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Here’s how it works: A normal functioning
pore produces a normal amount of sebum (oil). When a normal amount
of oil is produced, it effortlessly moves through the pore and out
onto the surface of skin, where it melts into an imperceptible film
forming a protective, healthy barrier over the face. The amount of
oil produced is regulated almost exclusively by hormones,
specifically androgens, which are the hormones that create
masculine human characteristics.
When hormones cause too much sebum (oil) to be produced, dead skin cells are in the way, and the pore is impaired or misshapen, the path for the oil is blocked, creating a clog—a perfect environment where blackheads or/and whiteheads can occur. Further exacerbating these conditions are the use of skin-care or makeup products containing ingredients similar to the composition of sebum (human sebum is a mixture of triglycerides, fatty acids, wax esters, squalene, cholesterol, and cholesterol esters). All these substances are typically found in thousands of cosmetic products and they can absorb into the pore, adding to the build up of sebum. Interestingly and contrary to popular belief, the ingredients mineral oil and petrolatum cannot absorb into the pore because their molecular size is too large. Both ingredients feel greasy, especially on oily skin, but neither has been proven to clog pores or contribute to blackheads. In short, when a combination of skin cells and too much sebum are trapped inside a pore and the pore is not covered over by skin, the clog is exposed to air, causing cells and sebum to oxidize and resulting in the dark color of a blackhead. When the sebum and skin cells are inside a pore that is covered by skin, they are not exposed to air and therefore stay clear, but form a slight white bump under the skin.
The never-ending questions are: Why do some people get whiteheads and not blackheads? Why does the problem occur in some areas of the face but not others? What causes some products to make people break out but not give them blackheads? And finally, what makes some products cause blackheads but not acne? Those questions have no specific answers. It seems to be primarily a genetic predisposition accompanied by the right conditions (mentioned above) randomly taking place in any one of the thousands of pores we have on our face. Not to mention an unknown reaction to the thousands and thousands of different cosmetic ingredients we may come in contact with from the various products we use.
Other than avoiding products that are too emollient (meaning thick or greasy creams) and not using moisturizers unless you truly need them, there are really only four essentials for dealing with whiteheads and blackheads:
When hormones cause too much sebum (oil) to be produced, dead skin cells are in the way, and the pore is impaired or misshapen, the path for the oil is blocked, creating a clog—a perfect environment where blackheads or/and whiteheads can occur. Further exacerbating these conditions are the use of skin-care or makeup products containing ingredients similar to the composition of sebum (human sebum is a mixture of triglycerides, fatty acids, wax esters, squalene, cholesterol, and cholesterol esters). All these substances are typically found in thousands of cosmetic products and they can absorb into the pore, adding to the build up of sebum. Interestingly and contrary to popular belief, the ingredients mineral oil and petrolatum cannot absorb into the pore because their molecular size is too large. Both ingredients feel greasy, especially on oily skin, but neither has been proven to clog pores or contribute to blackheads. In short, when a combination of skin cells and too much sebum are trapped inside a pore and the pore is not covered over by skin, the clog is exposed to air, causing cells and sebum to oxidize and resulting in the dark color of a blackhead. When the sebum and skin cells are inside a pore that is covered by skin, they are not exposed to air and therefore stay clear, but form a slight white bump under the skin.
The never-ending questions are: Why do some people get whiteheads and not blackheads? Why does the problem occur in some areas of the face but not others? What causes some products to make people break out but not give them blackheads? And finally, what makes some products cause blackheads but not acne? Those questions have no specific answers. It seems to be primarily a genetic predisposition accompanied by the right conditions (mentioned above) randomly taking place in any one of the thousands of pores we have on our face. Not to mention an unknown reaction to the thousands and thousands of different cosmetic ingredients we may come in contact with from the various products we use.
Other than avoiding products that are too emollient (meaning thick or greasy creams) and not using moisturizers unless you truly need them, there are really only four essentials for dealing with whiteheads and blackheads:
- Gentle, water-soluble cleansers (and avoiding bar soap).
The ingredients that keep soap in its bar form can clog pores, and
irritation can cause skin cells to flake off before they're ready
and accumulate in the pore. The good news is that there are lots of
gentle cleansers to consider. It’s actually getting more and more
difficult to find a cleanser that isn't gentle. Someone with dry
skin would want to use a slightly more moisturizing cleanser—but
be careful: cleansers that are too emollient can contain
ingredients that add to the sebum in your skin causing further
problems.
- Gentle exfoliants that can both remove the excess skin
cells on the surface of the face (so they don't build up in the
pore) and exfoliate inside the pore (to improve the shape of the
pore, allowing a more even flow of oil through it). Keep in mind
that the pore itself is lined with skin cells that can build up,
creating a narrowed shape that doesn't allow for natural oil flow
out of the pore. But don't get carried away with this step.
Overdoing it (removing too many skin cells) can cause problems and
hurt skin. Exfoliation is essential for both dry and oily skin to
eliminate blackheads or whiteheads. Again, someone with dry skin
will want an exfoliant that has a more moisturizing base.
