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Blackheads or Trichostasis Spinulosa Disorder Appearing on Your Nose

pexels-sam-lion-6001254 Blackheads or Trichostasis

Last updated 02/12/2022

Blackheads can be annoying little specks because they resemble dirt. And to have them clustered on your nose is super aggravating. But are they really blackheads or trichostasis spinulosa?

Having those clogged pores in the crevices of your nose can be frustrating to clear. If you have tried and tried with no result there could be other reasons for these little imperfections. Likewise some blackheads may be really tunneled in there.

This of course can make your task very difficult. In addition, they may not be even, what you think they are. So, if your spots haven’t gone away with over the counter methods let’s take a peek at this possibility.

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Blackheads or Trichostasis Spinulosa?

Trichostasis spinulosa is classified as a follicular disorder because it contains microscopic clusters of vellus hairs embedded in the hair follicle. Yes hairs! So the reason why you see black spots isn’t due to oxidized open comedones at all.

These follicular lesions are not painful. It is considered a common condition even though it is usually not diagnosed. The majority of TS cases consult the dermatologist about another condition not related. In other words this is because it is often not recognized as a problem.

It can involve the pilosebaceous follicles as acne does. However, it is not a kind of acne. In conclusion while this can occur anywhere you have pores; the most frequent area is usually the nose of adults.

Lesions can also be shown on the chest, back, arms and legs. Further it can occur in both men and women but often in older adults. In short it may sound kinda scary, calling this a disorder, then it really is.

The dark spots are smaller and they are difficult to remove even with pressure. Therefore, if you have this issue of not being able to remove them these black dots could actually be trichostasis spinulosa.

Each soft follicular hair plug can include some 5 to 25 dark, spiny hairs and its typically less than 1 mm in size. Furthermore, hair follicles are located in your dermis.

What are Vellus Hairs?

Vellus hairs (aka peach fuzz) are the fine, thin light-colored hair exposed along your cheeks. The hairs also tend to be short. However, they can also be seen on your arms, stomach and legs.

They’re mainly responsible to regulate body temperature especially during cold weather. Vellus hairs are essential with perspiration. As a result, as your hair follicles are open, sweat coats the hair and evaporates, while your sweat is wicked away.

The fine hair also has a sensory function. Say if an insect crawls on your skin (calm down) it alerts you with goose bumps.

Vellus Hair Conditions

Occasionally the growth of vellus hairs can be abnormal. For instance, it can be a sign like with Cushing’s syndrome. Therefore, an increased number can be attributed to an over production of adrenal hormones in your bloodstream.

There may also be an increase with the forming of vellus hairs with anorexia nervosa. Moreover, male pattern baldness with hormonal influence can result as a reversion of scalp hair from terminal to vellus hair.

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Trichostasis Spinulosa Symptoms

There can be itching along with the skin being scaly and rough. This can be more common with spots that show on  the trunk and arms of teenagers. Most importantly with teenagers the main complaint could be for cosmetic reasons about facial lesions.

Due to the lesions usually being black this presents confusion with blackheads. The teen may have complaints of not being able to get rid of the dark spots.

An unusual case was discovered with a 16 year old male having non-pruritic variant of TS in his lower eyelid. This gave him the appearance of having a double eyelid. As a result, surgery was performed to treat.

Trichostasis Spinulosa the Two Types

A case of TS was first reported in 1913 by Nobel. As of 2002 two types were recognized. There is the classical variant (aka non- itching (pruritic)) and pruritic variant. Moreover, the classical surfaces like a comedone lesion often on the face that is usually seen in the elderly.

In the itch type many follicular papules are located on the trunk, arms and legs. These are mainly seen in teenagers. Further there haven’t been many cases reported.

Trichostasis Spinulosa Causes

The cause for this skin disorder is still unclear. Another theory is the hair shaft is trapped resulting in it thickening the skin in the follicles. Thus, this prevents the hair to normally shed.

