In this article:
Different types of blemishes
What are blackheads?
What are whiteheads?
Severe blemishes
What’s the difference between adult and teen blemishes?
Can ice help blemishes?
Is there an anti-blemish diet?
What are the best non-skin care habits to prevent breakouts?
Best skin care ingredients for breakout and clogged pores, according to dermatologists
Stick to your skin care routine
No matter your stage of life, experiencing a painful pimple or particularly stubborn blackhead can be visibly and physically uncomfortable. This irritation can easily transition into confusion and frustration while diving into the plethora of blemish tips and breakout advice across the internet. Even worse? The tricks and DIY recipes you try might exacerbate the breakouts you’re experiencing.
To help separate fact from fiction, we spoke to Board-Certified Dermatologists Dr. Corey L. Hartman and Dr. Beth McLellan about all things blemishes, from types and prevention tips to blemish myths and best ingredients for prevention.
Different types of blemishes
Breakouts come in many shapes and forms. Although it may be hard to believe, common whiteheads and everyday blackheads are forms of blemishes. “Unfortunately, many people don’t understand that these lesions count as blemishes,” says Dr. Hartman, “and can lead to discolouration and the development of more severe blemishes if not treated.”
It’s understanding the key differences between the occasional reddened pimple and the persistent flesh-coloured bumps that appear along your jaw that can help you determine how to best approach both treatment and prevention.
So, let’s demystify some of the most common forms of pimples experienced.
What are blackheads?
Blackheads, AKA open comedones, often appear on the nose, forming after dead skin cells, oil, and other debris in the pore are exposed to air and oxidise, turning black (1). Beyond the nose, blackheads tend to pop up on the forehead and chin regions of the T-zone, where our skin naturally has more oil glands. Due to their usual location and colour, they’re easily identifiable.
Although annoying, blackhead removal is straightforward– if one approaches them carefully, with the right toolkit. “Blackheads are open comedones and can be safely extracted at home with gentle pressure since the pore opening is visible,” says Dr. Hartman. For more info on blackhead removal, check out our guide.
Beyond physical extraction, blackheads can be prevented through a thorough skin care routine with “evidence-based ingredients like retinoids and hydroxy acids” according to Dr. Beth McLellan. Regular use of over-the-counter retinoid products plus leave-on salicylic acid (beta hydroxy acid) exfoliants can significantly reduce the possibility of seeing more blackheads.
What are whiteheads?
Whiteheads are also easily identifiable. Whereas blackheads are black in colour due to oxidisation, whiteheads, AKA closed comedones, appear as tiny white or flesh-coloured bumps, usually dotting the forehead and cheeks. They’re covered with a thin layer of skin, preventing oxidisation, which also maintains their “closed” nature.
Sebum and excess keratin (the protein in skin cells) production within the pore are amongst the chief causes of whiteheads (2). Their treatment is a bit more difficult. According to Dr. Hartman, they usually “require in-office extractions to remove the keratin plug, clear the lesion, and tackle present discolouration.” However, if you’re hard-pressed for time, we have a guide to safely extracting whiteheads at home.
Severe blemishes
Severe forms of blemishes are often characterised as large, tender blemishes that can commonly appear red and cause a bit of discomfort. Beyond being painful, they tend to leave behind “pitted, ice pick and rolling blemish scars that cause textural change and require mechanical therapies like chemical peels, microneedling and resurfacing lasers to correct,” says Dr. Hartman.
That’s why "it's important to treat severe blemishes aggressively early to prevent scars,” relays Dr. McLellan.
Severe blemish treatment, management, and prevention of severe blemishes proves a bit more complicated than that for whiteheads and blackheads. Although for some, severe blemishes can be managed with over-the-counter products containing benzoyl peroxide, it often requires doctor-prescribed treatments (oral antibiotics or isotretinoin) and personalised dermatological advice, according to Dr. Corey Hartman.
When OTC skin care products aren’t enough to treat severe blemishes, Dr. Beth McLellan recommends consulting a Board-Certified Dermatologist.
What’s the difference between adult and teen blemishes?
We hate to burst anyone’s bubble, but blemishes aren't relegated to your teen years (3). It often stretches into, or can first occur, in adulthood. In fact, “having blemishes as an adult is very common – especially in women,” says Dr. McLellan.
But the cause of the blemishes must be different, right? Not exactly, says Dr. Hartman. “All blemishes are due to hormonal influence and inflammation."
Although blemishes later in life might feel different, it’s much the same, and requires similar ingredients to treat and prevent. Lucky enough, “many ingredients that help blemishes can also lessen signs of aging like fine lines and altered skin texture,” says Dr. McLellan.