The best option for a good exfoliant is a 1% or 2% BHA gel, liquid, or lotion. There are still only limited options for this one, including Neutrogena Clear Pore Treatment with 2% Salicylic Acid, Olay Total Effects Anti-Aging Anti-Blemish Daily Moisturizer, Paula's Choice 1% or 2% Beta Hydroxy Acid products, and Serious Skin Care Clarifying Treatment with 2% Salicylic Acid,. If you cannot use a beta hydroxy acid, you might want to try an alpha hydroxy acid, but AHAs are not able to penetrate the pore lining and affect mostly the surface of skin. That can be helpful, but salicylic acid can absorb into the pore lining and improve conditions.
By the way, topical disinfectants such as benzoyl peroxide or topical antibiotics available by prescription do not help in the treatment of blackheads and milia because there is no bacterial involvement related to these conditions.
- Deeper exfoliation treatments for stubborn blackheads
and milia are options you may want to consider. Microdermabrasion,
either from an at-home treatment (Neutrogena’s At Home
Microdermabrasion System) or the procedure performed at a doctor’s
office or spa are options. Also AHA or BHA peels and laser
resurfacing may possibly have a positive impact on the appearance
of blackheads and milia. However, the research on this is at best
limited. Anecdotally, it appears to be an option. Keep in mind that
none of these treatments alter hormone function or the structure of
the pore, or improve pore functioning—rather, they temporarily get
rid of the surface problem, making the skin look better in the
short term.
- Absorbing excess oil. This step is for those with oily
skin and is not necessary for those with whiteheads and dry skin,
because with dry skin the problem isn’t about excess surface oil,
it's only the oil trapped inside the pore. For those with oily
skin, clay masks (that don’t contain irritating ingredients of
mint, peppermint, camphor or the like) are an option and
oil-absorbing papers can also help.
- Retinoids play an important role in successfully
battling blackheads. Retinoids are forms of vitamin A that can
actually help skin cells function normally and improve the shape of
the pore so oil flow is normalized and clogs are far less apt to
take place. The most typical and well-researched retinoids are
tretinoin (found in prescription medications such as Retin-A,
Renova, Avita, and Tazorac) and adapelene (found in the prescripton
drug Differin). These can be used on their own or with a BHA
product. Research has definitely established that tretinoin and
adapelene have positive effects on how pores function, and these
products should be a strong consideration for battling blackheads
or breakouts in general.
- Hormone blockers, birth control pills, and Accutane: For
those with severe oily-skin conditions, prescription medications
such as hormone blockers or certain low-dose birth-control pills
can reduce hormone levels of androgens which are the cause of
excess oil production. And, when all else fails, Accutane should
definitely be considered. Though many doctors are reluctant to
prescribe Accutane for "merely" oily skin and blackheads, for those
with that kind of persistent skin problem, it does not feel like a
"mere" problem in the least and Accutane can be a cure. Either way
these are all options (albeit serious ones) you can talk over with
your physician.
- Removing blackheads: This isn't a pretty topic, but it
is a fact of life and human nature that just leaving a blemish or
blackhead alone is almost impossible. Fortunately, gently removing
a blackhead or blemish with light-handed squeezing can actually
help the skin. Removing the stuff inside a blackhead or especially
a pimple relieves the pressure and reduces further damage. Yes,
squeezing can be detrimental to the skin, but how you squeeze
determines whether you inflict harm. If you oversqueeze, pinch,
scrape the skin with your nails, or press too hard, you are
absolutely doing more damage than good. Gentle is the key word and,
when done right, squeezing with minimal pressure is the best, if
not only, way to clean out a blackhead or blemish.
How not to over-squeeze? Although I never recommend steaming the face (heat can cause spider veins to surface and create irritation), a tepid to slightly warm compress over the face can help soften the blackhead or blemish, making removal easier. First, wash your face with a water-soluble cleanser. Pat the skin dry, then place a slightly warm, wet cloth over your face for approximately 10 to 15 minutes. Once that's done, pat the skin dry again, then using a tissue over each finger to keep you from slipping and tearing the skin, apply even, soft pressure to the sides of the blemish area, gently pressing down and then up around the lesion. Do this once or twice only. If nothing happens, that means the blemish cannot be removed, and continuing will bruise the skin, risk making the infection or lesion worse, and cause scarring. Again, only use gentle pressure, protect your skin by using tissue around your fingers, and do not over-squeeze.
What about pore strips? What has me most concerned
about pore strips (which are not as widely available as they once
were) is that most people don’t pay attention to the warnings
clearly printed on the side of the box. Pore strips are accompanied
by strong warnings such as not to use them over any area other than
the nose and not to use them over inflamed, swollen, sunburned, or
excessively dry skin. It also states that if the strip is too
painful to remove, you should wet it and then carefully remove it.
