What You Need to Know about Blackheads

You know a blackhead when you see one.  The center of the blackhead is the dark grey, brown or tan material which is stuck inside a pore.  They can range from being as tiny as a point to being much much larger.  You might have found it irresistable to try to give it a good squeeze to get the material out from between your fingers and nails. But be careful!  You don’t want to do more harm than good.

Here are some FAQs I often get about blackheads.

What makes a blackhead black?

While not truly black, the center of the blackhead is often dark in color.  This darkening occurs when the debris which is normally whitish or ivory is exposed to the air and oxidizes.  This oxidation process darkens the debris.

What is that material inside a blackhead anyway?  What is a blackhead made of?

The material inside a blackhead is a mix of a variety of substances normally made and shed through your pore.  They may include sebum as well as dead skin cells.

How do I get rid of  blackheads?

You may have heard of people extracting blackheads or you may have tried it yourself as well.  In general, it’s best to leave this to a trained professional to minimize the risk of scarring, inflammation, infection, and further skin damage.

There are medications which can also shrink pores and the blackheads.  Retinoids are a type of medication that could be used for this.  There are over the counter retinoids such as retinol and adapalene/Differin as well as prescription retinoids.  These can be irritating so start slowly at first and slowly increase until you can tolerate it.  If you’re pregnant or trying to get pregnant, your physician may advise you to hold off on using retinoids.

You’ve been prescribed Retin A. Now what?

An example of acne on a teenage boy's forehead.
An example of acne on a teenage boy’s forehead.

Retin-A ® or tretinoin is a popularly prescribed medication for acne as well as preventing the signs of skin aging.  For acne, it is particularly effective for “whiteheads” (aka closed comedones) or “blackheads” (aka open comedones).  In terms of skin aging prevention, it can help improve the texture of skin, even out skin tone, and prevent really fine wrinkles from appearing.

However, many people find Retin A difficult to use and will note irritation.  Especially in the beginning of use, the skin often becomes reddish, dry, scaly, and sometimes itchy.  This is because the medication helps regulate the turnover of your skin cells and can speed up this turnover.

Here are some tips that you can stick to to make it easier to stick with your medication and see some really good results.

– Use a pea-sized drop for the whole face.  Squeeze out a little bit on one index finger and dab it on the other. Dot over the areas to treat (e.g. forehead, cheeks, chin) and then rub in.

– Apply at night

– If you’re having problems with irritation:

  • Mix the medication with a gentle face moisturizer (non-comedogenic of course!)
  • Space out use.  Start every other day and work up to every day.
  • Avoid the areas right by your eyes, nose and mouth where the skin is thinner.
  • Avoid any areas of open or damaged skin.
  • Start with a low dose.
  • Ask your physician if there is a gentler formulation of the medication if the above tips don’t help.

– Use sunscreen in the morning.  This is normal recommended practice anyways, but the Retin A can “thin out” your skin and make it easier to get a sunburn. Also, it’s no fun getting a sunburn over already irritated areas!

Another important point is that if you are thinking about getting pregnant or are pregnant, stop the medication and let your doctor know.