How to get rid of blackheads

Why blackheads look dark

Blackheads form when pores clog with excess oil, bacteria and dead skin cells but remain open; a closed pore creates a whitehead. A comedone is the medical term for a blackhead or whitehead. The dark colour comes from pigment at the surface, not dirt. Scrubbing can irritate skin or worsen acne, so keep cleansing gentle. Blackheads and whiteheads are both called comedones, a large name for a small clog.134

A routine to try

1. 1Wash your face with a gentle cleanser twice daily, and remove makeup at the end of the day.
2. 2Choose one acne product with an active ingredient that targets blackheads, rather than starting several at once.
3. 3Use the product at the time and frequency on its label. For a leave on acne medicine, spread a thin layer over the full acne prone area, not only visible spots.
4. 4Keep using the same product as directed for six to eight weeks before deciding it has not helped. Do not add another acne product during that trial.
5. 5Choose noncomedogenic skin care and makeup, which will not clog pores. Do not pick or squeeze spots, which can cause scars.

Salicylic acid unclogs pores and exfoliates, and it is available as a cleanser or lotion. Adapalene is a retinoid, a vitamin A derivative, that helps clear blackheads and whiteheads. Salicylic acid is a direct fit when blackheads are the main concern; adapalene also treats whiteheads and pimples. Either way, the useful choice is one product you can use consistently, not a collection of actives competing for space on your face.25

How long it takes

Do not expect blackheads to clear overnight. With an effective acne medicine, fewer breakouts can appear in four to eight weeks, while clearing can take sixteen weeks. Blackhead treatment can take several weeks to months before there is worthwhile improvement, and an effective treatment often needs to continue long term. Use the first six to eight weeks as a consistent trial, rather than switching products every few days.23

Retinoids can cause peeling or changes in skin colour. Using a retinoid every other day or with moisturizer can reduce these effects. Follow the directions for the exact product you are using.5

When to get medical advice

Ask a dermatologist about persistent blackheads after a consistent treatment trial; extraction or prescription acne treatment may help. Get medical advice sooner if you have many spots, deep or painful spots, acne that leaves scars, signs of skin infection such as hot, swollen, red skin, or acne that affects your mental health. Large painful pimples under the skin or acne that scars are unlikely to respond well to products bought over the counter. If you are pregnant or trying to become pregnant, consult a dermatologist before treating acne yourself, because some nonprescription acne treatments are not safe during pregnancy.124

Blackheads vs sebaceous filaments

Sebaceous filaments are thin structures that carry sebum, the skin's oil, from oil glands to the surface. Everyone has them, and they help keep skin hydrated. They are normal oil carrying structures, which makes them the skin's plumbing with a rather elaborate name. Squeezing them can irritate or damage skin, and pores can fill again within thirty days. Pore strips can remove sebaceous filaments along with blackheads, so they do not distinguish between an acne plug and a normal part of the skin.5