Many people have dealt with blackheads at some point in their lives, usually around adolescence when skin's oil production begins to speed up. Blackheads, also known as open comedones, are flat, darkened spots that form when pores become plugged with a mixture of sebum and dead skin cells. Their dark appearance is caused by the densely packed skin cells, which take on a dark color. It's a common myth that dirt or unclean skin causes blackheads. Blackheads are most prevalent in the in the T-zone, where these baceous glands are extremely active, but can show up anywhere on the face. They can turn into a full-blown acne lesion if they become inflamed or exposed to bacteria.
Unfortunately, blackheads are very hard to prevent because of skin's constant sebum production and cell turnover. Washing with a salicylic acid cleanser will temporarily remove pore-clogging debris and surface oil.
Alpha hydroxy acids are also a good first line of defense; they gently exfoliate skin to prevent cells from building up and clogging pores. Pore strips are also a good temporary solution. They help dislodge debris, but have a couple of drawbacks. Pore strips don't prevent further blackheads from forming and the adhesive can irritate sensitive skin when the strip is pulled off. Don't pick at blackheads or try to squeeze them with your fingers. You run the risk of infecting them and injuring your skin.
Stubborn blackheads require a more aggressive approach. Your dermatologist may prescribe a topical retinoid like Differin or Retin-A. Unlike alpha hydroxy acids, retinoids loosen the blackheads in addition to speeding up cell turnover so skin cells don't have a chance to clog pores. They also have the unique benefit of slowing down oil production so new blackheads are less likely to form. Unfortunately, retinoids are not a quick fix. It will take a few weeks to see results and skin may become extremely dry and flaky in the process.
A series of glycolic peels can also help, though they are not recommended if you are using a retinoid because of the potential for irritation. A peel will quickly slough off dead skin cells while removing some of the debris from pores. Five or six peels are recommended but results can usually be seen after the second peel. An at-home regimen of salicylic and glycolic acid skincare products is often used to maintain the benefits.
Your dermatologist may also use an extractor to remove individual blackheads. An extractor is a metal instrument with a small round opening on the end. The opening is pressed against individual blackheads for a few seconds to push out the debris. You may experience some discomfort but the process is usually very quick and it's an effective way to remove blackheads. There is no permanent solution for getting rid of blackheads, but a consistent skincare routine can help keep them under control.