear permanently?

Sebaceous filaments cannot be permanently removed, although you can make them less noticeable. After squeezing out their oil, pores refill within 30 days. Blackhead treatment takes patience: allow six to eight weeks before judging the response. More substantial improvement in clogged pores can take several weeks to months, and continued treatment is often needed to maintain it.146

When should I see a dermatologist?

If blackheads persist after six to eight weeks of treatment, a dermatologist can discuss prescription treatment or professional extraction. Seek help sooner for deep, painful bumps, worsening acne or scarring. A clinician can usually identify acne by examining your skin, without testing. Persistent discomfort is not a usual feature of sebaceous filaments.145