|A blackhead, or open comedo is a wide opening on the skin
with a blackened mass of skin debris covering the opening. Despite their
name, some blackheads can be yellowish in color. A comedo is a widened hair
follicle which is filled with skin debris (keratin squamae), bacteria and
A closed comedo is a whitehead, while an open comedo is a blackhead. the
plural of "comedo" is comedomes".
Blackheads are said to be the first stage of acne. They form before bacteria
invade the pores of the patient's skin. A blackhead can develop into a
pimple, which is also known as a papule or pustule.
Blackheads, and acne in general, usually develop after puberty, when hormone
levels surge and reach the skin. The presence of higher levels of hormones
in the skin triggers the stimulation of the sebaceous glands, which produce
oily substances. The sebaceous glands produce too much oil in the pores,
which accumulates and gets stuck. When the occluded oil is exposed to air it
Several conditions and circumstances can cause blackheads, or make them
worse, such as the use of topical oils and make up. Blackheads can affect
people with any type of skin, but are generally more common in those with
What are the causes of blackheads ?
The overproduction of oil is the main cause of the emergence of blackheads.
This is likely to occur in a high proportion of humans during puberty.
Spikes in hormone production can result in the high levels of DHT (dihydro testosterone),
a hormone which triggers over activity in the oil glands, resulting in
Clean skin - if the skin is not cleaned properly, more blackheads can
appear, especially during those milestones in life when they are more
prevalent, such as puberty. Improperly cleaned skin makes it more likely
that dead skin cells build up within the pores. The pore openings can become
clogged, which accelerates the build up of oil inside - thus causing
blackheads to form. However, many experts warn that dirt does not cause
blackheads to form - which frequently confuses and frustrates patients.
Blackheads are caused by oxidized oil, not dirt, experts add. Over-cleaning
the skin can lead to irritation.
In some cases, blackheads can emerge if moisturizers, sun screens, make up,
or foundations are overused.
In the majority of cases, blackhead susceptibility is not heredity, with the
exception of some severe acnes.
Food does not cause acne - although parents and grandparents commonly
tell their teenage offspring not to eat chocolates and greasy foods, because
they think they encourage the formation of acne - they do not cause
blackheads or make them worse. Some studies have pointed towards a link
between some dairy products and acne, but the evidence is not compelling.
Stress - stress does not directly affect blackhead occurrence.
However, stress and anxiety can cause people to pick at their blackheads and
acne, which may make them worse. Put simply, the behaviors resulting from
stress and anxiety may worsen acne symptoms, but not the stress/anxiety
What are the treatment options for blackheads
Hormonal treatments - contraceptives have often been used for the
treatment of blackheads and acne, often with good results.
Cleaning the skin - clean your face with a good cleanser, ideally,
one for oily skin, such as a salicylic acid cleanser.
Medications - adapalene is a third-generation topical retinoid, used
mainly in the treatment of mild to moderate acne. Many patients with
blackheads have had good results. In the USA adapalene is available under
brand name Differin, in three preparations - 0.1% cream, 0.1% gel, and 0.3%
gel. Since 2010, it has also been available in the USA under the generic
name Teva, (0.1% gel). Only the 0.1% cream and 0.1% gel forms are available
UV exposure - exposing the skin to sunlight or ultra-violet light
encourages it to peel, which helps unblock pores. Sunbathing or using
sunbeds may help. However, it is important to discuss this with your doctor.
Exposing skin to sunlight, if overdone, also raises the risk of burning and
developing skin cancer.
Hair - greasy hair touching the face of your skin can spread
infection and in some cases encourage the spread of blackheads and acne.
Keeping your hair away from your face may help keep blackheads to a minimum.
Written by Christian Nordqvist