How to remove large blackheads

Is it a blackhead or a deeper lump?

An ordinary blackhead is an open pore blocked with excess oil and dead skin cells. It looks black or brown, can be flat or slightly raised, and usually does not hurt. Blackheads are not caused by dirt, despite looking very committed to that explanation. Scrubbing harder will not solve the blockage and can make acne worse.1234

A large, painful lump beneath the skin can be a nodule or cyst rather than an ordinary blackhead. A giant comedo is a type of cyst with a visible opening that resembles a blackhead. That distinction matters: a large opening alone does not tell you what lies underneath, and deep or painful lumps need medical assessment rather than home extraction.35

How to treat blackheads at home

1. 1Wash gently twice a day. Use a gentle cleanser rather than scrubbing the dark spots. Remove makeup at the end of the day.
2. 2Choose a pore clearing treatment. Salicylic acid comes in cleansers and lotions and helps dissolve dead skin cells that block follicles. Retinoids help break up blackheads and prevent clogged pores; adapalene is available without a prescription in some markets. A pharmacist can help you choose an appropriate product.
3. 3Apply treatment across the affected area. For comedonal acne, meaning acne mainly made up of blackheads and whiteheads, topical treatments are generally applied as a thin layer over the whole affected area rather than only individual dots. Follow your product's directions for frequency.
4. 4Use moisturizer regularly. Retinoids can cause peeling or changes in skin colour. Using a retinoid every other day or alongside moisturizer can reduce these effects.
5. 5Choose skincare and makeup labelled noncomedogenic, meaning formulated not to clog pores. Keep your hands away from the blackheads rather than repeatedly checking whether they will squeeze out.

Benzoyl peroxide is another acne treatment, aimed at bacteria that can aggravate acne. A benzoyl peroxide wash can accompany a retinoid when treating blackheads and whiteheads. Lower concentrations and wash formulas are less irritating, but dryness remains a common side effect.12

Why not squeeze or use an extractor yourself?

Squeezing can leave part of the blockage behind or push it deeper, causing painful irritation. Pressure from nails can damage skin and cause inflammation or scars. Squeezing can also introduce bacteria or more oil into the opening. A stubborn plug is a reason to change the approach, not increase the pressure.13

What professional removal involves

A dermatologist or medical aesthetician can remove deep blackheads using a comedo extractor, a small instrument with metal loops that apply even pressure. Dermatologists also use acne extraction for blackheads that do not clear with treatment. Ask about treatment to prevent further clogs as well as removal of the existing ones. Ongoing treatment helps prevent clogged pores, because an extracted blackhead does not put the pore into retirement.16

How long should you wait?

Give blackhead treatment six to eight weeks before judging the response. Worthwhile improvement in comedonal acne can take several weeks to months, and treatment often needs to continue long term. If blackheads remain after that initial trial, a dermatologist can consider extraction or prescription treatment. A deeply embedded blackhead is less likely to disappear on its own than a superficial one.125

Seek medical help sooner for deep, painful lumps, scarring, or signs of infection such as hot, swollen, red skin. Redness can be harder to see on brown or black skin. Do not try to drain a cyst at home: doing so carries a high risk of infection.36