Both blackheads and whiteheads are caused by a combination of factors, including excess sebum production, dead skin cell buildup, and bacterial activity.

Sebum is an oily substance produced by the sebaceous glands in the skin. It helps keep the skin moisturized and protected. However, when there is an overproduction of sebum, it can mix with dead skin cells and bacteria, leading to clogged pores.

Several factors can contribute to excess sebum production, including hormonal changes, genetics, and certain medications. Hormonal changes, such as those that occur during puberty or menstruation, can increase sebum production. Genetics also play a role, as some people naturally produce more sebum than others. Certain medications, such as corticosteroids or androgens, can also stimulate sebum production.

Bacteria, particularly Propionibacterium acnes (P. acnes), also play a role in the formation of blackheads and whiteheads. P. acnes is a type of bacteria that naturally resides on the skin. However, when there is an overgrowth of P. acnes, it can lead to inflammation and acne breakouts.

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