Blackheads

Blackheads, medically known as open comedones, are a type of acne characterized by small, dark spots that appear on the skin due to clogged hair follicles. They are called "blackheads" because the surface looks dark or black. Blackheads are a common skin condition that can affect individuals of any age but are most commonly seen during puberty when hormonal changes can increase oil production in the skin.

Causes

Blackheads are caused by the clogging of pores with a combination of sebum (an oily substance produced by the sebaceous glands) and dead skin cells. The exposure of this mixture to the air leads to oxidation, which turns it black, distinguishing them from whiteheads, which remain covered by a thin layer of skin, preventing oxidation. Factors that can increase the likelihood of developing blackheads include:

• Excessive production of skin oils
• The buildup of the Propionibacterium acnes bacteria on the skin
• Irritation of the hair follicles when dead skins cells don't shed on a regular basis
• Hormonal changes that cause an increase in oil production during adolescence, menstruation, or while taking birth control pills
• Taking certain medications, such as corticosteroids, lithium, or androgens

Symptoms and Diagnosis

Blackheads are small, dark lesions that appear most commonly on the face, especially the nose, chin, and forehead. They can also occur on the back, chest, neck, arms, and shoulders. Unlike other forms of acne, blackheads are not painful because they are not inflamed like pimples.

Diagnosis of blackheads is typically based on a physical examination of the skin. Dermatologists can easily identify them due to their distinctive color and location on the body.

Treatment

Treatment for blackheads focuses on removing the clog and reducing oil production. Options include:

• Over-the-counter (OTC) treatments containing salicylic acid, benzoyl peroxide, or resorcinol
• Prescription medications containing vitamin A, such as tretinoin, adapalene, and tazarotene, which help prevent the plugging of hair follicles
• Manual removal using a special tool called a comedone extractor
• Microdermabrasion, chemical peels, and laser therapy, which are more invasive treatments performed by a dermatologist

Prevention

Preventive measures for blackheads include:

• Washing the face twice a day with a gentle cleanser and warm water to remove excess oil and dead skin cells
• Using non-comedogenic skin care products that do not clog pores
• Avoiding heavy skin creams or hair products that can contribute to the clogging of pores
• Keeping hair clean and away from the face
• Avoiding the temptation to squeeze or pop blackheads, as this can lead to skin infections and scarring

See Also

• Acne vulgaris
• Sebaceous gland
• Skin care