Blackheads are also called open comedones. They are open pores that become blocked by oil and dead skin cells (keratinocytes). This debris forms a hardened clump that continues to attract dirt and enlarges over time. The oil plug becomes oxidized and then turns black, giving the name and appearance of “blackheads”.
Blackheads are more common in people who have oily skin because of the excess sebum in their pores, but they aren’t limited to people who have oily skin. Since blackheads are formed from dead skin, an effective product should contain a “keratolytic” ingredient to break up the dead skin and oil. These are products that “lyse,” or disintegrate the dead keratinocytes. There are several non-prescription keratolytics that are used to treat both blackheads and acne. Salicylic acid, benzoyl peroxide, and glycolic acid are common keratolytics. A product that contains one of these ingredients can help treat blackheads. When the keratinocytes dissolve, the blackhead shrinks and loosens in the pore.
If your skin is dry, it is easy to overdo your treatment, resulting in chapped and reddened complexion. If you have dry skin, you should use less product and may have to experiment with frequency so the treatment isn’t too harsh. People with oily skin will be less sensitive to these drying products.
There are several products that can be left on the skin after washing your face, giving you an extra boost that may be necessary for treatment of stubborn blackheads. Combination products offer increased strength and can be more effective for treatment, but they’re not for everyone.
A cosmetic dermatologist can help you determine which of these products is appropriate for your complexion. Some people can’t tolerate one or more of these ingredients, but can still achieve excellent results with another. If your skin reacts poorly to salicylic acid, you can use benzoyl peroxide or glycolic acid products.
A complete skincare regimen to treat blackheads usually includes a cleanser with one of these effective ingredients followed by an exfoliating cream or lotion. In most cases, you should follow washing and application of a drying product with a moisturizer that is not oil-based. Sunscreen is necessary for everyone on a daily basis, even when it’s cloudy. A sunscreen should protect your skin from both UV-A and UV-B light. We recommend a product that has an SPF of at least 30. Dry skin treated with a keratolytic product is especially sensitive to the sun.
Aestheticians can improve your results with facials that combine deep cleansing and extractions, and a light chemical peel can help you achieve the best results. There are also skin-cleansing systems like the Clarisonic that use sonic waves to increase penetration and efficacy of active ingredients in your skin care regimen. Over the counter products like a clay mask can provide a temporary fix, smoothing out pores and reducing oil.
Your cosmetic dermatologist may prescribe a retinoid cream or ointment. Retinoids are much stronger than the keratolytic ingredients available over the counter, and include Retin A, Tazorac, and Differin. Retinoids aren’t for everyone. Pregnant women and women who may be planning to get pregnant should discuss use of retinoids with a physician as there is a risk of harm to a developing fetus. You will have to be cautious when adding a prescription product to a keratolytic that you may have purchased in a drugstore or department store. This is best done in consultation with a dermatologist.
We’ve had great success among our patients who are troubled with blackheads. If you are frustrated with these stubborn comedones, call BHSkin for a consultation with a skincare expert. We have offices in Glendale, Encino, and Beverly Hills, for your convenience.