What Causes Blackheads and How to Reduce Them?

The short answer to how blackheads go away: not by squeezing, but with a consistent routine that dissolves the mixture clogging the pore. Ingredients such as salicylic acid and retinoids can help loosen the plug and reduce the formation of new ones, but a clear difference usually takes weeks. Squeezing, on the other hand, can push the plug deeper, increasing the risk of inflammation and scarring. If you have used a product consistently for 4-6 weeks and see no change, or if you have painful, deep pimples alongside your blackheads, see a dermatologist.

What exactly is a blackhead?

The medical term for a blackhead is an open comedone. A comedone is a blockage of the shared duct between a hair follicle and an oil gland. If the duct opening stays open, it becomes a blackhead; if it is covered by skin, it becomes a whitehead. Both are different appearances of the same process and are considered the mildest forms of acne.

The first thing to know: dark color doesn't come from dirt. The tip of the plug contains melanin pigment, this tip is in contact with air, and it doesn't reflect light like the surrounding skin does. There is no single definitive explanation for how much of the color comes from which factor, but the information is clear that dirt is not the cause. That's why scrubbing your face harder won't remove blackheads; it will only irritate the skin.

Blackheads most often appear on the nose, chin, and forehead. They can also appear on the cheeks, neck, back, and chest. They don't hurt and aren't contagious. They are common in teenagers and young adults, but they also affect about 10-20% of adults.

How do pores get clogged?

A comedone doesn't come from just one cause. Several processes overlap:

1. The canal narrows. The cells lining the sebaceous gland canal multiply more than normal, and cells that should shed build up inside the canal.
2. Oil increases. Under the influence of androgen hormones, oil glands produce more sebum. This is why blackheads increase during puberty and hormonal changes.
3. The plug grows. Sebum and dead cells first form a small plug that is not visible to the eye, and over time this plug moves closer to the skin's surface.
4. The opening stays open. When the tip of the plug contacts the outside air, it looks dark. If the opening is closed, the same structure remains as a whitehead.
5. Sometimes inflammation is added. Free fatty acids produced from sebum by acne bacteria and inflammatory signals can join in. At this stage, the comedone can turn into a red, painful pimple.

Factors that can worsen the condition

• Over-moisturized skin: Pre-period days, humid environments, and moisturizers applied too heavily can increase comedones.
• Oily products: Hair pomades, oily hair products, cocoa butter and shea butter can clog pores. Isopropyl myristate, propylene glycol and some cosmetic dyes are also referred to as comedogenic.
• Smoking: Comedone-dominant acne is more common in people who smoke.
• Damage to the canal: Squeezing pimples, scrubbing harshly, or chemical peels or laser treatments can tear the canal and increase comedones.
• Diet: There are studies linking dairy products and foods that quickly raise blood sugar. Since these findings are mostly small or survey-based, they do not show a definite cause-and-effect relationship.

Not every comedone is the same

Comedones have several subtypes, and knowing them helps set your expectations. Closed comedones larger than 2-3 millimeters are called macrocomedones. A giant comedone is a cyst-like structure with an opening like a blackhead; do not try to extract it at home. Solar comedones seen on the cheeks and chin of older people are most likely related to long-term sun damage. This picture reflects the sun's mark more than acne, so sun protection keeps its place here too.

Not every dark dot is a blackhead: the difference with sebaceous filaments

The small gray dots on your nose and cheeks may be sebaceous filaments (oil gland threads). They aren't pimples; they're normal structures that carry oil to the skin's surface. Trying to squeeze them only strains the skin for nothing.

The oil you squeeze out of a filament can build up again within about 30 days. So squeezing is wasted effort, and it can damage the skin. Salicylic acid and retinoids can help filaments look less noticeable, but they don't eliminate them.

Why does squeezing make things worse?

You may feel relieved after removing a blackhead, but the cost of squeezing at home is often greater than the plug you remove:

• You may not be able to remove the whole plug, and the remaining part will grow back within a short time.
• Pressure can push the contents deeper and tear the duct wall. This increases the risk of the comedone turning into an inflamed pimple.
• Bacteria from your hands and under your nails can get into opened skin, and an infection can develop.
• Nails can cut the skin. It may leave a permanent scar or a dark mark that lasts for months.

