Blackheads are a problem I haven't dealt with too much - I'll get the occasional blackhead, maybe once a year (the rest is whiteheads and pimples, lucky me!).
However, I do get a lot of questions about blackheads, and recently my mother has been getting a lot of them on her face, around her chin, nose and cheeks, and they've been frustrating her. It's the first time my mother has ever come to me for skin advice, so I took it darn seriously!
But I also wanted to share the information with all of you, as well, considering how common of a problem blackheads are (liiiiike almost everyone gets them at some point in their life).
What Are Blackheads?
Blackheads are a specific kind of dark acne lesion, so-called because they contain oxidized melanin, the pigment made by skin cells called melanocytes.
Blackheads form as a result of excess sebum produced at the base of hairs, often as a result of hormone changes, especially during puberty. My mother is currently going through menopause, which could account for her blackheads.
Sebum has a protective role in the skin, helping to keep it supple and hydrated. When sebum is overproduced, however, it can form plugs in the pores by clumping with epidermal cells that shed from the skin. Sebum contains a dark pigment, melanin, which oxidizes and turns black when exposed to the air; this is why blackheads have a dark appearance, not because it is "dirt" trapped in your pore.
Myths About Blackheads
In general, blackheads (and acne as a whole) are not caused by:
Poor hygiene or inadequate face washing (excessive washing or scrubbing is likely to make blackheads worse). Having blackheads doesn't mean you're dirty.
Chocolate, nuts or greasy foods won't give you blackheads necessarily (although there are links to dairy consumption, high glycemic index (GI) diets and diets high in pro-inflammatory animal products).
Why Do I Get Blackheads?
Hormonal changes are the primary cause of excess sebum, especially during puberty but particularly for women - all throughout their reproductive lives. The male sex hormone androgen triggers greater secretion of sebum and higher turnover of skin cells, and its production surges in both boys and girls during adolescence.
There is also some evidence that blackheads are more likely to arise when poor diet or disease leads to increased insulin levels, increased levels of IGF-1, and rapid growth of skin cells that lead to clogged pores. This can be the result of high GI foods in your diet, or foods that promote increased IGF-1 levels such as meat and dairy.
Other factors that are often involved in the formation of blackheads can include:
Cosmetics, especially when left on overnight, or not thoroughly washed off.
Any skin care product that is intended to "seal in" moisture will also "seal in" the sebum and dead skin cells. Heavy moisturizers and sunscreens are common culprits, but cleansers can be, as well.
Heavy sweating or high humidity.
Dietary factors, disease or medications that encourage rapid skin cell turnover.
Some steroid drugs make acne worse or cause similar skin eruptions.
What Can I Do?
First of all, avoid benzoyl peroxide. I know, you've been told that BP will get rid of those blackheads for good, but the problem is that BP is antibacterial, which isn't necessarily an issue in blackheads and will likely only further dry up and irritate your skin. For blackheads, you need something that exfoliates, and for this I always recommend salicylic acid as the first-line of treatment.
Salicylic acid is oil soluble, so it penetrates into clogged pores, dissolving trapped oil. The highest over the counter concentration is 2%, but be mindful of your skin’s sensitivity, so you may want to vary your concentrations, until you find a strength that works. Start low and go from there.
For more severe non-inflammatory acne (a lot of blackheads and whiteheads) gels or lotions containing retinoids, which help to regulate cellular turnover, preventing dead skin cells from sticking together in the pores, may also help.
Hormonal agents, such as the oral contraceptive pill, can help with the problem of sebum production.
Clay, charcoal, and salicylic-acid face masks are all great pore-purging alternatives, that help to flush out the pore.
Chemical peels and microdermabrasion may also help.
The most important thing to remember when treating existing blackheads, is to be patient and consistent in your treatment - it took a long time for the blackhead to form, and it won't disappear immediately overnight.
In terms of prevention, reducing sebum production by balancing your hormones, taking medication, adjusting your diet, etc can make a world of difference.
I first got acne in high school, and it came back in my early adulthood. I was able to struggle through those difficult times and come out of it a stronger, wiser, healthier person as a result. I'm here to help you do the same thing!