You already know that not all pimples are alike. Some are small, white, near the skin’s surface, and go away pretty quickly. No big deal—at least compared to the ones that are deep, inflamed, and painful (what’s called cystic acne and nodule acne) and seem to last for weeks. The most common kinds of acne are whiteheads and blackheads, both of which occur when oil (sebum), dead skin cells, and bacteria combine to cause bumps. Understanding a little more about your skin may help you stay on top of breakouts and head them off before they happen. So with that in mind, here are six things you may want to know about blackheads:
Blackheads don’t mean your skin is dirty. Melanin, which is what gives skin its color, is found in sebum, too. When that melanin is exposed to air (what’s called oxidation) it turns dark, and that’s what gives blackheads their typical color. So resist the impulse to scrub your skin hard to remove the “dirt,” since that’s not what’s causing pimples, plus scrubbing can irritate skin and make acne even worse.
Blackheads are also called “open comedones.” If you’re decided to talk to a dermatologist she may refer to blackheads by another name: a comedone. This is a small, flesh-colored, white, or dark bump that reaches the surface of the skin (they’re what make your skin feel rough and sandpaper-y). Blackheads are called “open comedones” because the bump has surfaced; by comparison, a whitehead is a “closed comedone” because it’s beneath the skin. Both are what’s called “non-inflammatory acne,” whereas papules and pustules (those bigger, painful zits) are considered “inflammatory acne.”
Blackheads aren’t always black. Sometimes they’re actually yellow in color.
If you’re a woman, birth control pills may help keep your blackheads (and other kinds of acne) under control. A 2012 study looked at 31 trials including more than 12,000 participants to see if oral contraceptives were useful in helping women experience fewer, less severe breakouts of all kinds of acne: open and closed comedones, papules, pustules, and nodules. Their conclusion? The birth control pills were effective, and it didn’t matter much what brand of contraceptive a woman used.
Blackheads are the first stage in the progression of a pimple. When too much sebum is produced and there are too many dead skin cells, microcomedones (which aren’t visible to the naked eye) are formed—setting the stage for blackheads. From there, if a blackhead isn’t treated, it can progress to a whitehead below the skin, and then on to a larger, more inflamed papule or pustule. So keeping your skin free from blackheads, as much as possible, can help your acne from getting much worse.
Treating blackheads may require a combination of products. Research points to the use of a mix of topical benzoyl peroxide, retinol products, and antibiotics as perhaps the best approach to getting rid of (or least lessening) breakouts of mild to moderate acne (which includes blackheads). Salicylic acid, which works by reducing swelling and inflammation and unblocking clogged pores, has also been shown to be effective.