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Hold On, Are Those Blackheads On Your Nose *Really* Blackheads? A Derm Explains

Young woman applying facial cleanser in the bathroom mirror
Image by iStock
September 28, 2020

Blackheads are stubborn little specks—if you've ever gone head-to-head with a cluster of spots, you likely know how frustrating it is to clear those pores. And when they crowd the tiny crevices of your nose? It's all the more aggravating. 

Even if you smear on the best blackhead removers you can find, there are a couple of reasons you might not see results. First, some blackheads are tunneled super deep, which makes them much harder to remove. The second, as board-certified dermatologist Lindsay Zubritsky, M.D., explains in a recent TikTok video, you might be dealing with a separate issue entirely. "Fun fact," she says. "The blackheads on your nose aren't actually even blackheads." Um, what? 

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If you've done everything and more to get rid of your blackheads but those spots still persist, read on. 

So what are those little black spots? 

"These little black spots are smaller and much more difficult to get rid of with pressure," she continues. That's because they're not a type of acne at all: These black specks might actually be trichostasis spinulosa disorder, where the follicles become trapped with tiny, vellus hairs. Hairs! 

So the reason you see dark spots isn't because of oxidized open comedones—you may have little hairs growing out of the pore. While it can happen anywhere you have pores, the most common areas seem to be along the cheeks and nose1 (aka, where blackheads frequently cluster up). 

The "disorder" also sounds a bit scarier than it actually is: Oftentimes, trichostasis spinulosa goes undiagnosed for ages—the hairs are super tiny, so you may only notice it when examining with a magnifier of some sort. And if you do have it? Totally fine! Annoying, yes, but the little hairs should do no harm.

How can you get rid of them?

As you may know from exfoliators and DIY masks galore, treating these hairs the same as you would a pesky blackhead does next to nothing. Even with the best pore-clearing ingredients on hand, sometimes the hairs just don't budge. That's not to say you're stuck with them—think of it like any other hair removal procedure: You just need to, well, extract them out.  

Which can be pretty difficult, given their microscopic nature. Our advice: Put down the tweezers, and leave it up to the professionals. Zubritsky recommends seeing a derm who can squeeze out those hairs with a comedone extractor. If you can't make it to an office, though, she also mentions retinoids can help. Specifically, one study showed that a 0.05% solution of tretinoin (that's the prescription-strength retinoid) was able to effectively expel the hair plugs2

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The takeaway. 

Take a closer look at your blackheads: If the spots won't let up, you might be dealing with a whole other condition, here. It's no cause for alarm—just a slightly different mode of treatment. And in terms of the aftercare, standard skin care practices (like exfoliating and promoting cell turnover) can prevent those tiny hairs from taking root. 

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