As a result, there could be congenital dysplasia of the hair follicles and external factors like:

  • Ultraviolet light
  • Heat
  • Extended exposure to dust
  • Industrial oils
  • Hydrocarbons
  • Topical minoxidil
  • Malassezia yeast
  • Propionbacterium acne
  • Irritants in soaps or creams with paraffin

Internal factors include endocrine or metabolic disturbances. Reports of widespread TS have been linked to renal failure.

TS lesions may be similar to acne with lesion distribution and rarity with preadolescents. To sum up microorganisms like propionibacterium acnes and pityrosporum can also be possible causes.

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Diagnosing Trichostasis Spinulosa

A diagnosis of TS could be made without a biopsy. However physical findings for TS are limited to the skin.

The spots often present as dark, follicular plugs or papules. They could have tufts or spines of fine hair sticking out. In short this can be taken out with  a comedone extractor or small toothed forceps preferably by your dermatologist.

Due to possibly not being seen by the naked eye a diagnosis could be difficult to determine. Thus, this requires a hands lens or dermatoscope. Above all a skin biopsy can provide a specimen to view under a microscope.

This disorder can be confused with:

  • Comedogenic acne
  • Keratosis pilaris
  • Eruptive vellus hair cysts
  • Favre-Racouchot syndrome

How to get Rid of Trichostasis Spinulosa?

Well as you have learned by now your regular exfoliators and masks are no match for this. Your best pore cleaning ingredients may not get the hairs to budge. That is to say you don’t have to be stuck with them.

You just need a different approach. Like any other hair removal procedure you just desire to extract them out. Above all this can be pretty difficult since they are microscopic.

Although TS has no cure there are several treatment options with varying success.  It is best to put down your tweezers and consult the professionals.

Hair Removal


Electrolysis is done with shortwave radio frequencies transmitted through fine needles that are directly put in your hair follicles. This is to destroy the hair follicle so it can’t produce new hair to grow. Most importantly this procedure requires a dermatologist or a certified electrologist.

This method is considered a permanent solution by the Food and Drug Administration. However, for best results, more follow-up sessions may be needed.

Most people require follow-up sessions every week or two. This all depends on the length of your session. In short, the cost is usually about $35 to $100 per visit.

Electrolysis can be performed anywhere on the body. Side effects are commonly pain and redness due to skin irritation. But rare still more serious side effects could be scarring and infection from the needles being used. In addition, keloids (an overgrowth of scar tissue) could form.

Depilatory (aka epilation) Wax

To completely remove the hair from its root a depilatory wax can be used. With this the follicle is left empty. However, after about four weeks a new root could emerge and your hair will begin to grow again depending on your hair type.


Laser hair removal is usually done by a medical professional and can be through a type of medi-spa. It is a procedure utilizing a concentrated beam of light. Thus, this takes away the unwanted hair.

This laser gives off a light that is absorbed by the pigment of your hair. It transmits the light energy into heat that damages the tube-like hair follicles creating your hairs. As a result, your future hair growth is damaged or delayed.


You should consult your dermatologist to prescribe this for you. Some have had bad results. Likewise, it may help to apply at night so it doesn’t interact with your other products.

pexels-sam-lion-6001217 blackheads or trichostasis

Hydroactive Adhesive Tape

Have you ever used these before? I just find it so amazing to see the little black pillars after I pull off the tape. This is a deep cleansing pad that is applied on your wet skin. After that you peel it carefully off in about 10 minutes like a waxing strip.

Urea Cream

Urea is a common ingredient in hair removal cream. Spread the cream evenly on the area of your unwanted hairs. Most importantly this can stay on skin for about 3 minutes. Further you can use the spatula to scrape off a small testing portion.

Prognosis for Trichostasis Spinulosa

Trichostasis spinulosa may persist and become worse with age. Likewise, they are known to return.

Wrapping it up

If you’re dealing with stubborn blackheads on your nose, they could be something else. It just calls for a different method. Most importantly this is no cause for concern.

Trichostasis spinulosa is a follicular disorder. In addition to prevent the tiny hairs from taking root your regular skincare practices apply. This is to exfoliate and promote cell turnover.


Mary is the founder of All About Our Skin. Former esthetician and CPC. Enjoys researching skincare and has been studying our skin for the past fifteen years.

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