Blackheads: Identification, Assessment and Treatment Options

A comedo forms when keratin, dead skin cells and sebum block a hair follicle. When the follicular opening remains open, pigment and the exposed material darken at the surface and the lesion is called a blackhead. A closed comedo is commonly called a whitehead.

Blackheads are common on the nose and face and can also occur on the chest, back and other acne-prone sites. Comedonal acne may consist mainly of blackheads and whiteheads, while inflammatory acne also includes tender papules, pustules, nodules or cysts.

Some normal sebaceous filaments on the nose can look like small, evenly spaced dark or pale dots and may refill after their contents are removed. Enlarged pores, milia, a dilated pore and other lesions can also resemble a blackhead. An unusual, changing, bleeding or uncertain lesion needs medical assessment rather than repeated extraction.

Gentle cleansing up to twice daily and non-comedogenic skincare, sunscreen and make-up can reduce irritation and avoid adding further pore blockage. Repeated washing, abrasive scrubs and attempts to clean out blackheads do not remove the underlying follicular plug and may make acne worse.

For a few blackheads or whiteheads, a pharmacist can advise on non-prescription acne care. Treatment choice depends on acne severity, skin sensitivity, other medicines, pregnancy or pregnancy planning and personal preferences. Some acne treatments require a prescription and clinical follow-up. This page does not recommend a medicine or replace individual advice.

Professional comedone extraction uses controlled pressure and suitable sterile equipment to remove the contents of a selected lesion. It can be a temporary, lesion-specific measure. It does not shrink pores permanently, control every cause of acne, prevent recurrence or guarantee clear skin.

Potential effects of extraction include discomfort, redness, swelling, pinpoint bleeding, bruising, skin-barrier injury, infection, pigment change, incomplete extraction, recurrence and scarring. The risk can vary by lesion, technique, site, skin type and tendency to pigment after inflammation.

Pore strips, suction devices, masks and exfoliating procedures can remove surface material or change appearance temporarily, but they do not establish a diagnosis or permanently empty or close a pore. Strong acids, aggressive steam, needles and unregulated extraction tools can cause irritation, burns or injury. Physical or cosmetic procedures should only be considered after the concern and expected limits are clear.

Seek GP or dermatology advice for painful nodules or cysts, widespread or moderate-to-severe acne, scarring or persistent pigment change, acne that has not responded to completed treatment, diagnostic uncertainty, sudden severe symptoms or acne causing significant distress. Urgent same-day assessment is appropriate for severe acne with systemic illness.

The current Dr Sknn catalogue has six Black Heads consultation rows: two each for Doctor, Nurse and Qualified Practitioner across the Skin and Men Focused families. All are configured for Wilmslow and Didsbury; Leigh is closed. These rows do not establish a direct Blackheads treatment, a particular procedure, an exact treatment price or current appointment supply.