Get urgent help if…
Changing or persistent skin growth — call NHS 111
A growth or patch that is getting bigger or changing, or hurts, itches, bleeds, crusts or scabs for more than 4 weeks, needs checking.
Hot, swollen or red skin — call NHS 111
Hot, swollen or spreading red skin around spots can be a sign of infection.
Serious allergic reaction — call 999
Call 999 for swelling of the throat or tongue, a raised itchy rash or difficulty breathing after a skin treatment.
Do not wait for an online reply. ChatDoc is not an emergency service.
Blackheads, whiteheads and pores
Blackheads & whiteheads
Oil and dead skin block a follicle. An open plug looks dark because it reacts with air — it is not dirt. A closed plug forms a small skin-coloured bump.
Enlarged pores
Pores may look larger with oily skin, larger follicles, sun damage and ageing. They cannot open or close, but their appearance can improve.
Sebaceous filaments
Normal structures that carry oil to the skin surface. They are usually smaller, flatter and lighter than blackheads, especially on the nose.
Milia & sebaceous hyperplasia
Milia are tiny pearly bumps. Sebaceous hyperplasia forms yellow bumps with a central pore. A doctor checks photos when the diagnosis is uncertain.
Skin care that helps
- Wash twice daily with a gentle, soap-free cleanser. Avoid scrubbing or squeezing.
- Choose non-comedogenic moisturiser, make-up and SPF 30 or higher.
- Apply treatment to the whole affected area, not only visible blackheads.
- Start irritating products gradually and allow around 12 weeks to judge progress.
Management and treatment
Your doctor chooses an option for your skin, previous treatments and pregnancy plans. These are general options, not a personal recommendation.
Treatment options
Adapalene 0.1% gel
A retinoid gel that unblocks pores and helps prevent new blackheads. Apply thinly in the evening. Dryness, peeling and sun sensitivity can occur.
Tretinoin cream
A retinoid cream used at night to clear blocked pores. It can cause dryness, peeling and sun sensitivity.
Adapalene + benzoyl peroxide gel
Combines a pore-unblocking retinoid with benzoyl peroxide. It can irritate skin and bleach hair, towels or clothing.
Benzoyl peroxide
Helps reduce blocked pores, oil and acne bacteria. Dryness or peeling can occur, and it may bleach fabrics.
Azelaic acid 20% cream
Unblocks pores, calms inflammation and can help dark marks after spots. Mild stinging or redness can occur.
Salicylic acid
A chemical exfoliant available in cleansers and leave-on products that helps clear pore blockages. Start gradually to limit irritation.
Niacinamide
Vitamin B3 in creams and gels that may reduce oiliness and redness.
Compounded creams
Tretinoin, adapalene or azelaic acid can be combined at the strength and combination your doctor chooses. Side effects depend on the ingredients.
Pregnancy and breastfeeding
Tell your doctor if you are pregnant, trying to conceive or breastfeeding. Retinoids such as adapalene and tretinoin, including in compounded creams, should not be used in pregnancy. Your doctor can choose a suitable option such as azelaic acid or benzoyl peroxide.
Oral isotretinoin
Oral isotretinoin is for severe acne when other prescription treatments have not worked. It is not part of ChatDoc's online blackheads treatment.
Your online blackheads assessment
- 1
Tell us about your skin
Share where the pores appear, products and treatments tried, medicines, allergies and pregnancy information.
- 2
Upload clear photos
Photos are required: close-ups of affected areas and one photo of your whole face in good light.
- 3
Doctor reviews your case
A doctor checks your photos, confirms the likely cause and makes every treatment and prescription decision.
- 4
Get your personalised plan
Discuss treatment in live doctor chat, with a prescription if clinically appropriate.
Complete care. One simple price.
£24.99
Includes clinician review, live doctor chat & prescription
One payment. No subscription. Any prescription depends on clinical suitability.
Start your consultationKeeping pores clear
- Use treatment consistently; improvement usually takes several weeks.
- Continue gentle skin care and daily sunscreen alongside treatment.
- Repeat treatment is reviewed by a doctor and is never automatic.
Frequently asked questions
How do I get rid of blackheads?
Use a treatment that unblocks pores, such as salicylic acid, benzoyl peroxide, azelaic acid or a retinoid like adapalene or tretinoin, on the whole area for about 12 weeks. Wash twice a day with a gentle cleanser, use non-comedogenic products and avoid squeezing.
Is there a prescription cream for blackheads in the UK?
Yes. A doctor can prescribe adapalene 0.1% gel, tretinoin cream, adapalene + benzoyl peroxide gel, azelaic acid 20% cream, or a compounded cream combining suitable ingredients at the strength your doctor chooses.
Can I treat blackheads if I'm pregnant or breastfeeding?
Yes, but tell your doctor first. Retinoids such as adapalene and tretinoin should not be used in pregnancy, so your doctor will choose a pregnancy-suitable option such as azelaic acid or benzoyl peroxide.
What causes blackheads?
Oil and dead skin cells block a hair follicle. When the blockage reaches the surface, its pigment reacts with air and looks dark. Blackheads are not caused by dirt.
How do I get rid of blackheads on my nose?
Some dark dots on the nose are sebaceous filaments rather than blackheads. Salicylic acid or a retinoid may improve both. Pore strips and squeezing only give brief results.
Can enlarged pores be shrunk?
Pores cannot open or close, and they cannot be removed. Retinoids, niacinamide, gentle exfoliation, sun protection and avoiding pore-blocking products may reduce their appearance.
What's the difference between blackheads and sebaceous filaments?
A blackhead is a plug blocking a pore. Sebaceous filaments are normal structures that carry oil to the surface and usually look smaller, flatter and lighter.
Should I squeeze blackheads?
Try not to. Squeezing can damage the skin, push the blockage deeper and cause inflammation or scarring.
Are blackheads a type of acne?
Yes. Blackheads and whiteheads are comedones. If you also have red, pus-filled or painful spots, read our acne treatment page.
Related conditions
General medical information, not a substitute for individual medical advice.