Dealing with Blackheads

Blackheads aren't as serious or potentially disfiguring as some other forms of acne, like pustules, nodules, or cysts. But blackheads can cause serious terror when they appear on your forehead, nose, cheeks, or chin.

Contrary to myth, blackheads aren't a sign of poor hygiene and dirty skin. Like all forms of acne, these tiny yellow or black spots result when oil glands in your skin secrete too much sebum — a natural moisturizer you start producing in puberty — and clog your pores or hair follicles.

Blackheads — also known as open comedones — are simply a basic acne lesion that opens to air, which oxidizes and darkens its contents. The other type of basic acne lesion — whiteheads, or closed comedones — also contains excess sebum, but stays white because it's not exposed to air.

Although all forms of acne are most common in adolescence, they frequently affect people over the age of 20, especially women. Studies show that 50 percent of women ages 20 to 29 and more than 25 percent of those ages 40 to 49 suffer at least occasional breakouts. Fortunately, most forms of acne — including blackheads — can be successfully treated.

Getting to the Root of Blackheads

Common triggers include:

• Hormone fluctuations.
• Medications.
• Genetic predisposition.
• Skin and hair products. Oily sunscreens, hair greases, and some cosmetics can promote a type of acne called "acne cosmetica." In women of color, one of the most notorious offenders is pomade, an oil or ointment for hair that causes forehead acne cosmetica — usually blackheads and whiteheads — in up to 70 percent of users. To help prevent this condition, only use skin and hair products that are labeled "non-comedogenic" or "non-acnegenic."

Blackhead Prevention Strategies

Proper skin care is essential. Here's what dermatologists recommend:

• Practice gentle face washing. Wash your entire face from under the jaw to the hairline twice a day with a mild soap or facial cleanser, and then rinse thoroughly. Also wash after heavy exercise. Vigorous washing — especially with strong soaps or a rough scrub pad — irritates the skin and worsens acne.
• Protect your skin. Rule number one is to resist the temptation to pick at your blackheads, which can cause permanent scarring. Also be sure to use a non-comedogenic sunscreen of at least SPF 15 when you spend a lot of time outdoors, and avoid clothing and sports equipment — such as tight hats and backpacks — that rub and irritate the skin.

Home Treatment for Blackheads

Over-the-counter options include:

• Acne remedies containing sodium sulfacetamide and sulfur.
• Topical retinoids.
• Moisturizers and foundations that contain proven acne-fighting ingredients such as salicylic acid.
• Blackhead extractors, devices that remove blackheads by suction.
• Blackhead strips, which contain glue that binds to blackheads and whiteheads, and remove them when peeled off.

If prevention measures and home treatments don't work, consult your family doctor or a dermatologist.

Medical Treatment for Blackheads

Prescription medications include creams or lotions containing benzoyl peroxide, which reduces sebum production; and resorcinol, salicylic acid, or sulfur, which help break down blackheads and whiteheads.

Some of the most effective medications contain prescription-strength retinoids, vitamin A derivatives that work to unclog pores and prevent the formation of blackheads and whiteheads. Approved retinoids for acne treatment include adapalene, tazarotene, and tretinoin.

Although retinoids have a reputation for causing skin irritation, newer formulations are less likely to cause this side effect. But it's still advisable to avoid using these medications during pregnancy because they may cause birth defects, and to use sunscreen outdoors because of an increased risk of sunburn.

If a prescription medication doesn't improve your skin within six to eight weeks, talk to your doctor or dermatologist about changing treatment.

If you have blackheads, there's no reason to suffer in silence. With proper skin care and treatment, you can banish this beauty bane and enjoy blemish-free skin.