Blackheads (open comedones) are small, dark skin lesions that often appear on the face and neck. These painless, tiny skin bumps are often present in the skin condition acne in which the sebaceous glands are blocked, but symptoms of this skin disease are not always present. Blackheads contain an oxidized version of melanin (the dark color made by cells in the skin). Properly treating these symptoms will prevent the patient from developing more severe acne. Some do’s and don’ts help patients relieve symptoms without additional damage to the skin.

• Causes: Clogged skin pores
• Risk factors of blackheads
• Symptoms
• Diagnosis and examinations
• Treatment of open comedones

• Do’s for blackheads
• Don’ts for blackheads

• Prognosis of small black bumps on the face

Causes: Clogged skin pores

A blackhead (open comedone) is a kind of plug consisting of hair and sebaceous gland remains, sebum and horn lamellae. The open comedone does not contain any stuck dirt, but is made of oxidized melanin. The plug fills up a hair follicle. Blackheads occur when the skin pores become clogged with dead skin cells and sebum. When this combination of material is exposed to the air, it oxidizes and turns a black color. The top of the blackhead is therefore visible as a black bump.Blackheads are more common in pregnant women (perhaps due to hormonal factors) / Source: PublicDomainPictures, Pixabay

Risk factors of blackheads

Some factors increase the chance of developing blackheads. For example, age and hormonal changes play an important role. The blackheads most often appear during puberty, when hormones cause a peak in sebum production. In women, menstruation, pregnancy and the use of contraceptive pills are also linked to the presence of open comedones.Other factors include:

• the blocking or covering pores of cosmetics and clothing
• high humidity and the presence of fats in the immediate environment
• severe sweating (hyperhidrosis)
• the use of some steroid medicines, such as corticosteroids
• medications that lead to faster production of skin cells
• shaving the skin and other activities that open the hair follicles
• some conditions, such as stress, polycystic ovary syndrome (condition involving hormonal imbalances) and premenstrual syndrome (symptoms before and during menstruation)

Symptoms

Blackheads most often appear on the face, back, neck, chest, arms and shoulders. There are more hair follicles in these areas. Small, dark lesions develop on the affected areas. Blackheads are a symptom of acne (skin condition with inflammation of sebaceous glands). They do not cause pain or discomfort unlike pimples. Open comedones have a raised texture, but they are flatter than pimples. The change in appearance caused by blackheads leads to embarrassment and social or psychological problems in some patients.

Diagnosis and examinations

Patients with blackheads rarely visit a doctor unless they are experiencing severe acne symptoms. The doctor is able to quickly and easily diagnose blackheads based on their appearance.

Treatment of open comedones

Opting for a healthy diet is necessary / Source: Jill111, Pixabay

Do’s for blackheads

Patients may use special scrubs to gently remove the open comedones from the face. These must be neutral and mild products for people with sensitive skin. Make-up products that do not clog the pores (water-based make-up) are recommended to reduce the build-up of dead skin cells. The doctor may also prescribe topical (applied to the skin) agents such as azelaic acid, salicylic acid or benzoyl peroxide. Medicines containing vitamin A, such as tretinoin, tazarotene and adapalene, can also be used. However, the best method is to have a skin care specialist look at the blackheads and then have them removed. The patient should take sufficient rest and reduce stress, because these factors do increase sebum production. A healthy and balanced diet with lots of fresh fruit and vegetables is good for your health. This reduces the risk of infection of the skin lesions. Finally, it is recommended to wash the pillowcases regularly. The accumulation of dead skin cells and oil from the hair during sleep may end up in the pores.

Don’ts for blackheads

When the patient tries to squeeze out the open comedones, picking at them or scrubbing them excessively, the condition worsens and later scarring occurs. Taking a steam bath is also said to open the pores, but in some patients this actually worsens the symptoms. Furthermore, a patient should be careful when using strips, masks and certain skin care products as these sometimes lead to irritation or damage to the skin if the patient uses them incorrectly. Oil-based make-up and skin care products are also not recommended. Wearing tight clothing that closes off the skin, humid environments and skin products based on alcohol are also prohibited. This causes tight and dry skin more quickly.

Prognosis of small black bumps on the face

Blackheads usually disappear when the hormones are back to normal and no longer fluctuate too much, but sometimes this takes many years. A patient may have psychological problems due to the appearance of blackheads. Seeking a care provider is a possible solution for this patient.

read more

• Sebum & sebaceous glands: Function, location & imbalance in production
• Pimples under armpits: Causes of bumps under forearms
• Pimples on the arms: Causes and treatment
• Pimples on chin: Treatment of acne on chin area
• Acne: Skin condition with inflammation of sebaceous glands