What are blackheads?
The US Library of Medicine describes blackheads as small, dark spots on the skin, caused by a small blockage in the opening of a pore (follicle).
Blackheads are said to be the first stage of acne. They form before bacteria invade the pores of the patient's skin. A blackhead can develop into a pimple, which is also known as a papule or pustule.
Blackheads and acne in general usually develop after the onset of puberty, when hormone levels surge and reach the skin. Certain hormones overstimulate the sebaceous glands, resulting in the overproduction of sebum.
Sebum is designed to lubricate the hair and skin and usually drains out of the pore opening on the surface. Sometimes the sebum becomes blocked and bacteria begin to accumulate. If the buildup of bacteria and sebum has no opening to the surface of the skin it is called a whitehead. A blackhead forms if the pore opens to the surface allowing air to enter.
Sebum contains melanin, a pigment. It is the same substance that gives skin its color. Melanin turns dark (oxidizes) when exposed to air. That is why blackheads are dark. The dark color does not mean they are dirty, and scrubbing does not remove them.
Several conditions and circumstances can cause blackheads, or make them worse, such as the use of topical oils and make up.
Blackheads can affect people with any type of skin, but are generally more common in those with oily skin.

What are the causes of blackheads?
Blackheads are typically caused by the overproduction of oil, which tends to occur when a person reaches puberty.
Spikes in hormone production can result in the high levels of DHT (dihydrotestosterone), a hormone which triggers overactivity in the oil glands, resulting in clogged pores.

Skin hygiene and blackheads - a myth
Many people believe that if your skin is not cleaned properly more blackheads can appear, especially during periods of fluctuating hormone levels such as puberty or just before menstruation.
Scientists and doctors say this a myth. The National Health Service in the UK explains that most biological reactions that trigger acne do not occur on the surface of the skin, but beneath it.
"You should wash every day and wash your face twice a day. More frequent washing will make no difference to your acne and could make symptoms worse by aggravating your skin."
In some cases, blackheads can emerge if moisturizers, sun screens, make up, or foundations are overused and irritate the skin.
In the majority of cases, blackhead susceptibility is not heredity, with the exception of some severe acnes.

Food does not cause acne
Although parents and grandparents commonly tell their teenage offspring not to eat chocolates and greasy foods because they think they encourage the formation of acne, they do not cause blackheads or make them worse.
Some studies have pointed towards a link between some dairy products and acne, but the evidence is not compelling.

Stress
Stress does not directly affect blackhead occurrence. However, stress and anxiety can cause people to pick at their blackheads and acne, which may irritate the skin.
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I cud remember as of six months back, my face was even worse than the pictured above but now,its as smooth as a new born baby's. basically, what makes pimples(as we all know it to be) spread is,picking. popping it can aggravate the spread of acne or pimples. there's no medical remedies to it cos I tried, damatol,skineal,funbact A, crusader soap,lime, nixoderm and so many others but didn't seem to abate the situation of my face. powdering may also help,but the most effective of it all is by avoiding it; in short, just forget you have a face for two weeks and u see d majic.