When blackheads bust onto the scene, it's never pretty. While a few small black dots are easy to cover up, larger, embedded blackheads are a different beast 1. Embedded blackheads are difficult to remove because they reside deep under the skin's surface 1. Trying to dislodge them at home with an extraction tool or your fingertips will likely leave a pit in your skin. Treat embedded blackheads with a strict acne-fighting cleansing routine. Visit a board-certified dermatologist for extractions and prescription medications if you have continual issues with embedded blackheads. If you treat the symptoms yourself, the scarring and pits that result may require skin resurfacing.
The Life of a Blackhead
Blackheads, also called comedones, form when sebum, bacteria and dead skin cells form in a hair follicle. If the skin over the bump stays open, the air turns it black; otherwise a whitehead forms. According to the American Academy of Dermatology, nearly 85 percent of people in America have experienced blackheads and pimples on their face, chest and back at some point 34. Most of these can be wiped out with a consistent skin-care routine consisting of a benzoyl peroxide cleanser, a toner with salicylic acid and spot treatments with prescriptions for retinol or sulfur products. Blackheads that are deeply embedded into the skin require professional attention 1.
Why Pits Happen
Squeezing blackheads with your fingertips or using a stainless steel extraction tool at home is not advisable for large blackheads. Taking matters into your own hands -- especially with blackheads that are embedded deep within the skin -- can cause a deep hole in your skin, known as an ice pick scar 1. Forcing the blackhead out -- especially without the proper follow-up treatment -- can damage the surrounding skin. The pit happens when your body isn't able to form collagen in the normal way after a pimple or blackhead is extracted, explains New York-based board-certified dermatologist Dr. Whitney Bowe. The enzymes in the area eat away at the collagen and elastin, which is necessary for skin regeneration.
A dermatologist can remove embedded blackheads with a comedone extraction tool that presses down on the blackhead and lifts it out. A dose of acne-fighting medication is then applied to the area of extraction. Already formed pits can be helped with fillers, a temporary option that works by injecting collagen, hyaluronic acid, polymethylmethacrylate or your own fat to plump them up. In addition, microdermabrasion and chemical peels take off the top layer of your skin to reveal fresh skin underneath. When the skin repairs itself, the blackhead pits become less noticeable. Laser resurfacing burns off the epidermis to reveal new collagen fibers underneath, which results in smoother, tighter facial skin. Dermabrassion is another option that is similar to laser, using high-speed sanding to remove the surface layer of skin.
Prevent embedded blackheads by following a strict face-washing routine twice a day. In the morning, wash with a benzoyl peroxide cleanser to kill bacteria and follow up with a toner featuring salicylic acid to swipe away dead skin cells that can clog pores. Apply an oil-free moisturizer with a built-in sunscreen featuring an SPF 30 and zinc. At night, wash make up, dirt, oil and environmental pollutants off your face with the same benzoyl peroxide wash, use a toner and then spot treat your blackheads with a prescription of sulfur and retinol, which can kill bacteria, unclog pores and make your skin appear brighter.
- Healthline: What Are Blackheads?
- Columbia University Health: Getting Rid of Acne Scars?
- American Academy of Dermatology: Acne
- American Academy of Dermatology: Dermatologists Advise Patients That Over-the-Counter Acne Products Can Have Benefits and a Place on Their Medicine Shelf
- AcneNet: Depressed Acne Scars: Effective Treatment Available
- AcneNet: Physical Procedures for Treating Acne
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