Blackhead vs. Pimple: What's the Difference?

Blackheads vs. Pimples: Inflammation

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One of the differences between a blackhead and a pimple is inflammation. Pimples are a type of inflamed blemish. Pimples are red and swollen. They often hurt, but not always.

Some pimples stay small, but others can get fairly large. Pimples can appear on the:

• Face
• Neck
• Shoulders
• Upper torso area
• Butt

Blackheads vs. Pimples: No Inflammation

Blackheads differ from pimples because they are non-inflamed blemishes. They are typically flat, aren't red or swollen, and they don't hurt. In fact, you might not even notice you have a blackhead unless you're really inspecting your skin in the mirror.

You can get blackheads in the same places pimples appear, but they're most common on the nose, chin, around the lips, and in the ears.

Some blackheads can get quite large and obvious, while others are so tiny you can barely see them with the naked eye.

Blackheads vs. Pimples: Red or White Head

Another way that blackheads and pimples are different is the types of each. There are actually many different types of pimples.

A pimple with a red head, or just a red bump on the skin, is called an acne papule.

As it progresses, a papule may develop a white or yellow pus-filled top. If it does, it's now called an acne pustule. Not all papules turn into pustules, though. 

Pustules are sometimes called "whiteheads." Just to make things more interesting (or confusing) there is another type of blemish that is also called a whitehead: milia.

Blackheads vs. Pimples: Dark Brown or Black Head

Another easy way to tell a blackhead from a pimple is by how they look. While pimples can take on different forms, blackheads have a dark blackish-looking head, (hence the name). Some blackheads are more brown than black.

Blackheads look like well-defined dark dots on the skin. Have a "freckle" appear that has never been there before? Look closely; it's probably a blackhead. 

Some blackheads are super tiny, so small you can barely see them. Other blackheads can get quite large, several millimeters in diameter.

The technical name for a blackhead is open comedo.

Blackheads vs. Pimples: How They Form

In addition to having different looks, pimples and blackheads also form in different ways. Pimples develop when a plug of oil and dead skin cells become trapped in the pore. This plug stops up the pore opening.

Your skin's sebaceous glands continue to do what they're designed to do: create oil for your skin. The oil is pumped into the pore.

However, instead of being able to flow up and out of the pore, it becomes trapped in the pore by the plug. Add in some normal skin bacteria (Propionibacteria acnes) and the follicle becomes irritated and engorged.

With nowhere else to go, this glut of oil, skin cells, and bacteria swells and breaks the follicle wall. White blood cells rush in, and the pore becomes red and swollen. 

Voila! A pimple has formed.

Blackheads vs. Pimples: How They Develop

Like pimples, blackheads also appear when a plug develops in the follicle. The difference is that the plug develops at the skin's surface, not deeper within the pore.

Although it may look like dirt has become trapped in your pore, that black spot isn't dirt at all. It's actually the plug of your skin's oil that you're seeing.

The top of the plug oxidizes because it's exposed to air, and turns into that dark blackish-brown spot your see. (Think about what happens to an apple when it's cut and exposed to air; it turns brown. The same thing happens with blackheads.)

Blackheads typically don't become red and swollen because they rarely lead to a break in the follicle wall.

Blackheads vs. Pimples: How They're Treated

Pimples and blackheads have similar prevention and treatment. Plenty of pimple-busting products and medications are available. For minor breakouts, over-the-counter acne medications should do the trick.

More stubborn or widespread acne can be treated with prescription acne medications that you get from your healthcare provider.

Some of the most common treatments for inflamed breakouts are:

• Benzoyl peroxide
• Topical retinoids
• Topical antibiotics and oral antibiotics
• Salicylic acid
• Oral medications like isotretinoin and birth control pills (for biological females only)

Blackheads vs. Pimples: Skincare and Prevention

One way that pimple and blackhead treatment is different is that because blackheads occur at the skin's surface, you can gently squeeze them to remove them (gently being the operative word). You can extract blackheads yourself or have an esthetician extract them for you during a facial.

Pore strips are another way to treat blackheads, although the results are temporary. They just get the top portion rather than the entire blackhead. For quick results, say just before a big event or a photo op, they're a good option.

Mild blackheads can be treated with OTC products. If you have lots of blackheads and bumpy skin, you have a type of non-inflamed acne called comedonal acne. Prescription medications are best to treat more entrenched comedonal acne.

Options for treating blackheads include:

• Salicylic acid
• Benzoyl peroxide
• Topical retinoids
• Alpha hydroxy acids, including glycolic acid, lactic acid, and mandelic acid

Summary

Pimples and blackheads have some key differences. Although inflamed pimples and blackheads are different types of acne blemishes, they get their start the same basic way: as a plug of oil within the pore.

Everyone gets occasional pimples and blackheads. These random blemishes generally heal quickly and aren't a big concern.

If you're dealing with constant pimples and blackheads, give your healthcare provider a call. They can help you find treatment options for getting breakouts under control.