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Blackheads: Causes, Treatments & Prevention

Mary Lucas, RN

Medically reviewed by Mary Lucas, RN

Written by Our Editorial Team

Last updated 12/26/2020

Blackheads are a small, dark form of comedonal acne that can develop on your forehead, nose, cheeks, chin and other parts of your face and body.

Although blackheads usually aren’t painful, they can be a major annoyance, especially if they’re in an obvious, highly visible location. 

Contrary to popular belief, blackheads aren’t caused by poor hygiene or dirt. Instead, their black color is caused by a chemical reaction between the substances that can clog your pores and the oxygen in air.

Just like other types of acne, blackheads are treatable using a variety of different products, from over-the-counter creams, gels and washes to prescription medications.

Below, we’ve explained what blackheads are and the most common factors that can cause them to develop on your skin. We’ve also listed a complete range of treatment options for blackheads, as well as tips and techniques that you can use to avoid acne breakouts in the future.

What Are Blackheads?

Blackheads, like whiteheads, are a form of comedonal acne. They form when the hair follicles, or pores, in your skin become clogged due to the formation of a “plug” made from sebum and dead skin cells.

Unlike pimples or cystic, nodular acne, blackheads tend to be small, painless and not affected by inflammation. They usually develop on oily areas of the face, although it’s also possible for blackheads to develop on your neck, chest, back and other parts of your body.

Blackheads tend to look like small, black dots. Their dark color is the result of a process called oxidation, in which the skin pigment melanin inside the blackhead reacts with oxygen in the air and changes color. 

What Causes Blackheads?

Like other types of acne, blackheads form when the hair follicles in your skin become clogged with debris.

All acne, whether it’s small and painless or large, red and inflamed, first forms when hair follicles become clogged with a combination of sebum (a type of natural oil that’s produced by your skin) and dead skin cells. 

Sebum is an oily, wax-like substance that’s made up of triglycerides and fatty acids. It’s secreted by your sebaceous glands and plays an important role in keeping your skin moisturized, healthy and protected from the outside world.

Without sebum, your skin would quickly become overly dry and brittle, exposing it to damage or infection. 

Although your sebaceous glands usually do a good job of producing the right amount of sebum, certain factors may cause your skin to secrete more sebum than normal. This extra sebum can become trapped inside your hair follicles, contributing to blockages and acne lesions.

Another major factor that plays a role in your skin’s health is cellular turnover. In order to repair your skin from damage caused by environmental factors such as ultraviolet (UV) radiation, your body constantly creates new skin cells in a process called epidermal turnover.

Epidermal turnover is essential for keeping your skin healthy, youthful and protected. However, it has one side effect — by continually replacing your old skin cells with new ones, dead skin cells tend to build up on the surface layer of your skin over time. 

When these dead skin cells mix with the sebum on the surface of your skin, they can turn into a form of debris that clogs hair follicles and results in blackheads.

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Although they look different, blackheads and whiteheads are both forms of comedonal acne, or non-inflammatory acne.

In a blackhead, there’s a tiny opening in the clogged follicle that allows air to come into contact with the debris causing the blockage. The characteristic dark color of a blackhead is caused by a chemical reaction between the debris and the oxygen in the air.

In a whitehead, the comedone is closed. Since there’s no contact between the debris and open air, whiteheads maintain their natural white/yellow color. 

A variety of factors can influence your body’s production of sebum and the buildup of dead cells on the surface of your skin, increasing your risk of getting blackheads. These factors include:

  • Hormones. Several androgens (male sex hormones), including testosterone and dihydrotestosterone (DHT) can bind to receptors inside your sebaceous glands and stimulate the secretion of extra sebum. This excess sebum can contribute to blocked hair follicles and acne.

    This is one reason why acne breakouts are so common during adolescence, when your body’s production of sex hormones increases swiftly and significantly. These androgens, while commonly referred to as “male sex hormones” are actually present in both men and women. In women, it’s also common for premenstrual changes in hormone levels to cause acne breakouts.

  • Skincare and hair products. Oil-based skincare and hair care products can also cause your hair follicles to become clogged, creating blackheads, whiteheads and other forms of acne.

    Before using any skincare, hair care or massage oil products, check that they’re labeled non-comedogenic. These products are formulated to be less likely to clog hair follicles, making them a better option if you’re prone to blackheads and other acne.