What a warning! You may at first be impressed with what comes off
your nose. (Well, if you have extremely superficial, noticeable
black-looking blackheads, there is no question: you will be
impressed.) Most people do have some oil sitting at the top of
their oil glands (most of the face's oil glands are located on the
nose), and whether you use these strips or a piece of tape, black
dots and some skin will be removed. Is that helpful? Briefly, but
if you use these repeatedly, they will not eliminate the problem
and the ingredients on the strip can eventually irritate skin and
potentially trigger further breakouts.
The way these strips adhere can absolutely injure or tear skin. They are especially unsafe if you've been using Retin-A, Renova, AHAs or BHA; having facial peels; taking Accutane; or if you have naturally thin skin or any skin disorder such as rosacea, psoriasis, or seborrhea.
(Sources for this article: Cutis, May 2005, pages 289-293; Journal of Drugs in Dermatology, May-June 2005, pages 281-288; British Journal of Dermatology, November 2005, pages 919-924; Clinical Dermatology, September-October, 2004, pages 367-374; Dermatology, January 2003, pages 11-16 and 29-36; Journal of Cosmetic Science, 2001, pages 211-214; http://www.emedicine.com/DERM/topic2.htm.)
Paula’s Choice Battle Plan for Blackheads
The Paula’s Choice battle plans for blackheads below include effective yet gentle cleansers, state-of-the-art toners (which, depending on your skin type may be the only moisturizer you need), topical exfoliants, oil-absorbing products, and lightweight serums and/or moisturizers if you do have dry areas.
Battle Plan for Blackheads with Oily T-Zone and Normal Skin Elsewhere
The way these strips adhere can absolutely injure or tear skin. They are especially unsafe if you've been using Retin-A, Renova, AHAs or BHA; having facial peels; taking Accutane; or if you have naturally thin skin or any skin disorder such as rosacea, psoriasis, or seborrhea.
(Sources for this article: Cutis, May 2005, pages 289-293; Journal of Drugs in Dermatology, May-June 2005, pages 281-288; British Journal of Dermatology, November 2005, pages 919-924; Clinical Dermatology, September-October, 2004, pages 367-374; Dermatology, January 2003, pages 11-16 and 29-36; Journal of Cosmetic Science, 2001, pages 211-214; http://www.emedicine.com/DERM/topic2.htm.)
Paula’s Choice Battle Plan for Blackheads
The Paula’s Choice battle plans for blackheads below include effective yet gentle cleansers, state-of-the-art toners (which, depending on your skin type may be the only moisturizer you need), topical exfoliants, oil-absorbing products, and lightweight serums and/or moisturizers if you do have dry areas.
Battle Plan for Blackheads with Oily T-Zone and Normal Skin Elsewhere
- One Step Face Cleanser for Normal to Oily/Combination Skin
- Final Touch Toner for Normal to Oily/Combination Skin
- 1% Beta Hydroxy Acid Lotion
- Essential Non-Greasy Sunscreen SPF 15 (for daytime, or a foundation with sunscreen, such as Paula’s Choice Best Face Forward SPF 15)
- Completely Non-Greasy Moisturizing Lotion (for nighttime use over dry areas and around the eyes) or Skin Balancing Moisture Gel
- Skin Balancing Carbon Mask (as needed after cleansing)
NOTE: If desired, you may supplement this routine with
the addition of Skin Balancing Super Antioxidant Mattifying
Concentrate. This may be applied morning and/or evening.
Battle Plan for Blackheads with Very Oily T-Zone and Normal Skin Elsewhere
Battle Plan for Blackheads with Very Oily T-Zone and Normal Skin Elsewhere
- Skin Balancing Cleanser for Normal to Oily/Combination Skin
- Skin Balancing Toner
- 1% Beta Hydroxy Acid Gel
- Essential Non-Greasy Sunscreen SPF 15 (for daytime, or a foundation with sunscreen, such as Paula’s Choice Best Face Forward SPF 15)
- Skin Balancing Super Antioxidant Mattifying Concentrate (skin supplement for day and/or nighttime use)
- Skin Balancing Moisture Gel (for nighttime use over dry areas and around the eyes)
- Skin Balancing Carbon Mask (as needed after cleansing)
Battle Plan for Blackheads with Oily to Very
Oily T-Zone and Dry Skin Elsewhere
- One Step Face Cleanser for Normal to Dry Skin
- Skin Recovery Toner (use over dry areas and/or oily areas if flakiness is present)
- 1% Beta Hydroxy Acid Gel
- Essential Non-Greasy Sunscreen SPF 15 (for daytime, or a foundation with sunscreen such as Paula’s Choice Best Face Forward Foundation SPF 15)
- Skin Balancing Super Antioxidant Mattifying Concentrate (for T-zone)
- Skin Recovery Super Antioxidant Concentrate (for dry areas, including dry skin around the eyes)
- Completely Emollient Moisturizer (for nighttime use over dry areas)
- Skin Balancing Carbon Mask (for oily areas, as needed after cleansing)
