Blackheads...What are they and how do you get rid of them? Do blackhead removing masks work?

Blackheads AKA open comedones are part of acne along with white heads (AKA closed comedones!). Our ESK skintellectuals will know that there are 4 factors responsible for acne;

1. Overproduction of skin cells, which die, leading to the formation of a blockage in the pores
2. Increased oil AKA sebum production
3. Overgrowth of bacteria – specifically C.acnes feeding off that excess oil
4. Inflammation

In the case of acne, the oil, bacteria and dead skin cells that get stuck in the pores turn black because they attract surface pigment (melanin). There’s no dirt stuck in the pores.

How do you treat them?

The treatment for black heads is the same as for acne generally;

1. Soap free cleanser.

Soap itself is great at stripping oil out of the skin. Soaps also tend to cause inflammation and increase the pH of the skin. Studies have shown it doesn’t get rid of the bacteria, C. Acnes from the skin. But washing is important for acne-prone skin. Go for a gentler pH balanced soap free cleanser like ESK’s Hydroxy Cleanser or Gentle Cleanser.

2. Vitamin A AKA Retinoids.

These blockbuster ingredients help with cell turnover, so unclog pores, and promote the normal flow of sebum. Plus they seem to help reduce C. Acnes in the skin. All of this reduces the pimple count significantly. Vitamin A can either be on prescription from your doctor or in your skincare. Both prescription Vitamin A (Retinoic Acid) and Retinol- a form found in many skincare brands can be very irritating. Retinol also doesn’t have conclusive evidence to support its use. Retinal has great evidence to support its use in acne. It is the hero ingredient in ESK’s Ultimate A and Ultimate A+. Just a reminder that Vitamin A is rendered inactive by sunlight so should only be used at night- just once a day.

3. Alpha Hydroxy Acids AKA (AHAs).

They help to gently remove dead skin cells and reduce inflammation. AHAs, as found in ESK’s Smooth Serum, also stimulate the growth of new skin cells which helps improve the appearance of acne scars and gives the impression of smaller pores. They also seem to make Vitamin A more effective. Because they can make the skin more sensitive to the sun, experts suggest using them at night as a leave on serum. They can also be used as a peel in the clinic.



4. Salicylic Acid.

Salicylic acid dissolves oil and exfoliates excess dead skin cells, is anti-inflammatory and helps combat the bacteria, C. Acnes. ESK’s Hydroxy Overnight Mask can be used as a weekly face treatment instead of your other skincare or as a spot treatment.



5. Good sunscreen.

Because hydroxy acids and vitamin A can make your skin more prone to sun damage, and because UV damage can cause significant inflammation in the skin, a sunscreen is always a good idea. ESK’s Zinc Shade is made of Zinc which is non comedogenic (doesn’t cause breakouts) and is anti-inflammatory in itself.

The trip to the doctor

If simple skincare doesn’t work, OR if your acne is already moderate to severe (large red throbbing pimples), you should see the doctor sooner than later. You are at risk of scarring. You might benefit from either antibiotics (applied directly onto the skin or orally). These need a prescription from the doctor. You might need oral Vitamin A which is the most powerful anti-acne treatment of all. You need to see a dermatologist for this treatment. Hormonal therapies like the pill and/or a medication called spironolactone can also be prescribed for in women and girls, but they work much more slowly.

Lasers and lights can also help but the results tend to be a bit unpredictable, even in the most experienced clinician’s hands. Most people get some improvement but it might not be the silver bullet you see on social media.

Can you squeeze a blackhead? 

Yes. But be careful! Take these steps;

1. Wash your hands and face
2. Use a blackhead remover from the pharmacy
3. Make sure you have even pressure around the blackhead
4. Press down gently and remove the plug of oil and dead skin cells.
5. Only do a couple at a time and if it doesn’t come out easily, abandon! Excessive squeezing causes inflammation of the skin which can make acne worse.

What about blackhead removing masks?

There is no evidence at all for anti-acne masks such as clay, oatmeal, cinnamon, or even honey (which does have a bit of evidence for combatting bacteria but not in acne).

 

References

https://www.racgp.org.au/afp/2017/december/acne-in-adolescents/

https://pubmed.ncbi.nlm.nih.gov/32385554/

https://pubmed.ncbi.nlm.nih.gov/30674002/

https://pubmed.ncbi.nlm.nih.gov/19746671/

https://pubmed.ncbi.nlm.nih.gov/21566426/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3834713/

https://pubmed.ncbi.nlm.nih.gov/7738225/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225141/

https://pubmed.ncbi.nlm.nih.gov/18053051/

https://www.aad.org/public/diseases/acne/derm-treat/lasers-lights

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4746462/