May 24, 2021

Blackhead Removal Tips From the Derms: What's Effective and What to Avoid

You’ve probably stood in front of the mirror with a pair of tweezers aimed at a pesky blackhead, ready to pop it, or slathered on a clay mask to loosen the clogged pores. While popping blackheads and using clay masks can be tempting, both methods can create more skin problems. According to board-certified dermatologists Dr. Sheila Krishna and Dr. Lana Kashlan, the best way to treat and prevent blackheads is retinoids.

Aggressive methods like pinching, peeling, and scrubbing can cause blackheads to look worse and damage your skin. It’s better to use gentler methods like retinoids for blackhead removal. Then, develop the right skin habits to prevent blackheads from coming back.

What is a blackhead?

Blackheads are a type of acne, also called open comedones, that appear as small, black bumps. They form when pores clog due to a buildup of sebum (oil) and dead skin cells around a hair follicle. The skin cells are too sticky, causing them to get stuck inside the pore instead of exfoliating like they’re supposed to.

The other type of comedonal acne that you’ll be familiar with are whiteheads, or closed comedones. They’re similar to blackheads; the difference is that blackheads are exposed to the air. This oxidizes the trapped particles around the hair follicle, causing the black color.

The good news is blackheads are primarily cosmetic. Dr. Krishna says, “There are very few cases where a blackhead would be a danger to the health.” The only danger is if you misidentify something more concerning, like a mole, as a blackhead. If you have a spot that changes shape, size, color, or has undefined edges, head to your doctor to get it checked out.

That said, if you leave a blackhead long enough without treating it, Dr. Kashlan adds, it becomes a breeding ground for bacteria and can turn into an inflamed, red pimple. Even without the pimples, clogged pores left for too long can turn into ice pick scars, which are harder to treat.

But not all those tiny dark spots are blackheads. You know those greyish or brown dots on your nose that seem to be in every pore? They’re not actually blackheads. They’re sebaceous filaments, and you shouldn’t try to remove them! Sebaceous filaments are a natural part of the skin’s structure that helps oil flow out of the sebaceous glands to keep the hair and skin moist. They can become more visible with excess oil buildup, causing pores to appear larger. To make pores look smaller, check out the American Academy of Dermatology’s guidance for minimizing pores.

Use proven, dermatologist-recommended treatments for blackhead removal

Put down the tweezers and nip your blackheads in the bud by considering these derm-approved treatments.

Retinoids

Dr. Krishna and Dr. Kashlan praise retinoids (aka vitamin A derivatives) as the number one treatment for blackhead removal. “Specifically things like tretinoin or even something like adapalene,” says Dr. Krishna. “These can all work to exfoliate the skin gently and get rid of the trapped oil and skin cells.”

Retinoids also reduce the size of the oil gland—so there’s less oil to begin with, and therefore less buildup. This is particularly helpful for oily skin. Retinoids boost collagen production, too, so they can reduce oil buildup between the collagen and the glands.

Extractions

Another popular treatment you can get in-office from a dermatologist is blackhead extraction. But, Dr. Kashlan says, “They’ll just refill.” You’re not treating the root cause of blackheads, which is stickier skin cells clogging the pores. Dr. Kashlan continues, “You have to have a retinoid on board in order to reprogram the skin cells, so they exfoliate more properly.” It will teach your skin cells to be less sticky and exfoliate like they’re supposed to.

So, while blackhead extraction can be an effective blackhead removal treatment, a proper skincare regimen including face wash, moisturizer, and retinoids is the best way to prevent them moving forward.

Avoid methods that could cause more harm than good

Don’t squeeze or pick them

It can be tempting to pick or squeeze your blackheads, but Dr. Kashlan recommends against that. “Please don’t squeeze your blackheads,” she says, “It tends to cause scarring, irritation, and it makes them look worse.”

Steer clear of facial scrubs

Pause before you grab a facial scrub or other exfoliants. “Unfortunately,” says Dr. Krishna, “these products can actually serve to irritate the skin, cause more oil production, or even leave scars and marks on the skin.” Instead, she recommends good skincare to exfoliate more gently.

