A blackhead, or open comedo is a wide opening on the skin with a blackened mass of skin debris covering the opening. Despite their name, some blackheads can be yellowish in color. A comedo is a widened hair follicle which is filled with skin debris (keratin squamae), bacteria and oil (sebum).
A closed comedo is a whitehead, while an open comedo is a blackhead. the plural of "comedo" is comedomes".
Blackheads, and acne in general, usually develop after puberty, when hormone levels surge and reach the skin. The presence of higher levels of hormones in the skin triggers the stimulation of the sebaceous glands, which produce oily substances. The sebaceous glands produce too much oil in the pores, which accumulates and gets stuck. When the occluded oil is exposed to air it becomes black.
Several conditions and circumstances can cause blackheads, or make them worse, such as the use of topical oils and make up. Blackheads can affect people with any type of skin, but are generally more common in those with oily skin.
What are the causes of blackheads
The overproduction of oil is the main cause of the emergence of blackheads. This is likely to occur in a high proportion of humans during puberty. Spikes in hormone production can result in the high levels of DHT (dihydrotestosterone), a hormone which triggers overactivity in the oil glands, resulting in clogged pores.
Clean skin - if the skin is not cleaned properly, more blackheads can appear, especially during those milestones in life when they are more prevalent, such as puberty. Improperly cleaned skin makes it more likely that dead skin cells build up within the pores. The pore openings can become clogged, which accelerates the build up of oil inside - thus causing blackheads to form. However, many experts warn that dirt does not cause blackheads to form - which frequently confuses and frustrates patients. Blackheads are caused by oxidized oil, not dirt, experts add. Over-cleaning the skin can lead to irritation.
In some cases, blackheads can emerge if moisturizers, sun screens, make up, or foundations are overused.
In the majority of cases, blackhead susceptibility is not heredity, with the exception of some severe acnes.
Food does not cause acne - although parents and grandparents commonly tell their teenage offspring not to eat chocolates and greasy foods, because they think they encourage the formation of acne - they do not cause blackheads or make them worse. Some studies have pointed towards a link between some dairy products and acne, but the evidence is not compelling.
Stress - stress does not directly affect blackhead occurrence. However, stress and anxiety can cause people to pick at their blackheads and acne, which may make them worse. Put simply, the behaviors resulting from stress and anxiety may worsen acne symptoms, but not the stress/anxiety itself.
What are the treatment options for blackheads
Hormonal treatments - contraceptives have often been used for the treatment of blackheads and acne, often with good results.
Cleaning the skin - clean your face with a good cleanser, ideally, one for oily skin, such as a salicylic acid cleanser.
Medications - adapalene is a third-generation topical retinoid, used mainly in the treatment of mild to moderate acne. Many patients with blackheads have had good results. In the USA adapalene is available under brand name Differin, in three preparations - 0.1% cream, 0.1% gel, and 0.3% gel. Since 2010, it has also been available in the USA under the generic name Teva, (0.1% gel). Only the 0.1% cream and 0.1% gel forms are available in Europe.
UV exposure - exposing the skin to sunlight or ultra-violet light encourages it to peel, which helps unblock pores. Sunbathing or using sunbeds may help. However, it is important to discuss this with your doctor. Exposing skin to sunlight, if overdone, also raises the risk of burning and developing skin cancer.
Hair - greasy hair touching the face of your skin can spread infection and in some cases encourage the spread of blackheads and acne. Keeping your hair away from your face may help keep blackheads to a minimum.
Skin virus may fight blackheads and acne - a virus that lives on our skin seems to naturally seek out and destroy the bacteria responsible for blackheads and zits. Researchers from the University of Pittsburgh said that harnessing a virus that naturally preys on the bacteria that cause pimples could offer an extremely useful tool against this skin condition.