Why Do I Get Blackheads

Blackheads are little dots that are dark in colour and usually appear when someone has acne. Acne happens when the skin is oily and spots or pimples begin to appear. They can appear on different areas of the body, although they are most commonly seen on the face. Blackheads aren’t harmful to your health, but they may be considered visually unappealing and some people may struggle with low self-esteem, anxiety, or depression because of acne.¹ Acne is a common skin condition, so no one should be worried about experiencing it. Even though blackheads and acne can be stubborn, there are many treatment options available to help treat the condition.

This article will take a closer look at what blackheads are, what causes them in the first place, and how to best manage them with the different treatment options available. 

What are blackheads

Blackheads are a form of mild acne and look like little, dark dots or bumps on the skin. They usually appear on the face, but they can be seen on other body parts such as the back, neck, or chest. Blackheads form when dead skin cells block the opening of a pore and the excess oil (or sebum) produced by the sebaceous gland in your skin follicles can’t escape.² This causes the sebum to build up in the pore and results in a blackhead. A common misconception is that blackheads are dark in colour because of dirt stuck in the pores. Instead, they have a dark colour because the pore is ‘open’ and doesn’t have skin covering it, so a reaction with the air causes it to look black.² They can also be known as open comedones.² If the pore was ‘closed’, meaning that skin covers the top, then this is known as a whitehead.²

Acne and blackheads are commonly seen during puberty and they occur less after young adulthood.³ People with acne usually experience both blackheads and whiteheads. Severe acne can be more painful, seeing as pimple inflammation occurs. Some people may struggle with acne and blackheads for a long period of time, whereas for others it may resolve quickly. 

Causes of blackheads

The primary cause of blackheads is the blockage of the oil or sebum produced by our skin underneath the dead skin cells in our pores.² Because the sebum cannot leave the pore, this causes the formation of a blackhead. There are factors that may increase your likelihood of acne and blackheads such as:^3,4

• Hormonal changes - Acne and blackheads usually appear during puberty and this is to do with changes in hormone production and an increase in sebum production.² Typically, during puberty, a hormone called androgen is produced in both males and females.² Androgen causes more oil (or sebum) to be produced by your skin, which may increase your chances of having acne and blackheads appearing
• Genetics – There is a genetic link associated with acne.³ If a child’s parent(s) suffered from acne, then there is an increased chance that the child will also develop acne in its lifetime
• Age – Acne is commonly experienced during adolescence and after young adulthood it is less common³
• Sebum production – People with oily skin or mixed skin types have increased sebum production, so have a higher risk of experiencing acne and pimples⁴
• Diet – What you eat can influence your chances of getting acne. Products such as milk or chocolate may increase the risk of acne, but these are highly debated topics with mixed results.³ Eating lots of fruits and vegetables as well as fish may reduce the risk of acne³
• Body mass index (BMI) – This is used to categorise a person’s weight, which either falls under underweight, healthy, overweight, or obese. BMI can increase your chances of getting acne if you fall under the overweight or obese category.³ This may be to do with the increased production of androgen, which causes more sebum to be produced³
• Stress – People with higher stress levels may suffer from acne more often than those with lower stress levels⁴

Signs and symptoms of blackheads

Blackheads are easy to spot because of their dark colour on the skin. You may be able to feel the dark dot or bump as it can be slightly raised above the skin. Blackheads don’t hurt when you touch them. Because blackheads are a form of mild acne, it is good to know the general signs and symptoms of the different acne severities:

• Mild acne – This usually presents as blackheads and whiteheads on the skin which aren’t inflamed.⁵ There may also be a few inflamed pimples, known as papules or pustules.⁵ They occur when bacteria enter the hair follicle on the skin which can cause inflammation and redness of the papules and pustules
• Moderate acne – An increased number of inflamed papules or pustules are seen on the skin alongside blackheads and whiteheads.⁵ There may be some scars present as well
• Severe acne – There are widespread inflamed papules or pustules on the skin.⁵ Hard lumps underneath the skin called nodules and cysts that are pus-filled  lumps are also present. These pimples are very painful and unpleasant to experience. Usually, scarring can be seen on the skin

Blackheads and mild acne can be treated with products found in health stores which are discussed in the next section, but if you struggle with moderate or severe acne then it is best to speak to your doctor or healthcare provider.

Management and treatment

There are lots of different treatment options available for blackheads. It is usually easier to treat blackheads that are closer to the surface of your skin, while deep blackheads are more stubborn and it may take longer to treat these. Products that may help to prevent blackheads and acne in general are:

• Glycolic acid – This works by removing the top layer of the skin which in turn removes the dead skin cells.⁶ This means that fewer  dead skin cells block the pores and decrease  the likelihood of blackheads forming
• Salicylic acid – It is an exfoliating agent that works in the same way as glycolic acid.⁶ It helps to unclog blocked pores and stops blackheads from appearing
• Azelaic acid – It works in a similar way to glycolic acid and salicylic acid by unclogging pores and killing bacteria

• Benzoyl peroxide – It has an anti-inflammatory effect and helps to reduce the amount of bacteria on the skin.⁶ It can help to clean out clogged pores and therefore help less blackheads appear
• Retinoids – It is also known as vitamin A. This works by stopping the dead skin cells from building up and blocking pores by exfoliating the skin.⁶ This can help to reduce the number of blackheads appearing
• Tea tree oil - It has anti-inflammatory and antimicrobial properties that may help stop blackheads from forming⁶

FAQs

How common are blackheads

Blackheads usually appear if you have acne. Acne is a common skin condition and according to the NHS around 95% of 11- to 30-year-olds are affected by acne to some degree. Acne is most commonly seen in adolescence.

Who are at risk  of blackheads

There are different risk factors that could affect whether you get blackheads and acne. One such factor is genetics - a person whose parents suffered from acne has  a higher likelihood of experiencing acne themselves.⁴ Other factors such as age, hormonal changes, sebum production, diet, body mass index, or stress can play a role as well.^3,4

How are blackheads diagnosed

Blackheads can be self-diagnosed  because they are easy to spot on the skin. They appear as dark dots or bumps most commonly on the skin of the face.

How can I prevent blackheads

Things that may help to reduce acne and blackheads are remembering to wash your face a few times a day, removing any makeup at the end of the day before bed, and avoiding oil-based skincare products.

When should I see a doctor

If you have stubborn blackheads as well as moderate or severe acne then it is a good idea to see a doctor as they could prescribe you other medication if over-the-counter  medication isn’t helping. 

Summary

Blackheads frequently occur with acne. Acne breakouts are very common during adolescence, but the y can affect people later on in life as well. Blackheads are caused by dead skin cells clogging up pores in the skin which means that the oil produced by the skin cannot escape. You can easily spot them by their dark colour on the skin. Blackheads can be treated with many different products that you can get over the counter such as salicylic acid or glycolic acid. They help to exfoliate the skin so the dead skin cells don’t clog your pores and reduce the appearance of blackheads.