How do I tell if my skin is purging or breaking out?

How can I tell the difference?

A purge is a temporary increase in breakouts associated with faster skin turnover or acne treatment. Retinoids can initially aggravate acne, and dryness or peeling can also happen with topical retinoid use, so those signs alone do not settle the question. A product reaction becomes more likely when skin turns red, itchy or swollen. Allergic contact dermatitis is a skin allergy that can cause those symptoms. Prescription skin care can cause periods of increased breakouts.2345

How long does skin purging last?

After a facial, purging should subside in a week or two, so scheduling it before a photo is a remarkably optimistic use of a calendar. That is not a general timeline for every acne treatment: it can take at least six to eight weeks to see fewer breakouts with acne treatment, and topical retinoids can take 12 weeks or longer to show improvement. The wait for improvement is not a promise that an initial flare should last that long. If breakouts keep worsening, ask a dermatologist or prescriber to review the treatment.146

Which skincare ingredients can cause purging?

Topical retinoids such as adapalene, tretinoin and isotretinoin are used for acne and can initially make breakouts look worse. Facials can also trigger brief purging as they speed skin turnover. Alpha hydroxy acids and beta hydroxy acids exfoliate, but too much exfoliation can irritate skin; irritation is not automatically a purge. Glycolic acid can be strong, so start once or twice weekly at night and increase use only if your skin is not irritated. Retinoids are often started in a small amount on alternate nights to limit irritation. If you are pregnant, check with your clinician before using a topical retinoid because some are not suitable during pregnancy.1247

Where does purging usually appear?

Location alone cannot identify a purge. Dermatologists consider both the type of bumps and where they appear. Perioral dermatitis around the mouth or T zone, and folliculitis, can resemble acne, so persistent or unusual bumps are worth having assessed.6

What should I do with a new product?

Test a new product on a small area before using it across your face. Testing one small area first is less theatrical than promoting the whole face to the test department.3

1. 1Choose a spot on your inner arm or the bend of your elbow.
2. 2Apply the product there twice daily for seven to 10 days, using the usual amount. Leave it on as you normally would; for a cleanser, use it for five minutes or follow its directions.
3. 3If you have no reaction after the test period, begin using the product as directed.

If a reaction develops, wash the product off gently and stop using it. Seek medical care for hives, a severe rash, or extreme swelling, especially of the lips or tongue. If a product is prescribed, ask the prescriber before changing how often you use it. Avoid adding another acne treatment to a prescription acne cream without guidance, since combining treatments for the same concern can increase dryness.356