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BLACKHEADS dreamstimeextralarge_124699572

Treating Blackheads and Enlarged Pores

Blackheads and enlarged pores are one of the most common complaints we receive from patients at Pure Dermatology. These conditions concern all ages, skin types, and all skin colors. Our team has a passion for treating acne and rosacea and this naturally leads us to blackheads and large pores since these conditions are very closely associated to blackheads and large pores.

What is a blackhead?

Blackheads are considered a feature of mild acne. Also known as an open comedone, a blackhead is a small, dark spot that often appears on the face, shoulders, chest and back. Blackheads are NOT trapped dirt. They form when the opening of a hair follicle becomes clogged or plugged with dead skin cells and oil.  The keratin in the dead skin cells becomes oxidized when it is exposed to the air and turns dark.

What causes blackheads?

  • Hormones: Blackheads are more common during puberty due to hormonal changes. Increasing hormonal levels cause an increase in oil, which can causes more clogging of the hair follicle. After puberty, hormonal changes related to menstruation, pregnancy, and the use of birth control pills can also bring on blackheads in women.
  • Heavy cosmetics – Oil based cosmetics or simply too much make up can cause increasing clogging of the hair follicles, thus increasing blackheads. Make sure your makeup is ‘non-comedogenic’ which means not blackhead forming.
  • Tight or Heavy Clothing – this can cause increase friction and rubbing which can clog the hair follicle, thus forming a blackhead.
  • Sun damage – UV radiation damages the collagen and elastin of our skin which worsens the appearance blackheads appear more prominent. Extreme and excessive long term sun exposure can also cause solar comedones or Favre-Racouchot syndrome.
  • Medications – some steroid based drugs can make blackheads.
  • Genetics – some people are genetically programmed to have more blackheads and acne than others. This likely has to do with the way their hair follicles are made and how much oil their oil glands make.

How do you get rid of blackheads?

Squeezing or over-manipulating blackheads at home can leave scarring and make them worse.  At Pure Dermatology, we have lots of methods to reduce blackheads. Regular cleansing is important for decreasing blackhead formation.  Some of our favorite ingredients in products are below: The keratin in the dead skin cells becomes oxidized when it is exposed to the air and turns dark.

  • Benzol peroxide is a keratolytic agent. This means that it can break up the keratin, or dead skin cells, which can help reduce blackheads
  • Salicylic acid is an exfoliating agent, which can help shed the top layer of the skin and decrease blackheads.
  • Topical retinoids can also help unclog the hair follicle and shed the top layer of skin, this decreasing blackheads and other stubborn acne.
  • Clay masks can draw out impurities and loosen dirt and blackheads.
  • Skin Cleansing Brush, such as a Clarisonic can be helpful in removing buildup and preventing blackheads.

How we treat blackheads?

Medical grade topical treatments are critical to prevent and treat scarring and discoloration from acne. We offer and help select medical grade cosmeceuticals specific to your skin needs like Pure Confidence 5% Benzoyl Peroxide Wash, Pure Confidence 2% Salicylic Acid Wash, EltaMD UV Clear broad-spectrum SPF 46, Avène Clean-Ac Soothing Cleansing Cream, various alpha, beta, and poly hydroxy acids and exfoliants. Pure Dermatology carries distinguished product lines such as skinbetter science, SkinMedica, and Revision Skincare, which all have great sunscreens for acne-prone patients.

At Pure Dermatology, we offer several peels that help to unclog pores and reduce oil production. These gentle procedures are also effective for active acne, redness and pigmentation. Peels help with prevention of new acne and treatment of scars. As board-certified dermatologists, Dr. Haseltine and Dr. Holcomb select peels that are unique to your skin type and need. Superficial peels often cause minimal dryness to a few days of peeling. A series of 5-6 treatments are recommended, spaced 4-6 weeks apart. The cost of superficial peels starts at $150 each and we also have special package pricing for Pure Dermatology Patients.

Black Head extractions are carefully performed to blackheads with specialized tools. This procedure will treat and remove individual blackheads. The areas that were treated can look irritated and inflamed for about a day and sometimes a series of treatments is needed. This can be performed in conjunction with chemical peels and Oxygen facials.

OxyGeneo 3-in-1 Super Facial gently bubbles away damaged skin cells and helps improve cell stimulation. This action can prime the skin for topical treatments. OxyGeneo also oxygenates and infuses nutrients into the skin, revitalizing a dull complexion. It is gently exfoliating and will reduce blackheads. This treatment has no downtime and is safe for patients who suffer from acne and acne scarring.

What is the difference between a Blackhead and an Enlarged/Clogged pore?

Enlarged Pores or Clogged Pores often appear on the nose.  Unlike a blackhead, Enlarged or Clogged Pores are caused when either oil in the pore or something around the pore causes the pore to look large.  This can be because:

  • The oil gland is producing a lot of oil, which fills the pore and causes it to look large.
  • Sun damage causing loss of elasticity of the skin around the pore can cause an enlarged pore.
  • Inflammation around the pore from a skin condition, such as Rosacea, can cause swelling in the surrounding skin causing the pore to look larger.
  • Extractions, which are carefully performed to extra individual blackheads with specialized tools.