  • Genetics. Certain genetic factors can affect the percentage of branched fatty acids that are present in your sebum. Studies suggest that you might inherit certain acne-related traits from your parents.

  • Medications. Certain medications, including anticonvulsants, steroids and lithium, may affect your risk of developing blackheads and other forms of acne.

  • Certain types of clothing. Certain types of occlusive clothing and protective equipment, such as shoulder pads, headbands, backpacks and other clothes that press against your skin, may increase your risk of developing acne in some areas of your body.

  • Smoking. In addition to its other negative health effects, some research has found that cigarette smoking is closely correlated with non-inflammatory acne such as blackheads and whiteheads.

  • Stress. Research has found that severe levels of stress are closely correlated with an increase in acne severity. Severe anger and anxiety may also aggravate acne due to stimulation of your body’s stress hormones.

Although research is limited, there’s also some evidence that your diet might play a role in your risk of developing acne lesions such as blackheads.

Contrary to popular belief, the idea that oily foods, such as chocolate or dairy products, play a role in acne breakouts isn’t supported by any convincing scientific evidence.

However, there is some evidence that eating large amounts of sugary, carbohydrate-rich foods such as white bread, candy and potatoes may contribute to acne. With this said, research into the effects of your diet on acne is in its early stages and as such, is still far from conclusive.

How to Treat Blackheads

Because they’re a relatively mild form of acne, treating blackheads is usually a straightforward process. 

If you only have a few small blackheads, over-the-counter acne products may be enough to get rid of your existing acne and prevent breakouts in the future. For more severe acne, you’ll likely need to use prescription medication. 

Over-the-Counter Treatments for Blackheads

A variety of over-the-counter products can help to reduce sebum levels, wash away dead skin cells and get rid of blackheads. Many of these products are also effective against whiteheads, pimples and other types of acne. 

Common over-the-counter products for treating blackheads include:

  • Facial cleansers. If you only have a few blackheads, or you only get acne breakouts from time to time, using an over-the-counter facial cleanser can help to get rid of your acne and prevent it from coming back.

    Facial cleansers help to wash away excess oil and dead skin cells, stopping your hair follicles from becoming clogged. Look for safe, skin-friendly cleansers that don’t make use of harsh chemicals, as these may cause dryness and irritation.

  • Benzoyl peroxide. Benzoyl peroxide is a topical medication that works by preventing the growth of acne-causing bacteria. It also has anti-sebum effects, making it helpful for treating blackheads and other types of comedonal acne.

    You can find benzoyl peroxide in many facial cleansers, acne washes and other men’s skincare products.

  • Salicylic acid. Salicylic acid is an acid-based peeling agent. It works by gently peeling away the outermost layer of your skin. This helps to get rid of dead skin cells that can build up on your skin’s surface and contribute to blackheads and other types of acne.

    Like benzoyl peroxide, salicylic acid is widely available in cleansers, exfoliating creams and other over-the-counter skincare products.

  • Azelaic acid. Like salicylic acid, azelaic acid is an exfoliant that can prevent comedonal acne from developing. It’s commonly used as an ingredient in cleansers, suspensions, creams and other skincare products.

    You can find azelaic acid, along with other acne-fighting ingredients, in our customized acne cream.

  • Over-the-counter retinoids. Topical retinoids such as retinoic acid are highly effective at treating and preventing acne, including blackheads. You can find retinoids such as topical retinol in a variety of strengths, from mild to more concentrated.

Prescription Medications for Blackheads

If you have lots of blackheads, or if you get comedonal acne that doesn’t seem to go away with over-the-counter cleansers and other products, you may need to use prescription medication to treat your blackheads and prevent them from coming back.

Several medications are available for treating blackheads and other acne. Since these require a prescription, you’ll need to talk to your healthcare in order to purchase and use them. 

Common prescription medications for treating blackheads and other acne include:

  • Tretinoin. Tretinoin is a prescription topical retinoid. It works by increasing the speed at which your body replaces its skin cells, reducing the number of dead skin cells that can build up on the surface of your skin and cause blackheads and other acne.

