“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.

1. Prepare Your Skin:

• Cleanse your face: Start by thoroughly cleaning your face with a gentle cleanser to remove dirt and oil.
• Steam your face: To loosen up the pores, steam your face. You can do this by either placing a warm, damp towel on your face for 5–10 minutes or by using a facial steamer. This softens the skin and makes the blackhead easier to extract.

2. Extract the Blackhead:

• Use gentle pressure: Once the pore is opened, gently apply pressure around the blackhead with your fingers (wrapped in clean tissues or cotton pads to avoid bacteria). Be careful not to force it, as it can lead to scarring or infection.
• Comedone extractor: If the blackhead is really stubborn, using a comedone extractor tool (a small metal tool) may help. Gently press it around the blackhead to pop it out.

3. Clean and Soothe the Skin:

• Antiseptic: After extraction, clean the area with an antiseptic or witch hazel to prevent infection.
• Moisturize: Use a gentle, non-comedogenic moisturizer to hydrate your skin after the procedure.

4. Prevent Future Blackheads:

• Exfoliate regularly: Use a mild exfoliant or a chemical exfoliant (like salicylic acid) to help prevent dead skin cells from clogging your pores.
• Regular cleansing routine: Keep a good skincare routine to remove excess oil and dirt daily, especially if you’re prone to blackheads.

A Few Warnings:

• Don’t squeeze too hard: Forcing a blackhead out with too much pressure can lead to scarring or pushing bacteria deeper into the skin, causing more breakouts.
• Professional help: If the blackhead is deep, large, or you’re unsure about removing it, consider seeing a dermatologist or esthetician who can safely extract it.

Step-by-Step Guide to Removing Blackheads

Step 1: Prepare Your Skin

• Cleansing:
  First, use a gentle facial cleanser to remove dirt, oil, and makeup. Avoid harsh cleansers, as they can irritate the skin and worsen blackheads. Look for a non-comedogenic cleanser, which means it won’t clog your pores.Recommended product:
  • CeraVe Foaming Facial Cleanser or Neutrogena Ultra Gentle Daily Cleanser.
• Steaming (to open pores):
  To make the extraction process easier, you can steam your face. Steaming softens the pores and loosens up any buildup inside them.
  • Method:
    Use a bowl of hot water and place your face over it (but not too close to avoid burns). Alternatively, you can use a warm, damp washcloth for about 5-10 minutes.Why it works:
    A study published in the International Journal of Dermatology mentions that steaming can help dilate pores, making it easier to remove blockages like blackheads.

Step 2: Extract the Blackhead

• Manual Extraction with Fingers: Using your fingers to squeeze blackheads should be a last resort due to the risk of injury or infection. However, if you choose to use your fingers, make sure your hands are thoroughly washed and your nails are clean to avoid bacteria transfer.
  • Method:
    • Wrap tissues or cotton pads around your fingers to reduce pressure and create a barrier against bacteria.
    • Place gentle pressure around the blackhead to see if it pops out. If it doesn’t, don’t force it.

  Why it’s important:
  Forcing blackheads out can lead to skin damage and scarring. If you feel resistance or discomfort, stop immediately.

• Using a Comedone Extractor Tool: This is a better option for safer extraction, especially for larger blackheads. A comedone extractor is a small metal tool with a loop that applies pressure evenly around the blackhead.
  • Method:
    Place the loop directly over the blackhead, and apply gentle pressure on both sides. The blackhead should come out easily.
    • Clean the tool with rubbing alcohol before and after use to prevent contamination.

  Why it works:
  According to dermatologists, tools like comedone extractors are safer and more effective for removing blackheads without causing trauma to the surrounding skin.

Step 3: Cleanse and Soothe the Skin

• Antiseptic Solution:
  After extracting the blackhead, your pores will likely be open and susceptible to bacteria. Using an antiseptic solution like Witch Hazel or Tea Tree Oil (diluted with water) can help prevent infection.Why it works:
  Tea tree oil has natural antiseptic properties and can reduce the risk of post-extraction inflammation.
• Moisturizing:
  Even if you’re dealing with oily skin, don’t skip moisturizing. Choose an oil-free moisturizer to prevent dehydration.
  Recommended product:
  • Neutrogena Hydro Boost Water Gel (non-comedogenic and lightweight).

Step 4: Prevent Future Blackheads

• Exfoliate Regularly:
  Regular exfoliation helps to clear dead skin cells that can clog pores. You can use a physical exfoliant (like a scrub) or a chemical exfoliant like salicylic acid, which is proven to break down the oil and dead skin inside your pores.
  • Salicylic acid:
    Salicylic acid is a beta hydroxy acid (BHA) that penetrates deep into the pores, helping clear up and prevent blackheads. Use a gentle salicylic acid-based exfoliant 2-3 times per week.

  Recommended products:

  • Paula’s Choice 2% BHA Liquid Exfoliant
  • The Ordinary Salicylic Acid 2% Solution
• Avoid Over-Cleansing:
  Washing your face too frequently can strip your skin of its natural oils, which can actually cause more oil production and potentially more blackheads. Stick to cleansing 1-2 times a day.
• Retinoids:
  If you’re prone to blackheads, incorporating a topical retinoid into your skincare routine can help prevent future breakouts. Retinoids speed up cell turnover, preventing the clogging of pores with dead skin cells.
  • Retinol:
    Over-the-counter options like Differin Gel (adapalene) or The Ordinary Retinol can be effective. Use these at night, as retinoids can make your skin sensitive to the sun.

Additional Tips and Considerations

1. Don’t Squeeze Too Hard:
   Applying too much pressure when trying to remove a blackhead can push the clog deeper into the pore or cause inflammation. It’s always better to be gentle.
2. Consider Seeing a Professional:
   If a blackhead is particularly large or deeply embedded, or if you’re dealing with an entire area of blackheads, a licensed esthetician or dermatologist can offer professional extraction services to minimize risks.
3. Know When to Seek Help:
   If blackheads are a recurring issue or if you have other acne concerns, a dermatologist can help develop a personalized skincare regimen or consider treatments like chemical peels or microdermabrasion to address the root cause.