A blackhead forms as a result of the continuous accumulation of oil, fatty acids, and dead skin cells trapped within the follicle. Often, the pore opening is slowly stretched to accommodate the accumulation. The combination of melanin (skin pigment) and the oxidation at the surface gives the oil plug its color. Some blackheads can extend from one to 3mm. below the surface. By the time a blackhead can be seen, it may already be several weeks old. Quite often, too, the blackheads become more noticeable on an aging skin – the pores gradually become enlarged and lose some elasticity along with the rest of the skin. Other factors contributing to their formation are hormonal imbalance, the birth control pill, stress, improper cleansing methods (eg. using a cleanser that is too rich for the skin), not rinsing well, too harsh a cleanser, dietary factors, application of inappropriate creams, lotions or makeup, poor circulation, etc.

We suggest that you do not squeeze the blackheads yourself. Most people tend to use fingernails when doing this and this is likely to rupture the skin below the surface, which can cause some scarring, infection or bruising.

Blackheads can be removed safely during a facial treatment but this is not permanent. They reappear for the same reason they appeared in the first place. With proper care, the reappearance can, however, be minimized and the pore size somewhat tightened. This tightening will in turn help to minimize the blackheads as the oils are more easily pushed up to the surface.

Treatment time can vary, depending on the steps the esthetician takes and on what the salon offers. Generally it involves a cleansing process, a history taking and skin analysis (the first time), deep-pore cleansing and/or exfoliating of dead skin cells, steaming or atomizer, removal of debris from the pores, application of nourishing creams, a soothing massage, a mask, then a toner and day or night cream as required. In most cases, no makeup should be applied for a few hours afterward. The cost range for a non-specialized treatment can be anywhere from $65 to $200. The number of visits depends upon the state of the skin and what it needs. Most estheticians would recommend regular treatments in order to maintain the benefits of good skin care. No one should expect one or two treatments to reverse the changes that have gradually taken place over the past 20 years.

To find a reputable salon, first ask friends or relatives if they know of one. Failing that, locate the ones in the Yellow Pages (under ‘Skin Treatment’) that are nearest to you and request a consultation. Most salons offer these free of charge. When there, note the cleanliness of the clinic, whether the esthetician explains things to you clearly and whether you feel comfortable with her. You should find out if she will be able to offer you advice for home care. You will also need to check the price.

I have a problem which I would like to work on during the winter. The skin on my knees is much darker than the rest of my legs. They actually look dirty. I use a pumice on them twice a week but notice little improvement. Have you any suggestions?

The skin in areas that are subject to continuous friction, such as on the knees and elbows, can become discolored with the build-up of dry, keratinized skin (keratin is a hard protein found in the skin cells). You could try bleaching the skin with some diluted lemon juice. First remove some of the dead skin cells by brushing with a loofah using circular motions. Dilute the lemon juice and apply it to the skin leaving it to act for five minutes. Rinse off well then apply a good moisturizing body cream as lemon can be dehydrating. You should see the results within a couple of weeks. If not, you may wish to ask your doctor to refer you to a dermatologist for further treatment.