How can I tell purging from a product breakout?

When the timing fits tretinoin

Tretinoin increases production of new skin cells and unclogs pores. Acne sores should improve after 2 to 3 weeks of regular use, though improvement sometimes takes more than 6 weeks. With acne treatment more generally, it can take at least 6 to 8 weeks before you see fewer breakouts. A short flare early in tretinoin use can fit that pattern; timing is not enough to classify breakouts from every product.12

Check for irritation and frequent product changes

Tretinoin can also cause dryness, itching, burning, stinging, peeling, swelling, redness, blistering, or flaky skin. Keep those irritation symptoms separate from the question of whether new acne spots are purging. Trying new acne treatments too often can irritate skin and cause breakouts, which makes a routine with a rotating cast less like a plan than a plot.13

What to do next

• If tretinoin was prescribed, use it exactly as directed and daily at bedtime. Do not use more or use it more often than prescribed; more medication will not clear acne faster.
• If your skin gets irritated, tell your dermatologist. They may suggest using a smaller amount, using it less often, or applying moisturizer first. Make these changes only with their help.
• Keep the rest of your routine gentle: wash with a mild cleanser up to twice daily and after sweating, and avoid scrubbing, astringents, toners, and exfoliants.
• Protect skin treated with a retinoid from the sun with shade, sun protective clothing, and sunscreen with broad spectrum protection and SPF 30 or higher.
• If you are pregnant, planning pregnancy, or breastfeeding, tell your doctor. Call your doctor if you become pregnant while using tretinoin.

Call your doctor immediately for itching, rash, hives, pain, or discomfort at the treated area. If breakouts continue despite sticking with treatment, a dermatologist can examine the type and location of the spots; some other conditions can look like acne and need different treatment.12