What Is the Difference Between Blackheads and Pimples?

What's the difference between a blackhead and a pimple? Both pimples and blackheads are types of acne blemishes. But these blemishes develop differently, and are treated differently too.

Pimples Are Red and Inflamed

Woman looking at skin in mirror
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Pimples are a type of inflamed blemish. Pimple 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 and upper torso area, and even on the butt.

Blackheads Are Not Inflamed

Nose from a 20 years old male human.
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Blackheads 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.

Pimples Have a Red or White Head

There are actually many different types of pimples (crazy, right?) 

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

Your papule, as it progresses, may develop a white or yellow pus-filled top. If it does, it's now called an acne pustuleNot 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.

Although they share the same nickname, milia and pustules are completely different types of blemishes. In fact, there are many different skin issues that cause white bumps on the skin. But if your bump is red, inflamed, with an obvious white head, it's more than likely an acne pustule.

Blackheads Have a Dark Brown or Black Head

Blackheads have a dark blackish-looking head, hence the name. Some blackheads are more brown than black.

Blackheads look like a well-defined dark dot 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.

How Pimples Develop

Pustule Illustration
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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. But, 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, called Propionibacteria acnes, and the follicle becomes irritated and engorged. With nowhere else to go, this glut of oil, skin cells, and bacteria swells and causes the follicle wall to break. White blood cells rush in, and the pore becomes red and swollen. Voila! A pimple has formed.

How Blackheads Develop

Blackhead illustration
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Similar to a pimple, blackheads also appear when a plug develops in the follicle. The difference is, the plug develops at the skin's surface and 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. Same thing happens with blackheads.)

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

How To Treat Pimples

There are plenty of pimple-busting products and medications 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 physician.

Some of the most common treatments for inflamed breakouts:

  • Benzoyl peroxide
  • Topical retinoids
  • Topical antibiotics and oral antibiotics
  • Oral medications like isotretinoin and birth control pills (for women only)

Remember, don't pop inflamed pimples. This won't help them to heal any faster but can cause acne scars.

How To Treat Blackheads

Unlike pimples, because blackheads occur at the skin's surface, you can gently squeeze blackheads to remove them (gently being the operative word). You can extract blackheads yourself, or have your esthetician extract them for you during a facial.

Pore strips are another way to treat blackheads, although the results are temporary. They don't get the blackhead in its entirety, but rather just the top portion. For quick results, say just before a big event or a photo op, they're a good option.

To keep blackheads away for good, though, you need to get on a regular treatment program. Again, 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

A Word from Verywell

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. But if you are struggling with constant pimples and blackheads, give your doctor a call. There are many treatment options to help you get breakouts under control.

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