A blackhead, also known as a comedone, is a form of acne that can occur anywhere on the body in proximity to a sebaceous gland. Sebaceous glands produce an oil called sebum. When excess sebum is produced and combines with sloughed skin cells in a hair follicle, a soft plug can form called a comedone. When the comedone forms deep inside the follicle, it is called a whitehead. When the comedone forms towards the outer layers of skin and is exposed to the outside air, it oxidizes and creates a blackhead. When blackheads occur it is important not to try to squeeze or extract it yourself. Instead, you should leave the comedone alone, or talk to your dermatologist about treatment options.
Salicylic Acid
For mild comedones, your dermatologist may recommend an over-the-counter product called salicylic acid. Salicylic acid is a keratolytic substance. This means that it can break down a protein called keratin. The skin cells that make up a comedone are largely made up of keratin. According to the New Zealand Dermatological Society, as the salicylic acid breaks down the keratin, it also breaks up the blackhead, clearing the follicle.
Benzoyl Peroxide
Benzoyl peroxide may also be reccomended or prescribed by your dermatologist for blackheads. Benzoyl peroxide works in two ways on blackheads. First, it removes dead skin cells from the follicles, helping to reduce the acne plug. Benzyol peroxide also kills off the acne-related bacteria called Propionibacterium acnes (P. acnes), which can progress a blackhead into more serious cases of acne such as pustules, cysts or nodules.
Retinoids
Your dermatologist may also prescribe a topical retinoid, such as adapalene, tazarotene or tretinoin. According to the American Academy of Dermatology, retinoids help treat blackheads and other forms of acne by unclogging pores and preventing whiteheads and blackheads from forming in the future. Due to potentially serious side effects, it is not recommended that women who are pregnant use topical retinoids for blackheads.
Extraction
Your dermatologist may also manually extract blackheads from your face. To remove a blackhead your dermatologist will use a surgical tool to extract the blackhead from your skin tissue. Your dermatologist may also combine manual extraction with a chemical peel to help in the extraction process. Chemical peels use specialized chemicals (such as hydroxy acids) to detach the outer layer of dead skin cells from the body so that they can peel away from new cells beneath.
