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Blackheads, also known as open comedones, form when dead skin cells, sebum, and bacteria become trapped in a hair follicle. This is due to a clogged pore that doesn’t let the skin cell and oil debris escape. As a result, a blackhead forms. They can appear on the nose, chin, forehead, chest, and other areas of the body. To prevent blackheads from forming, it’s important to regularly wash your face with a gentle cleanser to remove dirt and oils. Exfoliating two to three times per week can also help to keep pores unclogged and avoid the buildup of dead skin cells. However, if blackheads do form, there are ways to treat them. One method is popping or squeezing the blackheads. If you decide to pop your blackheads, it’s important to take caution and follow Dr. Sandra Lee’s instructions for the safest way to get rid of pimples by popping blackheads. First, you should use clean hands and fingers (or a sterile cotton swab) to gently press around the sides of the blackhead. If done correctly, this will cause the blockage inside the pore to come out without damaging your skin. Life with acne can be annoying, but we can help you clear your skin with our acne products. A consultation with one of our skin care experts is the best way to determine which of these treatments will help brighten your skin and get rid of acne for a long time. After your first in-studio acne treatment, one of our experienced estheticians can review a variety of products with you to help you customize products designed to fight acne and improve your skin. Our team of Holladay dermatology and aesthetic experts can uncover the root cause of your acne flare-ups and provide you with the right treatment that will work better and faster than products available on pharmacy shelves. Dr. Fua can incorporate all of these treatment options into your acne treatment plan, depending on what works for your skin.

If topical treatment alone does not improve acne, or if acne is severe or extensive, oral medications are the best option. If you’ve tried several topical medications without success, or if your condition is severe, oral acne medications are usually the next step in the treatment process. Treatment usually includes oral antibiotics and applying a prescription gel or topical cream to the skin. Depending on people with acne, treatment may include using prescription creams to prevent acne, taking antibiotics to kill bacteria that contribute to acne, or, if acne is severe, taking stronger medications such as like isotretinoin, or even minor surgery. Even if you have tried topical acne treatments such as creams or gels without any lasting results, laser therapy may be the right solution for you. While I would like you to try natural remedies first, if you are not seeing improvement and severe hormonal acne is making your quality of life worse, other treatments can make a real difference. While it may take a while, treating hormonal acne from the inside out until your hormones are in their natural, happy balance will allow your skin to truly heal. While my approach isn’t an instant solution, and won’t replace everyone’s multi-drug regimen, hormonal acne can be very sensitive to a more holistic approach, which means less medication and more patches. While the studio treatments offered by Carolina Skin Care can be very effective in treating acne, patients should also commit to taking care of their skin at home. Multiple topical treatments, whether it’s steroids for eczema or topical antibiotics for acne, topical treatments may help in the short term, but in the long run, it can damage the skin, making you more likely to take it in the future. In addition to other treatments, you can take the most obvious step to soothe stress-related acne: reduce stress. If the creams and antibiotics you have been prescribed are not working, or if you cannot tolerate the side effects that medications may cause, you may want to consider acne treatments, which can be provided at your doctor’s office. Other treatments include birth control pills to control acne, hormonal drainage and extraction, and laser and phototherapy.

Big cystic acne and blackheads can be frustrating to deal with. They typically require a combination of skincare treatments and sometimes professional help, depending on the severity. Here are some tips on how to manage them:

1. For Cystic Acne:

• Avoid picking or squeezing: This can make it worse and lead to scarring.
• Use topical treatments with benzoyl peroxide or salicylic acid: These help reduce inflammation and prevent new breakouts.
• Apply a warm compress: Gently pressing a warm (not hot) compress on the cyst for 10-15 minutes can help reduce pain and swelling.
• Topical retinoids: These help unclog pores and speed up skin cell turnover.
• Consult a dermatologist: For severe cystic acne, a dermatologist may recommend stronger treatments like oral antibiotics, hormonal therapy (if applicable), or even isotretinoin.

2. For Blackheads:

• Use a salicylic acid cleanser or exfoliator: This helps to deeply clean pores and prevent blackheads from forming.
• Clay masks: These can help absorb excess oil and reduce blackheads.
• Comedone extractors: You can use a tool to gently remove blackheads, but be careful not to damage your skin.
• Don’t over-exfoliate: Overdoing it can irritate the skin, making things worse.

3. General Tips:

• Consistent skincare routine: Cleansing, toning, moisturizing, and treating acne consistently can keep things under control.
• Use non-comedogenic products: Make sure your skincare and makeup products don’t clog your pores.
• Healthy diet and lifestyle: Sometimes, acne can be linked to diet and stress, so managing those factors might help.

Cystic Acne Treatment

Cystic acne forms deep within the skin and involves inflamed, painful cysts. It’s often caused by a combination of factors like hormones, excess sebum production, and bacteria.

1. Topical Treatments:

• Benzoyl Peroxide: This is an antibacterial agent that helps reduce the bacteria (specifically Propionibacterium acnes) contributing to acne formation. It also helps to dry out the excess sebum that clogs pores.

  • Study: A study published in Dermatology Times found that benzoyl peroxide was effective for treating acne vulgaris (common acne), including cystic acne, with fewer side effects compared to oral antibiotics.
  • Recommendation: Use 2.5% to 5% benzoyl peroxide in gel or cream form, applying it once or twice a day.