Skip blackhead removal strips

According to Dr. Kashlan, pore strips like those from Bioré “do not do anything. What you’re seeing is not actually the blackheads coming out; that’s actually just the top layer of the stratum corneum.” The stratum corneum is the outermost layer of your skin. It acts as a barrier to protect the sensitive skin tissue underneath. Damaging it can make your skin more sensitive and prone to irritation. So, these strips are not only not effective blackhead removers; they’re making it harder for you to get healthy skin.

Hold off on clay or peel-off face masks

Dr. Krishna is not a fan of clay masks that aim to draw oil out of the skin. “First of all,” she says, “they can irritate the skin. Secondly, they can cause a really exuberant drawing out process where it does start to draw the oil out, but… doesn’t do it all the way…all that oil gets stuck, and it doesn’t actually end up coming out.” Instead, people may end up with a bad acne breakout that needs antibiotic treatment.

Dr. Kashlan adds that we should reconsider our use of those black peel-off face masks, too. She says, “You can damage the skin surface.” Not good for anyone.

Be wary of home steaming

Finally, Dr. Kashlan recommends against home steaming. “You can cause burns from the steam that can be dangerous,” she informs us.

The best path forward for treatment is to use retinoids or get an in-office extraction from a derm. Then, develop a strong skincare routine to prevent them from coming back.

Prevent blackheads from coming back with good skincare habits

Now that your blackheads are gone, it’s time to develop consistent skincare habits to keep them from coming back.

Keep hair off the face. Your hair has additional oils that can get on the skin, so Dr. Krishna recommends wearing a headband at night.
Wash your face after exercise. With sweat comes more oil that can get trapped in pores. Keep them clear of gunk with a gentle purifying cleanser.
Keep objects that touch your face clean. We’re talking cell phones, glasses, CPAP machines, and other headgear. Oil and bacteria build up on these objects and transfer to your face. Make sure to regularly clean or disinfect anything that touches your face regularly.
Check your makeup and skincare products for comedogenic ingredients. These are pore-blocking ingredients that can cause blackheads and enlarged pores. Some common comedogenic ingredients include oils (like coconut oil and palm oil), beeswax, and alcohols (like cetyl alcohol and stearyl alcohol), among dozens more. That said, if you want to keep using your favorite makeup products, make sure to wash your face thoroughly at the end of the day.
Cleanse and moisturize daily. According to Dr. Krishna, moisturized, clear skin “will help promote the natural exfoliation of blackheads and prevent their development.” Wash away impurities with a gentle cleanser and nourish with a non-comedogenic moisturizing lotion as the base to your skincare regimen.
Protect against sun damage with a good SPF. Blackheads can also show up later in life due to years of sun damage, Dr. Krishna informs us. So, keep up a good sunscreen habit by applying every day before you go out in the sun, and every two hours. Use a broad-spectrum sunscreen with a minimum SPF of 30.
Integrate retinoids at night. Dr. Krishna and Dr. Kashlan are huge fans of retinoids for blackhead removal and prevention. Retinoids keep the pores clear by promoting healthy exfoliation. Use them as part of your nighttime skincare routine, as they can make your skin more sensitive to the sun if applied in the morning.

Get a derm-grade retinoid for blackhead removal

The most effective retinoid can’t be store-bought. And you can’t ensure you’re getting the right concentration of this powerful active for your skin by grabbing something off the shelf at Sephora. Tretinoin is a dermatology-grade retinoid that’s 20 times more potent than over-the-counter retinol¹. It has 50 years of research to back up its safety and efficacy, including for blackhead removal².

Night Shift is a dermatologist-formulated Tretinoin serum tailored to your skin by doctors online. After sharing your skin story, a provider will determine the best concentration for your skin. They’ll write a prescription if applicable. Then, you’ll get your tailored retinoid serum in the mail. It’s that easy!

New to retinoids or have sensitive skin? Your provider may send you a starter strength to start to give you a chance to adapt to your new serum. Then, increase over time to the strength that’s optimal for your skin.

Questions? Skincare can be confusing, but we’re here to help. Feel free to reach out if you have any questions.

Mukherjee, S., et al. (2006, December). Retinoids in the treatment of skin aging: An overview of clinical efficacy and safety. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/
Kaur, J., et al. (2015). A comparative study to evaluate the efficacy and safety of combination topical preparations in acne vulgaris. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4456883/