Skin care tips for acne purging

What is acne purging?

Purging describes a temporary increase in breakouts after starting some skin treatments. Breakouts after a facial can follow faster skin cell turnover, the process of replacing old cells with new ones. Acne can also worsen at the beginning of isotretinoin treatment before it improves. These situations have different timelines, so there is no single countdown that applies to every product.45

A new breakout alone cannot tell you whether you are purging. Acne develops when hair follicles become blocked with oil and dead skin cells. Irritation can also cause more breakouts, and topical retinoids, vitamin A medicines applied to the skin, can cause redness, peeling and dryness. If those symptoms appear, ask your prescriber or pharmacist to review the treatment instead of automatically pushing through.126

How should you care for your skin?

1. 1Wash with a gentle cleanser in the morning and evening. Do not scrub your skin, and remove makeup at the end of the day.
2. 2Follow your acne treatment's directions. Topical retinoids are generally applied at bedtime, but your prescription or product instructions determine your schedule.
3. 3Use moisturizer to manage dryness. During isotretinoin treatment, apply an oil free moisturizer after cleansing while skin is still damp, and again whenever skin feels dry.
4. 4Protect exposed skin during the day. For isotretinoin treatment, choose sunscreen with SPF 30 or higher, broad spectrum protection against UVA and UVB, and water resistance.
5. 5Leave spots alone. Picking and squeezing can cause scars, and scrubbing can irritate skin and make acne worse.

Look for skincare, sunscreen and makeup labeled "oil free," "noncomedogenic" or "won't clog pores." Noncomedogenic means formulated not to clog pores. Those labels give you a useful shopping filter, not an assignment to buy everything on the shelf.16

Should you keep using the treatment?

Give a tolerable acne treatment time rather than switching products whenever a spot appears. General acne treatment often needs 6 to 8 weeks before improvement becomes visible. Reducing a pimple's swelling and redness quickly is different from preventing new blemishes. The useful goal is fewer new breakouts over time, not just a less noticeable spot tomorrow.6

Topical retinoids such as adapalene and tretinoin can treat mild to moderately severe acne. They are generally used once daily at bedtime, and improvement can take 12 weeks or longer. Keep them away from the eyes and lips, where they can be irritating. Cream formulations are generally less irritating than gels, and adapalene is generally less irritating than tretinoin.2

If you take isotretinoin capsules, tell your dermatologist when acne worsens. Early worsening does not necessarily mean the medication is failing, and the full benefit can take several weeks or longer. Take the medicine exactly as prescribed; your doctor adjusts the dose according to your response and side effects. Acne can continue improving after the course ends.35

How long does purging last?

The treatment timelines describe when improvement can appear, not how long you should ignore worsening symptoms. Deep, painful spots, scarring or acne that is not improving with self treatment deserve medical review. Do not wait for a calendar deadline if your acne is already meeting those criteria.1

Will a facial help you get through purging?

A facial can include exfoliation and extractions, so it is more than an elaborate appointment to wash your face. Temporary breakouts can follow treatment, especially after a first facial. Avoid booking your first facial immediately before an important photo event. Trained professionals can extract blackheads and whiteheads; squeezing them at home is not the equivalent. Follow the practitioner's aftercare instructions rather than adding more procedures yourself.4

Who needs extra care?

Topical retinoids can worsen eczema through drying and can increase sensitivity to sunlight. A rash or substantial irritation needs a treatment review, not a new exfoliant. Retinoids also carry pregnancy precautions: some topical versions are contraindicated during pregnancy. If you are pregnant or planning pregnancy, check your exact medicine with your prescriber before using it.2

Isotretinoin commonly causes dry skin and chapped lips. Use a rich, creamy moisturizer as needed; petroleum jelly can help lips indoors, and lip balm with SPF 30 or higher protects them outdoors. Skin can become more sun sensitive during treatment. Seek shade, wear protective clothing and reapply sunscreen at least every 2 hours, and after swimming or sweating. A mineral sunscreen containing zinc oxide or titanium dioxide can help when skin is sensitive.3

Isotretinoin capsules must not be taken during pregnancy because they can cause severe birth defects and pregnancy loss. Follow your prescriber's pregnancy prevention requirements. Stop taking isotretinoin and call your doctor immediately if you think you are pregnant, miss a menstrual period or have sex without the required contraception.5

When should you get medical help?

See a doctor for numerous spots, deep painful lumps, scarring, unsuccessful self treatment or acne affecting your mental health. Hot, swollen and red skin can signal infection; redness can be harder to see on brown and black skin. Severe acne needs more than a topical retinoid alone. During isotretinoin treatment, report worsening acne to your dermatologist and tell them immediately about mood changes.123