Generally squeezing a large or clog pored is not helpful – no material will come out.  Squeezing these areas can actually damage the skin and make the area look worse and cause scarring.

How do I improve the appearance of Enlarged/Clogged Pores?

It is not likely that any ONE thing will make your large pores completely go away.   But there are lots of different things to do for maintenance that can improve the appearance of large or clogged pores.

If your enlarged pores are due to a medical condition such as Rosacea, treating the underlying medical condition will decrease the appearance of large pores.  Dr. Haseltine and Dr. Holcomb will make customized recommendations for your skin type.

  • Washing the face both morning and evening to remove excess oil and dirt from pores. Some patients with oiler skin types prefer a gel cleanser. Avoiding oil based products
  • Light exfoliation can remove the excess debris from pores and make them appear smaller.
  • Topical retinoids can exfoliate the upper layers of the skin, or the largest portion of the pore. The pore is “cone shaped” so as the outer layer of skin is exfoliated, the inner layers appear smaller.
  • Clay masks can draw out impurities and temporarily tighten skin.
  • Daily sunscreen is crucial to prevent sun damage, which can decrease elasticity, or tightness, of the skin and allow the pore to open wider.

How do we treat Enlarged Pores?

If your enlarged pores are due to a medical condition such as Rosacea, treating the underlying medical condition will decrease the appearance of large pores.  Drs. Haseltine and Dr. Holcomb will make customized recommendations for your skin type.

At Pure Dermatology, we offer several peels that help to unclog pores and reduce oil production and are safe in all skin types. Peels also help with active breakouts, prevention of new acne, and treatment of scars and hyperpigmentation. As board-certified dermatologists, Dr. Haseltine and Dr. Holcomb have the best qualifications to select peels that are ideal for your skin type. Superficial peels often cause minimal dryness to a few days of peeling. The cost of superficial peels starts at $150 each and we also have special package pricing for Pure Dermatology Patients. 

aka Secret RF, this type of microneedling has the added benefit of radiofrequency (RF) transmitted as heat into the deep layers of skin resulting in further collagen stimulation and skin tightening. The addition of heat also seals up the blood vessels resulting in even less downtime than conventional microneedling and seems to have some effect on improving active acne and overall redness. Compared with laser procedures for acne scarring, microneedling RF does not typically worsen or flare acne. Most patients need 4-6 treatments spaced 4-12 weeks apart and 1-2 maintenance treatments per year.

Secret RF also treats the following skin concerns:

  • Acne scars
  • Dull complexion
  • Sun damaged skin or premature aging
  • Scars from injury or surgery
  • Skin revitalization or adding luminosity to the skin
  • Active acne (especially when combined with topicals)
  • Overall skin rejuvenation
  • Stretch marks also known as striae
  • Neck lines (necklace lines)
  • Skin tone and texture
  • Fine lines and moderate wrinkles
  • Mild skin laxity
  • Crepey skin of the neck, knees, and upper arms
  • Hyperhidrosis (excessive sweating)

Laser genesis is a pain-free and no downtime cousin of Excel V that reduces the inflammation from acne and is good for mild pink acne scars and the appearance of pores. Laser genesis is also safe in pregnancy. This restorative treatment is often administered as 5 total treatments done every 2-4 weeks. Treatment costs $275 per treatment or we offer packages of 5 and 10 with discounted pricing.

Microneedling also known as collagen induction therapy imparts tiny sterile needles to cause controlled microchannels in the skin to stimulate new collagen formation, reduce the appearance of pores and also rejuvenate the skin. Microneedling also treats wrinkles and blemishes. After the procedure, most patients experience pink skin for 24 hours and mild flaking for 3-5 days. Most patients need 4-6 treatments spaced 4-6 weeks apart and 1-2 maintenance treatments per year.

Excel V is a laser that can reduce redness and inflammation around pores thus making them appear smaller.  Excel V does not disrupt the skin barrier meaning you can return to normal activities immediately after. However, there can be swelling for a few days with the setting used for enlarged pores. Excel V treatments vary from 2-5 treatments spaced 2-4 weeks apart and cost $150-$525 per treatment depending the size of the area treated.


Excel V also treats the following skin concerns:

  • Rosacea
  • Diffuse redness (red face)
  • Bruising seen after fillers, surgery, or injury
  • Scars
  • Poikiloderma (sun damage)
  • Blue veins under or around eyes
  • Broken blood vessels (Telangiectasias)
  • Acne
  • Acne scarring
  • Melasma (in specific cases)
  • Pigmented brown lesions or brown spots
  • Folliculitis or hair bumps
  • Laser hair removal in dark skin types
  • Spider veins
  • Stretch marks (early red color)
  • Leg Veins
  • Cherry angiomas (hemangiomas)

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