Blackheads are a mix of oil and dead skin cells sitting in the pores. Exposure to air causes them to oxidise and turn black giving them their characteristic appearance. They start to appear in puberty around the same time that sebum production increases and one of the most common complaints I hear from teenage patients is that they are self conscious about visible pores or blackheads, especially on the nose.
Establishing a skincare routine and teaching teens how to look after their skin is important, both for skin health and for self-esteem. I usually suggest the following tips for those who want to try something over the counter before seeing a doctor:
1. Wash your face morning and evening with a mild cleanser, such as Cetaphil Gentle Skin Cleanser. For those with very oily skin, foaming cleansers like Bioderma Sebium Purifying Cleansing Gel or salicylic acid-containing cleansers like Garnier Pure Active Intensive Anti-Blackhead Charcoal Gel Wash and Neutrogena Visibly Clear Spot Clearing Facial Wash can be used in the morning instead.
2. Blackheads and acne are not because you are dirty so scrubbing too hard, or using harsh exfoliators, is not particularly helpful and may actually increase inflammation.
3. Apply a sun protection moisturiser after cleansing in the morning. Acne blemishes can leave dark marks on the skin if not properly protected from the UV rays in sunlight. Choose a broad spectrum product with SPF30 or higher e.g. La Roche-Posay Anthelios or Garnier Ambre Solaire. Always check the label for the words "non-comedogenic" which means the product won't block the pores.
4. There are some really good products for concealing acne blemishes and improving self-consciousness e.g. Vichy Dermablend Corrector Stick. Mineral make-up containing zinc oxide or titanium dioxide is great for absorbing excess oil and camouflaging redness. I like the range from Bare Minerals.
5. In the evenings, a targeted bacteria-zapping gel like benzoyl peroxide e.g. Acnecide or a pore unblocking agent containing salicylic acid e.g. La Roche-Posay Effaclar Duo can be applied to affected areas after cleansing.
6. Follow with a light moisturiser, such as La Roche-Posay Toleriane Fluide or Effaclar H. Moisturiser makes it easier to tolerate the treatment creams in the previous step which may otherwise cause dryness and peeling. Again, make sure that moisturisers or any other leave-on products are labelled non-comedogenic.
7. Wash your hair regularly and tie it back away from your face. Greasy hair, or application of hair serums and gels, can cause breakouts on the forehead. Wearing a headband or hat should also be avoided if you are prone to spots around your hairline or on your forehead.
8. Remove sweaty clothes as soon as possible after sport or exercise and cleanse your skin thoroughly. If sweat remains on the skin for prolonged periods, acne-causing bacteria will thrive.
9. For boys who are starting to shave, be careful to avoid nicking any existing spots. Clean the blade regularly, make sure it is sharp and shave in the direction of the hair growth.
10. Try to break the habit of touching your face and, whatever you do, do not squeeze or pick your blackheads. This can introduce infection and may also lead to permanent scarring. Instead, try a pore cleansing face mask once or twice per week, such as Garnier Pure Active Intensive 3 in 1 charcoal mask or The Body Shop tea tree skin clearing clay mask. If this doesn't help, you could have your blackheads professionally extracted by an experienced beauty therapist under strict hygienic conditions every month or two.
11. It might sound obvious, but change your sheets weekly. This is especially important for your pillowcase where grease can build up over time and rub off on your skin as you sleep.
85% of teenagers will experience some form of acne at one time or another and I try to reassure my patients that they are not alone. Nonetheless, it should not be considered a rite of passage that everyone has to go through regardless of the severity.
If your teen has lots of red and inflamed bumps, dark marks or signs of scarring, or if their skin is starting to impact their self-esteem, I'd love to be able to help. To book an appointment, call my team on 0203 733 3225.
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