    Tretinoin is highly effective against comedonal acne, with extensive research noting its comedolytic benefits. It’s available in a range of strengths, from mild formulations for sensitive skin to more concentrated options for treating severe or persistent acne.

    Our guide to using tretinoin for acne goes into more detail on how tretinoin works and its benefits for getting rid of blackheads, whiteheads and other acne. You can find tretinoin, along with several other active ingredients, in our customized acne cream.

  • Isotretinoin. Isotretinoin is a prescription oral medication for acne. It works by reducing the amount of sebum secreted by your sebaceous glands, preventing acne lesions such as blackheads from forming.

    Isotretinoin is a powerful medication that generally isn’t used for mild forms of acne such as blackheads or whiteheads. However, your healthcare provider may recommend this if you also have inflamed, nodular acne in addition to comedonal acne.

Why You Shouldn’t Pop Blackheads

Finally, make sure not to squeeze, scratch or pick at your blackheads. As tempting as this can be, popping comedonal acne like blackheads on your own is an easy way to introduce bacteria into your skin and cause your acne to become infected, inflamed and painful.

It can also increase your risk of developing acne scars, some of which may be visually obvious and difficult to treat.

If you have big, obvious blackheads that you’d like to pop, contact a dermatologist to schedule an appointment. A dermatologist can get rid of your blackheads using professional techniques and equipment, ensuring you aren't’ at risk of infection or scarring. 

Tips & Techniques for Preventing Blackheads

Although there’s no perfect way to prevent acne, making a few simple changes to your lifestyle and habits can help to lower your risk of acne breakouts and keep your skin free of blackheads and other acne lesions.

Try the following tips and techniques to prevent blackheads and other forms of comedonal acne from developing: 

  • Be patient with medication. Many medications used to treat acne can require several months to start working. Some, such as tretinoin, even have a “purge” period in which you may notice issues such as dry skin and irritation.

    If you’re prescribed medication to treat blackheads, be patient and continue using it as prescribed even if you don’t notice results immediately. Often, you’ll start to notice real improvements over the course of three or six months of regular use.

    If your medication still isn’t effective after several months of use, talk to your healthcare provider before you make any changes on your own.

  • Avoid using oil-based skin or hair care products. Many skincare products and hair treatments contain oils that can soak into your skin and cause hair follicles to become clogged, leading to comedonal acne such as blackheads and whiteheads.

    If you use oil-based skin or hair care products, try to switch them for non-comedogenic alternatives. These products contain fewer oils, making them less likely to cause acne breakouts.

  • Wash your face, but never more than two times per day. While it’s good to keep your face clean, especially if you use a gentle facial cleanser, washing excessively can irritate your skin and increase your risk of developing acne.

    Try to wash your face two times per day — once when you wake up, and once just before you go to bed. If you exercise or do other activities that make you sweat, it’s also okay to clean your face afterwards.

  • Avoid scrubbing your skin aggressively. While it can be tempting to scrub your skin to remove dead cells and sebum, doing so can irritate your skin and increase the risk of blackheads and other acne flaring up.

    Instead of scrubbing, wash your face and other acne-prone skin carefully using a gentle cleanser. When you’re finished cleaning, gently pat your skin dry using a towel to avoid any extra irritation.

  • Avoid overusing pore strips. Pore strips — adhesive strips that remove blackheads by pulling out the blockage — are widely available from drug stores and can help to quickly remove debris from blackheads.

    However, the results of these products are usually temporary. When overused, they can cause dryness and irritation to your skin. As such, it’s best to only use them only occasionally and not rely on them as a long-term treatment for blackheads.

  • If you smoke, try quitting. Smoking is associated with a higher risk of comedonal acne such as blackheads. If you smoke, try to quit — a topic we’ve covered in more detail in our guide to quitting smoking

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In Conclusion

There’s no escaping it — blackheads and other forms of comedonal acne are annoying. Luckily, they’re also fairly easy to treat, with a range of products and medications available to get rid of blackheads and prevent them from coming back.

If you’re prone to blackheads, it’s best to talk to your healthcare provider. Based on the severity of your acne, they may recommend an over-the-counter treatment or prescription medication to stop your breakouts and keep your skin acne-free. 

You can also talk to a medical professional online and, if appropriate, receive a prescription for medication to treat and help prevent flare ups or recurrence of your acne. 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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