Acne and Blackhead Care
Learn more about the causes of acne and how to best take care of your skin!
What is Acne?
Acne is an inflammatory disease of the oil glands in the skin. Irregular exfoliation of skin cells in the hair follicles blocks the normal exit of oil from the oil glands. This results in inflammation and infections to the skin. The onset of acne is typically associated with puberty because oil gland production increases during this time.
Whether you’ve had acne before or not, few beauty problems are as frustrating as blemishes on adult skin. Sometimes women begin breaking out in their 30’s and 40’s. This may be a result of hormonal changes, such as pregnancy, menstrual cycle, or menopause. It can also be a result of an overproduction of androgens, male-type hormones that cause increased oil production. Other causes include breakouts that come from removing facial hair or using makeup.
Treating adult acne is like treating acne developed in earlier years. Use a mild cleanser, a non-oily sunscreen and noncomedogenic cosmetics. Over-the-counter remedies containing benzoyl peroxide or alpha and beta hydroxyl acids (such as salicylic acid) may be helpful. If these don’t work, consult a dermatologist, who may suggest antibiotics or other drugs such as Retin-A or Azelaic acid. If the doctor suspects the flare-up is caused by hormones, then birth control pills may be recommended for pre-menopausal women, and estrogen (hormone replacement therapy) may be recommended for menopausal women.
What causes acne?
Several factors play a role in why you get acne. Here’s what doctors say are the most common causes:
• Genetics. If your mother or father had acne as a teenager, there is a good chance that you will too.
• Hormones. During adolescence, hormones called androgens become active and stimulate oil glands in your skin, increasing oil production. This, in turn, clogs pores, causing pimples and blackheads. Hormonal changes around your period or birth control pills – starting or stopping – can also cause an acne flareup. (In some cases, however, birth control pills are a treatment for acne.)
• Stress. While stress can’t cause acne, it will potentially aggravate this or any other skin condition.
• Diet. Dermatologists aren’t sure if diet plays a critical role in acne. Some experts, however, do believe that food allergies can trigger acne outbreaks.
• Washing your face too often. This can aggravate the skin, causing acne to occur.
• Greasy skincare products and oily cosmetics. Any product that clogs oil ducts is a culprit and may cause acne.
• Medications. Acne can be a side effect of some drugs, including barbiturates, seizure medication, and steroids.
Special care for acne-prone skin:
• Cleanse the skin twice a day. Never go to bed without washing your face, even if you have had no makeup on.
• Oily skin tends to be dehydrated since moisturizers are not used as often; drink lots of water to keep skin well-hydrated.
Myths about Acne
For decades there have been volumes written about the causes of acne. However, thanks to scientific research, facts about blemishes have changed. Here are some common misconceptions:
• Chocolate, pizza, peanuts, and fried foods are no-no’s for everybody. The new school of thought on food intake is that some people react to foods they eat; others do not.
• The sun (or a sunlamp) is good for acne. Exposure to the sun may dry up pimples, but it hardly seems worth it when you weigh the cons: Sun exposure (especially burns) can cause skin cancer and will lead to premature aging.
• Acne will go away by the time you hit age 30. Unfortunately, many adults suffer from acne well into their 50’s and older.
• Poor grooming causes acne. The presence of acne does not mean your face is dirty. Many people are just predisposed to breakouts.
• Abrasive cleansers are good for acne. Doctors find that harsh exfoliants usually aggravate acne.
What is the T-Zone?
(and what is the best way to keep this area free of breakouts?)
The T-zone is the part of your face consisting of the forehead, nose, and the area around your mouth, including the chin. It is so named because it’s shaped like the letter T. Often the T-zone is oily, as the percentage of oil glands in this area tends to be higher than on the outer cheeks.
Oily areas of the face are more prone to blackheads, whiteheads, and large pores, all the things that comprise acne. Some of this is due to genetic factors, so until science has figured out genetic recombination for the T-zone, we can only manage, not cure, the problem.
You can help manage your skin’s condition in the T-zone area several ways:
• Wash your face with a cleanser containing alpha (lactic or glycolic acid) or beta hydroxyl acid (salicylic acid).
• Apply products containing salicylic acid in small amount to affected areas. Be careful of the chin area, which tends to get especially dry with these products.
• Use a matte-type powder which may be helpful in absorbing oil.
• Stay away from areas of the kitchen where foods are being cooked in oil. The oil can get on your face and make the problem worse.
• Do not pick at inflamed areas.
• Keep your hands and your hair off the skin. They bring extra oil and dirt to the area which further clogs the pores.
What are Blackheads?
Many people have dealt with blackheads at some point in their lives, usually around adolescence when the skin’s oil production begins to speed up. Blackheads, also known as open comedones, are flat, darkened spots that form when pores become plugged with a mixture of sebum and dead skin cells. Their dark appearance is caused by the densely packed skin cells, which take on a dark color.
It’s a common myth that dirt or unclean skin causes blackheads.
Blackheads are most prevalent in the T-zone, where the sebaceous glands are extremely active, but can show up anywhere on the face. They can turn into a full-blown acne lesion if they become inflamed or exposed to bacteria.
Unfortunately, blackheads are very hard to prevent because of the skin’s constant sebum production and cell turnover.
Washing with a salicylic acid cleanser will temporarily remove pore-clogging debris and surface oil. Alpha hydroxyl acids are also a good first line of defense; they gently exfoliate skin to prevent cells from building up and clogging pores.
Don’t pick at blackheads or try to squeeze them with your fingers. You run the risk of infecting them and injuring your skin. Stubborn blackheads require a more aggressive approach. Your dermatologist may prescribe a topical retinoid like Differin or Retin-A. Unlike alpha hydroxyl acids, retinoids loosen the blackheads in addition to speeding up cell turnover, so skin cells don’t have a chance to clog pores. They also have the unique benefit of slowing down oil production so new blackheads are less likely to form. Unfortunately, retinoids are not a quick fix. It will take a few weeks to see results and skin may become extremely dry and flaky in the process.
A series of glycolic or other mild acid peels can also help, though they are not recommended if you are using a retinoid because of the potential for irritation. A peel will quickly slough off dead skin cells while removing some of the debris from pores. Five or six peels are recommended but results can usually be seen after the second peel. An at-home routine of salicylic and glycolic acid skincare products is often used to maintain the benefits.
Your dermatologist or skincare technician may also use an extractor to remove individual blackheads. An extractor is a metal instrument with a small round opening on the end. The opening is pressed against individual blackheads for a few seconds to push out the debris. You may experience some discomfort, but the process is usually very quick and it’s an effective way to remove blackheads.
There is no permanent solution for getting rid of blackheads, but a consistent skincare routine can help keep them under control.
So what about toxin, fillers, chemical peels, microneedling, facials, etc? Wow. It's a lot, and it can be overwhelming trying to figure out what is right for you. That's where your healthcare professional comes onto the field. Nurse injectionists, estheticians, and dermatologists are specifically trained to assess your skin and make clinical decisions about what is right for you. Not everyone is a candidate for toxin, and not everyone can tolerate chemical peels. Overall, making an appointment to be assessed and having a skincare regimen created for you is the way to go.
Having said that, please see our guides on the various skincare treatments located under the services tab. They provide excellent and thorough descriptions of the benefits of each treatment and how they can help your skin.