Acne Treatment

Blackheads

Blackheads are sebum plugs trapped within open hair follicles; the exposed surface oxidizes upon contact with air and turns black—not from dirt. They commonly appear on the nose, chin, and inner cheeks. Proper management includes BHA or prescription retinoids, periodic medical-grade extractions, and oil control; pore strips and manual squeezing enlarge the follicles, causing blackheads to recur quickly.

Medically reviewed by BS.Ths.CKI Kim Kha — BonBoz Clinic

What Are Blackheads?

Sebum and dead skin cells accumulate inside hair follicles, forming a plug. If the pore opening remains closed, it becomes a whitehead or closed comedone; if the pore remains open, the exposed plug oxidizes in the air and turns dark—becoming a blackhead. This is why washing your face more thoroughly will not eliminate blackheads; the root cause is the plug deep inside, not surface dirt.

Why Do They Commonly Appear on the Nose?

The nose and T-zone have the highest density of sebaceous glands on the face and larger pores, causing plugs to form faster and become more visible. Oily skin, hormones, and overly rich skincare products make the condition more pronounced. Sebaceous filaments—the light gray dots distributed evenly across the nose—are a normal skin structure, not acne, and do not need to be "cured."

Can You Squeeze Blackheads?

Proper medical extraction (softening the follicle, using sterile tools, applying pressure in the correct direction) is a safe and integral part of treatment. In contrast, squeezing with fingers, using fingernails, or using pore strips does the opposite: tearing the pore opening, enlarging the pores, and pushing bacteria deeper, which leads to inflammation and post-inflammatory hyperpigmentation. The "clean" result after using pore strips lasts only a few days before new plugs form in pores that are now dilated even wider.

How to Manage Them and Prevent Recurrence

Use oil-soluble active ingredients inside the pores (BHA) 2–3 times a week; apply prescribed nighttime retinoids to regulate dead skin cells that clog follicles; control oil production and wear sunscreen to prevent further pore dilation; and schedule medical-grade extractions every 4–6 weeks as needed. A series of mild chemical peels can also help target densely congested T-zones.

How BonBoz Can Help

Our dermatologists conduct a thorough skin analysis to distinguish blackheads from sebaceous filaments and closed comedones, assess your skin's oil levels, perform professional medical extractions at the clinic, and prescribe a personalized home-care regimen to minimize recurrence. We are fully transparent about expectations: blackheads can be visibly reduced and appear much less frequently, but oily skin will naturally continue to produce new plugs if maintenance care is discontinued.

Severity levels

1

Mild — a few spots on the nose

Predominantly normal sebaceous filaments + occasional comedones. BHA and sunscreen are sufficient; no clinical intervention required.

2

Moderate — dense on the nose, chin, inner cheeks

Visible blackheads, dilated pores. Requires routine medical-grade extractions + prescription retinoids.

3

Severe — accompanied by blind pimples, inflammatory acne, post-acne marks

Widespread follicular occlusion, multiple lesions progressing to inflammation. Requires a comprehensive acne treatment protocol first.

When should you see a doctor?

  • Blackheads accompanied by red, painful, swollen bumps — indicating that congested follicles have become inflamed.
  • Enlarged pores on the nose and cheek areas after repeated home extractions or pore strips.
  • You are unsure whether it is blackheads or normal sebaceous filaments.
  • Over-the-counter products have shown no visible improvement after 2–3 months of use.

How BonBoz treats it

Medical-grade acne extraction

Softens follicles, uses sterile instruments, and applies directional pressure — clears impactions without enlarging pores.

Learn about this method →

Prescription BHA/retinoid regimens

Dissolves intra-follicular sebum and normalizes cell turnover — the most sustainable approach to prevent recurrence.

Learn about this method →

T-zone chemical peel

Supports clearing heavily congested follicles across a structured treatment course.

Learn about this method →

Enlarged pore refinement

For pores significantly dilated from improper extraction — laser toning or RF microneedling.

Learn about this method →

Cost guidance

Medical-grade acne extractions and chemical peels are charged per session, with affordable prescription topical medications. Estimated price ranges are available in our cost calculator; the doctor will recommend a tailored treatment schedule following a skin analysis.

The final price follows the doctor’s recommendation after an in-person exam. A confirmed quote has no hidden extras.

Chân dung BS.Ths.CKI Kim Kha

BS.Ths.CKI Kim Kha

Aesthetic Dermatology

  • Graduated as a General Practitioner — Tay Nguyen University (2018)
  • Specialist Level I in Dermatology — Pham Ngoc Thach University of Medicine, degree awarded in 2025
  • Medical Practicing Certificate No. 009784/ĐL-CCHN — Issued by the Department of Health of Dak Lak Province on 15/10/2021
  • Over 8 years of experience in aesthetic dermatology practice (since 2018), including over 4 years of practice with an official Medical Practicing Certificate
  • Primary Specialization in Plastic and Reconstructive Surgery; Certificates in Dermatological Procedures & Minor Surgery, Microsurgery, and Lasers & Light Therapies in Dermatology
  • Certificates in Dermal Fillers, Botox, and Thread Lifts; Certificates in Emergency Resuscitation and Infection Control
  • Formerly practiced at the Aesthetic Dermatology Unit — Post and Telecommunications General Hospital (2019–2021) and Venus Sunrise Clinic (2022–2024) before joining BonBoz Clinic (2025)
  • Former lecturer in Aesthetic Dermatology Theory at Ana Aesthetic Training School (2018–2019)
  • Over 5,000 clinical dermatology cases treated
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Frequently asked questions

Are blackheads caused by poor cleansing?

No. The dark color is caused by oxidized sebum, not dirt. Over-washing can strip the skin of moisture, triggering compensatory oil production and worsening the condition.

Are pore strips harmful?

While they offer instant gratification, they can tear the follicular opening, enlarge pores, and cause irritation. Regular use is not recommended.

How often should comedone extractions be performed?

Typically every 4–6 weeks depending on your sebum levels, combined with proper home care. Extracting too frequently causes irritation, while neglecting it allows plugs to accumulate.

What is the difference between BHA and AHA for blackheads?

BHA is oil-soluble, allowing it to penetrate deep into the pores, making it ideal for blackheads. AHA works on the skin's surface and is better suited for dry, rough skin.

Do sebaceous filaments need to be treated?

No. They are normal physiological structures on the nose. They cannot be permanently eliminated, but their appearance can be minimized using BHA and oil control.

What about blackheads on the back?

The underlying principles are the same as for the face. Because back skin is thicker, BHA-based body washes are often used, and consistent patience is required.

Can retinoids be used for blackheads?

Yes. They serve as a foundational active ingredient to regulate the shedding of dead skin cells that clog pores. They should be used as directed and introduced gradually.

What should be applied after extractions?

Gentle, anti-inflammatory products and sunscreen. Avoid applying rubbing alcohol or harsh exfoliating products to freshly extracted skin.

Can blackheads be completely cured?

Oily skin will naturally continue to produce new plugs. The realistic goal is to keep them sparse, smaller, less noticeable, and prevent them from becoming inflamed through ongoing maintenance.

What is the difference between extractions at a regular spa versus a clinic?

The difference lies in having a physician assess and identify lesion types beforehand, strict aseptic techniques, and an accompanying home-care regimen—rather than just a single cleansing session.

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