Blackheads are a specific kind of dark acne lesion, so-called because they contain oxidized melanin, the pigment made by skin cells called melanocytes; a plug of sebum in a hair follicle, darkened by oxidation.

Acne is caused by an excessive reaction of the skin oil glands (Sebaceous glands) due to hormonal influences and may commence before or during puberty and is aggravated by heat, sweat, sports, picking, contraceptives and cosmetics.

Adult acne may be non existent or dormant for years and certain factors—like stress, hormones, and diet—can eventually cause it to surface.

Intake of oral treatment may involve oral Isotretinoin and antibiotics or oral Vitamin A derivatives.