Do Blackheads Always Have to Be Manually Extracted or Can They Resolve on Their Own?

I have read inconsistent information from doctors regarding blackheads. Some say that topical medications, especially tretinoin, can help blackheads go away. Others say that tretinoin merely makes the blackhead easier to remove. Which is correct? Can diligent application of tretinoin get rid of blackheads itself or do they always need to be removed manually? I am on tretinoin (3 weeks) and have blackheads so I would like to know if they will go away without a dermatologist extracting them.

Doctor Answers 1

Do Blackheads Always have to be extracted or resolve on their own?

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Hi there,

Noninflammatory acne lesions consist of open comedones (whitehead) and closed comedones (blackheads).  At our practice, I typically have our patients with noninflammatory acne start with tretinoin or another comedolytic topical medication known as adapalene.  With these products, patients start to see improvement of their blackheads in about 4-6 weeks with full results in about 12 weeks.  After 2 weeks of starting the topical retinoid therapy, I recommend some patients to return for acne extractions if they want to achieve clear skin faster.

Orange County Dermatologist
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