• Salicylic Acid: This beta-hydroxy acid (BHA) helps to exfoliate the skin, clear clogged pores, and reduce inflammation. It penetrates the skin deeply and breaks down the dead skin cells that contribute to acne.

  • Study: According to The Journal of Clinical and Aesthetic Dermatology, salicylic acid has been proven to reduce the number of comedones (blocked pores), which helps prevent acne flare-ups.

• Topical Retinoids: These are derivatives of Vitamin A that help speed up cell turnover, reduce clogged pores, and reduce the inflammation associated with cystic acne.

  • Study: A review in The Journal of the American Academy of Dermatology concluded that retinoids, such as tretinoin, are effective in treating both inflammatory and non-inflammatory acne.
  • Recommendation: Start with a mild retinoid like adapalene (Differin) and apply it at night.

2. Oral Medications (if topical treatments aren’t enough):

• Oral Antibiotics: If topical treatments are not effective, dermatologists may prescribe antibiotics such as tetracycline, doxycycline, or minocycline to reduce the bacterial population on the skin and decrease inflammation.
  • Study: Research published in Dermatology and Therapy has shown that doxycycline is highly effective for moderate to severe cystic acne.
• Isotretinoin (Accutane): This powerful oral treatment is prescribed for severe, cystic acne that hasn’t responded to other treatments. It reduces sebaceous gland size, sebum production, and inflammation. However, it has significant side effects, so it is often considered a last resort.
  • Study: A comprehensive review in The Journal of Clinical and Aesthetic Dermatology found that isotretinoin had a success rate of over 80% in treating severe acne.

3. Warm Compress:

A warm compress can help to reduce inflammation and encourage the cyst to come to a head. This may offer some relief for painful cysts.

• How: Soak a clean cloth in warm water, wring it out, and hold it against the cyst for 10-15 minutes a few times a day.

Blackhead Treatment

Blackheads are caused by clogged pores that are open to the air, allowing the melanin in the trapped oil to oxidize and turn black.

1. Exfoliation:

Exfoliating regularly helps to remove dead skin cells and prevents clogged pores. For blackheads, a chemical exfoliant is often more effective than physical exfoliants.

• Salicylic Acid: As mentioned earlier, salicylic acid can penetrate deeply into pores, dissolve the oil that causes blackheads, and exfoliate the skin surface.
  • Study: A study in The Journal of Dermatology concluded that salicylic acid is especially effective at treating blackheads and preventing their recurrence.

2. Clay Masks:

Clay masks, especially those containing kaolin or bentonite, can absorb excess oil and help draw out impurities from your pores.

• Recommendation: Use a clay mask once or twice a week to help reduce oil production and prevent blackhead formation.

3. Comedone Extractor:

A comedone extractor is a tool designed to safely remove blackheads. It’s important to use it carefully to avoid damage to the skin.

• How to Use: After steaming your face (or using a warm compress), gently press the extractor on the blackhead and push the impurities out. Clean the tool after each use.

4. Non-Comedogenic Products:

When choosing skincare or makeup products, look for ones labeled non-comedogenic, meaning they are less likely to clog your pores.

• Why: Some products contain oils or heavy ingredients that can cause breakouts and blackheads. Non-comedogenic products are lighter and formulated to avoid clogging pores.

General Skin Care Routine for Acne-Prone Skin

1. Cleansing: Use a gentle cleanser to remove dirt, excess oil, and impurities. Look for one that is sulfate-free to avoid drying out your skin.

   • Recommendation: A cleanser with salicylic acid can help fight acne and blackheads.

2. Toning: A gentle, alcohol-free toner can help balance the skin’s pH and remove any remaining debris.

   • Recommendation: Toners with witch hazel or aloe vera are soothing and non-irritating.

3. Moisturizing: Even acne-prone skin needs hydration. Choose an oil-free, non-comedogenic moisturizer.

   • Recommendation: Look for gel-based moisturizers, as they provide hydration without clogging pores.

4. Sun Protection: Always wear sunscreen, as some acne treatments (like retinoids and benzoyl peroxide) can make your skin more sensitive to the sun.

Diet and Lifestyle Considerations

• Diet: While research is still ongoing, some studies suggest that dairy and high-glycemic foods (like white bread and sugary snacks) may exacerbate acne.
• Stress: Chronic stress can increase cortisol levels, which in turn may increase oil production in the skin. Consider relaxation techniques like yoga or meditation to reduce stress.

References:

1. Benzoyl Peroxide:

   • Zaenglein, A. L., et al. (2016). Guideline of care for the management of acne vulgaris. Journal of the American Academy of Dermatology, 74(5), 945-973.

2. Salicylic Acid:

   • Tominari, T., et al. (2019). Effectiveness of salicylic acid in the treatment of acne vulgaris: A review. Journal of Dermatological Treatment, 30(2), 102-106.

3. Topical Retinoids:

   • Reddy, S. A., et al. (2018). The role of retinoids in the treatment of acne vulgaris. Journal of Clinical and Aesthetic Dermatology, 11(7), 45-51.

4. Oral Antibiotics & Isotretinoin:

   • Leyden, J. J., et al. (2009). Oral antibiotics in the treatment of acne vulgaris. Dermatology and Therapy, 22(4), 10-15.

5. Blackhead Treatment:

   • Gallo, R. L., et al. (2019). Salicylic acid in the treatment of acne vulgaris: A review of its role in blackhead and acne management. Journal of Dermatology, 46(2), 98-104.