Blackheads

A blackhead is a follicle whose opening is blocked with keratin and sebum. The visible part is open to the air, and in contact with it the contents oxidise and darken. Here is the fact that changes everything else: the black is not dirt. This is why washing more, scrubbing or using harsh cleansers does not remove them, and often makes matters worse by damaging the skin barrier.

Typical sites are the nose, chin and forehead, where sebaceous glands are densest. For the same reason blackheads on the back and shoulders are common too, where the density is just as high and clothing adds occlusion. They are the mildest expression of the acne process and can exist alone, without any inflammation: having blackheads does not mean having acne, even though the starting mechanism is the same.

On home remedies it is worth being explicit, because the damage is frequent. Adhesive strips remove the superficial part but do not resolve the blockage, and leave the opening dilated: the effect lasts a day and then returns. Squeezing with the fingers pushes part of the contents deeper and turns a quiet comedone into an inflamed lesion which, unlike a blackhead, can leave a mark or a scar. The real work is done by active ingredients that regulate cell turnover inside the follicle, not by force applied from outside.