Does adapalene cause purging?

Why can acne get worse before it improves?

Adapalene is a retinoid, a medicine related to vitamin A. It increases skin cell turnover, helping unblock pores and reduce the formation of blackheads and spots. During the first weeks, pimples that were already forming beneath the surface can become visible. Adapalene also helps stop new pimples forming beneath the skin.12

How long does purging last?

The early acne flare can happen during the first few weeks; there is no fixed end date for everyone. Some people notice improvement after a couple of weeks, but most need at least a couple of months. Do not judge the final result from the first week's breakout. If there is little improvement by about 12 weeks, arrange a review rather than assuming continued worsening is still purging.23

Is it purging or irritation?

More pimples and irritated skin are different problems, even when they happen together. Redness, dryness, scaling, burning and stinging are adapalene side effects, not reasons to label everything purging. These symptoms commonly occur during the first 2 to 4 weeks. Report burning, itching, crusting or peeling to your care team promptly. If irritation is severe or does not improve, stop adapalene and consult your doctor.124

How should you use adapalene during the first weeks?

1. 1Remove makeup, wash gently with a mild cleanser and pat the skin dry.
2. 2Apply a thin film over the whole area affected by acne, not just individual spots. Avoid the eyes, lips and inside the nose or mouth.
3. 3Follow your label or prescription. Adapalene is usually used once daily at bedtime. For sensitive skin, starting two to three nights per week and increasing as tolerated is an option to discuss with your prescriber.
4. 4Let adapalene absorb before applying moisturizer, then wash your hands.
5. 5During the day, use sunscreen and protective clothing. Avoid tanning beds.

Do not scrub or wash acne affected skin more than twice a day. Squeezing new spots can worsen acne and cause permanent scarring.3

What should you change in the rest of your routine?

Moisturizer can help with dryness, even if its supporting role does not come with a dramatic product name. A fragrance free, water based moisturizer is an option for dry skin. With darker skin, pay particular attention to irritation because it can trigger dark marks; starting slowly and moisturizing can help reduce that risk.35

Avoid adding other retinoids, salicylic acid, glycolic acid or harsh drying products while using adapalene. Check with your pharmacist or prescriber before combining acne treatments, including benzoyl peroxide or topical antibiotics. Using more adapalene or applying it more often will not speed results and can increase irritation.124

When should you stop or get medical help?

• Get urgent medical help for difficulty breathing, hives or swelling of the face, lips, tongue or throat.
• See a doctor for deep, painful lumps, cysts or scarring rather than waiting for a presumed purge to finish.
• Do not apply adapalene to broken, sunburned or eczema affected skin.
• Do not use retinoids during pregnancy. Stop adapalene if you think you are pregnant and contact your doctor. Discuss breastfeeding or plans for pregnancy before use.