Black Head Extractions

Blackheads are the curse of many teenagers and young adults, and getting rid of them can become a time-consuming (and skin-damaging) fixation. Many acne sufferers try to take matters into their own hands by performing their own blackhead extractions, a practice safe and effective only in a professional setting.

*image of black head extractions

What are blackheads?

A blackhead, often called an open comedo, is a blocked pore that is exposed (or open) at the skin surface. The pore is blocked by a mixture of keratin (dead skin cells), sebum (your skin’s naturally produced oil), and bacteria. When the pore is open, oxygen turns this exposed mixture into a dark brown or black color. Note: when the clogged follicle is closed a whitehead, or closed comedo is created.

What are extractions?

Extractions involve physically removing blackheads with a tool, or extractor. Different types of tools have been created to facilitate blackhead extraction. Most extractors are slightly smaller than a pencil and made of metal, many with a stainless steel loop on one end. Gentle pressure is applied to the clogged pore, which pushes the keratin/sebum/bacteria mixture through the pore opening and out of your skin. Another type of extractor comes with a lancet, a sharp end that can be used to pick at the blackhead, creating more area for the blackhead to eject. Blackhead remover strips can also be applied to the face, binding to the skin’s surface before attempting to pull out blackheads from the pores.

Do black head extractions effectively treat acne?

Skillful comedo extraction can result in an immediate benefit, but should be performed only by a professional, and are most effective when coupled with topical retinoids, prescription medications that regulate the shedding of your skin. Topical retinoids help prevent the development of new lesions while existing comedones resolve, and they also facilitate the expulsion of the comedo itself. By increasing the turnover of skin cells, topical retinoids unclog pore openings and allow the sebum and bacteria to drain out.

Risks of black head extractors:

Do not try at home: Most dermatologists are against home extractions because, if not done correctly, scarring, inflammation and risk of further infection can occur.

They don’t always work: The limitations of comedo extraction include incomplete extraction, refilling  of keratin and sebum and the risk of tissue damage.

Expensive: Some sufferers elect to see an aesthetician, but facials with extractions can cost up to $200.

Bottom line:

Manual extraction of comedones is effective, but ideally should be performed by a professional in a sterile environment. To achieve optimal effectiveness, extraction should always be paired with the use of topical retinoids, which can only be obtained with a prescription through a dermatologist, or skin-doctor. If you don’t have a dermatologist or would like a convenient way to get a consultation, check out our online dermatology service.


  1. Gollnick, H. “Management of Acne.” Journal of the American Academy of Dermatology49.1 (2003): S1-S2. Web. <>.

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