Blackheads are one of the six main types of spots caused by acne. (Others include pus-filled spots called whiteheads, or closed comedones, and small red bumps called papules.) As dermatologists, we aren’t big fans of people trying to remove blackheads using their hands or shop-bought extractors because of the risk of scarring. Also, blackheads often form in groups: if you try to get rid of them with the extractor, you will be there all day.
We prefer a medical treatment. The best is a combination of washing the skin during or after a shower with a peroxide wash, then applying a retinoic acid cream to the blackheads, as retinoic acid is really good at drying out grease glands. Both of these can be bought over the counter or obtained with a prescription. You can also apply your washes with an exfoliator to remove debris from the pores, or you can use a microdermabrasion machine to exfoliate much deeper to get rid of small acne scars, too. If these don’t work, you need to visit a dermatologist or GP to be put on oral medication, which is much more intensive.
There is mixed evidence on diets preventing the formation of blackheads. You may notice a correlation among individuals, but there are no studies to show that certain diets prevent blackheads for all people. The same goes with moisturisers – there is no evidence that greasier moisturisers create more spots. In general, we like people to moisturise once a day.
If you are not succeeding with these treatments or blackheads are affecting your confidence, you should book an appointment with a dermatologist; we can use other interventions.
Dr Adam Friedmann is a consultant dermatologist at the Harley Street Dermatology Clinic. He was talking to Ammar Kalia