Nose strips aren't harmless either: they can pull out filaments and dry out the skin. Metal comedone extractors used at home can also leave scars. Using these tools properly matters only in the hands of a dermatologist or medical aesthetician, because the skin is prepared first, a sterile tool is used, and afterward a plan is made to prevent new ones.

How do blackheads go away? Choosing actives

Cosmetics and over-the-counter products do not magically erase a comedone. What they can do is loosen the buildup in the duct and reduce the formation of new plugs. The main options are these:

If your skin is prone to comedones, salicylic acid is an accessible place to start. It still isn't always enough on its own, especially if you also have inflamed pimples. If oiliness is your main concern, niacinamide can be added to your routine, as small studies have shown it reduces sebum. But don't expect it to solve comedones alone.

Stronger retinoids are prescription-only. Your doctor decides which one is suitable, how often to use it, and at what strength.

A sample starting point for adding salicylic acid to your routine

The routine below is not a prescription taken directly from sources; it's a starting point derived from general rules. Slow down based on how your skin responds.

1. Patch test first. Apply the new product to your inner arm or elbow crease twice a day for 7-10 days. Stop using it if you notice redness or itching.
2. Start with one active. Use a salicylic acid cleanser in the evening. A gentle, fragrance-free cleanser is enough in the morning.
3. Adjust based on your skin's reaction. If dryness or stinging occurs, use a salicylic acid cleanser one evening and a gentle cleanser the next evening.
4. Don't skip moisturizer. A non-comedogenic (non-pore-clogging) moisturizer helps maintain the skin's balance alongside drying factors.
5. Protect by day. In the morning, apply a broad-spectrum sunscreen with at least SPF 30. Reapply every 2 hours, or sooner if you've been sweating or swimming.
6. Don't add another active at the same time. If you're considering a retinoid or peel, let your current product settle in first. For the order to apply products in, you can check our skincare routine order article.
7. Wait 4-6 weeks. Photos taken in the same light make it easier to see small changes.

If you are not sure whether your skin is oily or combination, start with the skin type article and choose your products accordingly.

When should you see a dermatologist?

A few blackheads are not a health concern. You should get checked if the following apply:

• You've been using the over-the-counter product regularly for 4-6 weeks, but nothing has changed.
• Blackheads are accompanied by painful, deep swellings or pus-filled pimples.
• The area is warm, swollen, and red. This may be a sign of a skin infection.
• Where it heals, a scar or a long-lasting dark spot remains.
• It started suddenly in adulthood, along with irregular periods or new hair growth.
• You are pregnant or breastfeeding and need to choose an active ingredient.
• Your appearance is causing you worry, self-consciousness, or low mood.

What can be done at the dermatologist?

A doctor can perform comedone extraction with sterile tools. This procedure usually comes up when other methods are not enough, and it is not sufficient on its own; a maintenance plan is then needed. Prescription retinoids, oral antibiotics, chemical peels, microdermabrasion and laser are also among the options. For stubborn comedones, cryotherapy or electrocautery may be applied. For widespread or resistant acne, hormone therapy or isotretinoin may be discussed. Your doctor decides which one to use, at what dose and for how long.

How long does it take, and what should you not expect?

With acne-fighting products, a meaningful difference usually appears within a few weeks to a few months. If new formation is not prevented, the problem recurs, so you may need to maintain your routine for a long time. Many people's blackheads decrease in early adulthood, while some may have them for life. Those close to the surface may disappear on their own, while deeper ones are less likely to do so.

Set your expectations accordingly: the goal is not to have no blackheads at all, but to have fewer of them and for new ones to appear less often.

Habits that delay results

• Stopping a product after two weeks. That period is too short for most actives.
• Scrubbing harder. Since dirt is not the cause, scrubbing does not clear the plug and only increases irritation.
• Washing with hot water. Lukewarm water is enough; hot water can irritate the skin.
• Sleeping in makeup. Remove your makeup at the end of the day, and choose non-comedogenic products.
• Touching your face with your hands. Touching and picking can aggravate acne.
• Mistaking dryness for effectiveness. Tightness may mean your skin is struggling, not that the product is working well.

This article is for general information about blackheads; if you notice a painful lump, spreading redness, or a pimple that leaves a scar, consult a dermatologist for an evaluation.