Q: Why do I keep getting blackheads and how do I get rid of them?
A: Blackheads are a type of acne. Normally, older skin cells work their way to the top surface of the skin and shed on a daily basis. In acne-prone skin, this process breaks down, and skin cells don't shed normally. (We still don't understand the exact reason for this.) Blackheads occur when dead skin, oil and bacteria clump in hair follicles (a.k.a. pores), rather than shedding normally. These clumps turn black as a result of oxidation after exposure to the air.
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The best medications for treating blackheads are prescription retinoid creams like Retin-A. Over-the-counter medicine containing salicylic acid, retinol, and benzoyl peroxide, however, may be enough to treat mild blackheads/acne. There are a few tips for using these products: If you choose to use retinol, remember that you should apply it at night since sunlight may inactivate the product. And note that if you use a product containing benzoyl peroxide, it can bleach fabric. You should apply any product that you use to the entire affected area (don't just dab it on blackheads that you can see), in order to both treat obvious blackheads and those that are just starting but not yet visible.
If you choose to use pore strips, which attach to blackheads and may help remove them from the skin, know that they are not effective at preventing future blackheads from breaking out. Consult your doctor before using pore strips in combination with prescription creams, as they can cause skin irritation.
Be patient--it takes several months to see good results. Don't delay seeing a dermatologist, however, if you have acne that's leaving scars, as it could permanently damage your skin.
—Lawrence Osman, MD, is a dermatologist based in Woodland Hills, Calif.
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