Help! I Always Get Blackheads Around My Mouth

In the interest of full-disclosure, I must admit I most often find blackheads around my lips. I know, gross. And strange.

So strange, in fact, that I thought it was about time to get some advice from a professional. I chatted with Rachel Nazarian of Schweiger Dermatology Group about why this is happening and how to prevent it.

First things first. What even is a blackhead? I know what they look like, and that I hate them, but what are they, really? Rachel Nazarian explains, "Blackheads are essentially just pores in the skin that are filled with dead skin cells (we call it keratin), oil, and bacteria. The greater the amount of junk that fills the pore, the greater it dilates—enlarging and continuing to fill. When the substance in the pore is exposed to air, it oxidizes and turns black, hence the term 'blackhead.'"

Nazarian also asserts that my blackhead-driven confusion is a prevalent one. (At least I'm not alone). She explains, "I hear two common misconceptions. One is that they scar, but blackheads are naturally non-scarring types of acne. They are non-inflammatory lesions and can be safely treated with topical acne creams—that is, unless they're squeezed or picked. The second fallacy is that you should squeeze them forcefully to clean them. By squeezing and picking you'll create inflammation and increase the chances of scaring. The best way to approach them is to use a topical cream with salicylic acid or tretinoin for several weeks. This will loosen the blackheads or dissolve them. Have your dermatologist clean out the residual lesions that haven't resolved with topical treatment."

Now, for the reasons behind them. Blackheads pop up because of an increase in oil production, bacteria on the skin, and dead skin cells that tend to clog up the pores. Some people have increased oil production or use oil-based products; some people are not diligent about exfoliating skin and removing the dead keratin skin cells. So, blackheads are more common in areas of increased oil secretion and areas with higher density of glands—although they can happen anywhere you have pores and hair follicles.

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The area around the lips has many glands, which can increase the chance of having blackheads. But, using thicker lip glosses and lipsticks that are oil based will also induce the formation of blackheads in this area. Which makes sense in my case, because I wear lipstick most days. Nazarian suggests, "It's important to limit use of products on the lips to those labeled as 'non-comedogenic,' which means it's essentially non-blackhead-forming."

To prevent those sneaky little guys, it's important to use products that are generally oil-free. But if you're like me and can't live without your lipstick, make sure to exfoliate the skin often to remove the accumulation of dead skin cells. "Acne medication that contains tretinoin, or salicylic acid, will also break down the keratin buildup in the pores and help remove blackheads," Nazarian recommends.

In terms of the best products to use, it's tricky. Because the reason behind blackhead formation is multifactorial, there are several products that can help. Nazarian offered, "If I had to choose one, my over-the-counter solution would be a Neutrogena Blackhead Eliminating Daily Scrub. This product contains the ingredients that help dissolve the keratin (salicylic acid), but also provides a gentle physical exfoliation. My prescription choice would be tretinoin 0.025% cream—a stronger way to dissolve the blackhead. Though, you'll have to make a trip to your dermatologists office to get that one."
So what have we learned today, class? It's important to keep your face clean and exfoliated. The products you use matter, so invest in some good ones. Though, the drugstore does carry a few that are up to snuff. And if you're noticing blackheads around your mouth, look for lip products that are oil-free and non-comedogenic. And never (ever!) pick at them. Your face will thank you.