How do I get rid of this ?

[kizaaa]

 

Hi! I have been on my skincare journey for a while now and it hasn’t been too easy. Along with acne, I have been dealing with these on my nose. I have gone to the dermatologist many times and they’ve said they are blackheads and should be gone with prescribed azaleic acid, which hasn’t helped.

Before this, I was on tretnoin and they said that would help, but it didn’t do anything to solve it. It’s been years and it’s still there. They have warned my against using blackhead strips as well. What should I do?

 

[WinglessOne]

Hi @kizaaa ! Have you told your dermatologist that neither azelaic acid nor tretinoin have cleared your blackheads? If you still have a derm treating you, it’s best to keep working with them (or get a second opinion from another derm) to find a treatment that’s right for your particular skin. 

I’ll say this though: resist the urge to use blackhead strips. They’re not very effective and can do more harm than good. Do you use salicylic acid (BHA) in your routine? Have you already tried a clay mask to help loosen blackhead plugs? A good rinse-off option containing both those ingredients is The Ordinary Salicylic Acid 2% Masque  . 

[missaa8]

@WinglessOne, do you know if hydrocolloid nasal patches are any better than blackhead strips?

[WinglessOne]

@missaa8  Hydrocolloid patches and pore strips don’t do the same task. 😉 Hydrocolloid patches won’t stick to a blackhead plug and rip it out when the patch is pulled off. Those patches are meant to be used for several hours per patch on acne that’s actively seeping gunk. A hydrocolloid patch acts as a protective barrier over the acne spot (which is now an open lesion) to keep bacteria and environmental cooties out. The patch also creates a moist environment to help that open lesion heal, and it’ll absorb the gunk that’s actively seeping out. 

Pore strips aren’t meant to be worn for hours; they’re a quick-use item that stick more strongly to skin than a hydrocolloid patch. A lot of people who use those strips think they’re removing blackheads with them, but what they’re really removing (most likely) is sebum from sebaceous filaments. Your sebaceous filaments move sebum out onto the surface of your skin for moisturization. Sure, some of us would rather produce less sebum on and around our noses (that’s my oily zone), but a better way to manage that is with ingredients like salicylic acid and niacinamide, plus good moisturizers that help convince our skin it doesn’t need to overproduce oil. 

[kizaaa]

Thank you for your response!

I have gone to different dermatologists, but they insist that azaleic acid will help my blackheads with time, but I feel like it’s been too long for me to wait for the results. 

I do not use salicylic acid, and it’s been a while since I used a clay mask. This is because I’m not sure which acids/ingredients are okay to use with azaleic acid. I will have to check your recommendation out ! 

[WinglessOne]

@kizaaa  Quick tip: be sure to “@“ the person you reply to here on BIC, so they’ll get a notification. Otherwise they might never see your reply. 🙂 

Azelaic acid can help, though it may work better with an acne-fighting partner like vitamin A (retinoids) or salicylic acid. Azelaic acid (even the Rx strength stuff) is fine to use alongside both those ingredients, as long as your skin tolerates the combo. Each night, I use retinaldehyde (retinal) and OTC strength (10%) azelaic acid in my skincare routine, and sometimes I add salicylic acid to the mix. I’ve had no issues with that combo and it’s been blessed by my dermatologist. 

You mentioned you were on tretinoin before. Do you still have a tret Rx? Have you ever tried a different retinoid, perhaps adapalene? That retinoid’s a go-to for acne. It’s available in Rx strength, but also sold OTC as Differin Gel and La Roche-Posay Effaclar Gel (in the US), and I’ve seen other brands of adapalene at my local drugstores/Target. I’m rambling about these forms of vitamin A because for many people, a retinoid + some additional acne fighter (azelaic acid, salicylic acid, etc.) + consistency + patience = effective acne treatment. None of these ingredients are overnight miracles, not even the mighty tret. It can take up to 2 months of consistent use to see improvement. I’m sure dermatologists have already given you the “patience is key” lecture, but it’s true. 

You could go back to a derm and ask for other treatment options like in-office/clinic procedures they can do to remove blackheads in a much shorter timeframe. That won’t be cheap, but it’s an option. 

One more thing to consider: some of those dots might not be blackheads. If a derm has diagnosed them all as blackheads, then ignore what I’m about to say since I’m not a medical doctor. 😄 I have a couple of black dots on my nose that aren’t acne at all, or even sebaceous filaments. They’re trichostasis spinulosa: a small cluster of tiny black hairs sticking out of one hair follicle. I can actually tweeze the hairs out of one of the dots if I’m careful enough, but I don’t like doing that. I could also use a pore strip to remove them all, but I hate pore strips and don’t trust them to not cause excessive exfoliation (skin barrier damage). Anyway, I can’t tell you if you have this condition too; only a doctor can do that, unless you look at your nose with a magnifying glass to see if you’ve got multiple hairs sticking out of one spot. 

[kizaaa]

@WinglessOne I will have to try out the combo that you are mentioning! I actually had to stop using tretinoin after a year of consistency. It helped with cystic acne, but my skin was never able to tolerate it and became more irritated with time and seasonal changes.

I also used adapalene (differin gel) for a little bit, but I was not consistent with it. If I were to start over with Adapalene, would I have to deal with the same purging process that tretinoin does? If it is worth it, I might have to add it back into my routine. 

I actually spoke with an esthetician and she also told me that she thinks they are hairs as opposed to blackheads. I will have to go back to the derm and ask of the possibility of these not being blackheads on my nose. 

Also, thank you very much for your response a lot of the tips and knowledge on this subject. This is all very helpful to me!

[WinglessOne]

No problem @kizaaa, I’m glad I could help! And I hear you on tretinoin intolerance: my derm and I decided my reactive skin wouldn’t tolerate tretinoin, and I wanted faster results* than retinol provides, so I switched from retinol to a retinal product my derm recommended. 

*I use vitamin A to boost collagen, treat skin texture, and reduce hyperpigmentation. Retinaldehyde and retinol aren’t FDA-recognized as acne-fighting ingredients, but tretinoin and adapalene are. 

If you restart adapalene, there’s a chance you’ll get some purging again. Adapalene is infamous for purging. The results might be worth it, though. That’s something to bring up with your derm, along with the “are you sure all these black dots are blackheads” question. I hope your next derm appointment goes well!