What causes blackheads?

A blackhead is an open comedone, not trapped dirt. Extra oil mixes with shed cells inside a hair follicle. When the opening remains exposed, the material reacts with air and looks dark. Enlarged pores, oily skin, hormonal changes, occlusive cosmetics, and friction can all make clogging more noticeable. Scrubbing harder does not remove the underlying tendency and may irritate the skin.

Blackheads commonly occur on the nose, forehead, chin, chest, or back. They can occur alone or as part of [Acne](/conditions/acne/) or [Comedonal Acne](/conditions/comedonal-acne/). A dark pore is different from a flat brown mark or a small hair follicle plug, so examination matters when the appearance is unusual.

Wash gently, avoid picking, and choose products labelled non-comedogenic when possible. A topical retinoid can help normalise shedding inside pores; introduce it gradually and follow medical advice, especially during pregnancy or when planning pregnancy. A clinician can discuss [Topical Retinoids](/treatments/medical-dermatology/topical-retinoids/) or, for selected severe acne, [Isotretinoin Treatment](/treatments/medical-dermatology/isotretinoin-therapy/). Professional removal may temporarily clear visible plugs; [Acne Extraction Facial](/treatments/aesthetic-procedures/acne-extraction-facial/) should be performed hygienically rather than copied with force at home.

Arrange a dermatology assessment if blackheads are widespread, repeatedly return despite a consistent routine, leave marks after picking, or appear with painful spots, nodules, or scarring. Seek prompt advice for a rapidly changing, bleeding, crusted, or one-sided lesion that does not resemble your usual pores.

Could these spots be open comedones rather than pigmentation? Which cleanser and retinoid strength suit my skin, and how should I manage irritation? Do any of my medicines, hair products, or cosmetics contribute to blocked pores?