Can ice help blemishes?
Using ice on blemishes is a “hack” that makes its rounds on social media every few years. Videos and posts promise that ice or cold showers can do everything from reducing redness to eliminating stubborn breakouts. However, Dr. Hartman and Dr. McLellan agree that this tip is little more than a way to quell the pain that can accompany some types of blemishes.
“In general, ice can decrease inflammation in the short term, but there are no studies supporting the use of ice or cold showers for long term treatment or prevention of blemishes,” says Dr. McLellan. The board-certified dermatologist adds, “putting ice directly on the skin could cause damage,” which is why she doesn’t recommend it as a treatment.
In lieu of using ice to reduce redness caused by inflammation, seek out soothing azelaic acid in your skin care products.
Is there an anti-blemish diet?
It’s long been theorised that diets heavy in foods with a high glycemic index, meaning foods that increase blood sugar levels, can trigger breakouts (4). This spike in glucose levels “causes a cascade of hormones and inflammation that may exacerbate blemishes,” says Dr. Hartman. Milk’s also been linked to a higher risk of developing breakouts (5).
Before you go ahead and create a blemish diet plan or whip up a diet for clear skin, it’s integral to “pay attention to whether these foods seem to trigger your breakouts,” says Dr. McLellan.
If your skin breaks out after consuming these groups of food and drink, cutting back or eliminating them for a while is worth trying. However, remember Dr. McLellan’s advice: “Although diet can play a role, typically a good skin care regimen is also needed” to treat and prevent breakouts.
What are the best non-skin care habits to prevent breakouts?
Preventing breakouts requires a holistic approach. This includes examining daily habits beyond skin care that may be exacerbating or causing blemishes on the face and body.
“Blemishes are mostly hormonally mediated but certain hygiene habits can also impact its development,” says Dr. Hartman. “Any practise that increases the amount of oil on the skin or promotes occlusion of pores can make blemishes worse. It’s recommended that pillowcases be changed weekly, headbands and hats washed frequently, hair products be kept away from the skin and cellphones not be pressed against the face too often.”
For example, using skin care or other cosmetics that contain irritating ingredients can increase oil production at the base of the pore, potentially leading to more blemishes. Irritating ingredients like denatured alcohol and strong fragrances can also keep blemishes and post-breakout marks around longer since they interrupt skin’s ability to recover from damage.
Best skin care ingredients for breakout and clogged pores, according to dermatologists
Benzoyl peroxide is known as the most effective OTC antibacterial treatment for blemishes. Dr. Hartman explains that benzoyl peroxide “reduces bacteria found on the skin, so there’s less opportunity for that bacteria to turn into active blemishes.” Dr. McLellan adds it’s particularly great because it “doesn’t lead to resistance like antibiotics.” Most often found in face washes but best used in leave-on products, formulations with benzoyl peroxide can range in strength from 2.5% to 10%.
Salicylic acid, also known as BHA, is also well known for its ability to address skin concerns often associated with blemish-prone skin. When used in concentrations of 0.5-2%, this exfoliating powerhouse helps promote healthy skin by removing the dead cells and debris both on skin’s surface and within pores. Its natural soothing ability also helps temper redness associated with blemishes and can improve oil flow in the pore lining.
If you’ve just experienced a breakout and are looking to tackle the discolouration it’s left behind, regular exfoliation with BHA can help fade these marks. Even better, combine a BHA exfoliant with a vitamin C or niacinamide treatment to further improve discolourations.
Stick to your skin care routine
Follow your regimen to see results! This one might seem like common sense, but it can be quite difficult sticking to a routine when it doesn’t provide instant benefits.
Addressing breakouts isn’t a one-time thing. It’s a commitment and requires a holistic, dedicated approach. “Successful treatment of blemishes requires consistency to the regimen above all else,” says Dr. Hartman. “It can take up to three months of consistent use to see improvement and up to six months to see the blemishes resolve.” If during these months your blemishes have worsened or stagnated, schedule an appointment with your dermatologist.
“There’s a lot of false and potentially dangerous advice on social media – a dermatologist can help advise on a skin care regimen and add prescription medications if needed,” says Dr. McLellan.
Learn more about blemishes.
References for this information:
- Pediatric Dermatology, November 2015, pages 316-317
- The Nurse Practitioner, October 2013, pages 22-31
- The Journal of Clinical and Aesthetic Dermatology, January 2018, pages 21-25
- International Journal of Dermatology, August 2021, pages 95-112
- Journal of The European Academy of Dermatology and Venereology, August 2018, pages 185-202