What does purging mean in skincare?

What is happening in your skin?

Acne starts when oil and dead skin cells block pores. Adapalene, a retinoid medicine derived from vitamin A, increases skin cell turnover and helps unblock those pores. Some topical retinoids cause an early worsening of acne even though they are used to reduce blackheads and spots. The name sounds like a cleaning service, but 'purging' describes an early acne flare, not a separate skincare treatment.12

Is it purging, irritation or another breakout?

Look at the treatment you started and the symptoms, not just whether they appeared afterwards. Early acne worsening is recognised with topical retinoids. Retinoids can also cause dermatitis, meaning inflamed skin, with redness, dryness and peeling. Adapalene can cause burning and itching too. Those symptoms need attention rather than being treated as proof that the medicine is working.123

Oily skincare products, greasy moisturisers and hair products can cause or worsen acne. A breakout after a new moisturiser therefore does not automatically mean purging. Calling every new breakout 'purging' gives the product a rather generous performance review. If the rash looks unusual, get it checked, because not all spots are acne.1

How long should it last?

The early worsening associated with retinoids can last a few weeks. That is different from the time needed for acne treatment to produce its full benefit: most acne treatments take 2 to 4 months. Topical retinoids can take 12 weeks or longer before improvement is seen. Do not use the full treatment timeline as permission to ignore persistent irritation or increasingly severe acne.13

What should you do next?

1. 1Check the active ingredient and follow its directions. For mild adult acne, use one acne treatment consistently for 6 to 8 weeks rather than adding another product during that trial.
2. 2If you are starting adapalene, test a small area first. Apply a thin layer to clean, dry acne affected skin, not just individual spots. Start two to three nights per week and increase towards nightly use as tolerated.
3. 3Let adapalene absorb before applying moisturiser. Avoid adding other retinoids, salicylic acid, glycolic acid, abrasive cleansers or strongly drying products alongside it.
4. 4Protect your skin from the sun. With adapalene, use SPF 50 sunscreen and protective clothing, and avoid sunbeds.
5. 5If adapalene causes marked irritation, reduce how often you apply it or pause temporarily. Stop and contact your doctor if irritation is severe or does not improve.

When should you get medical advice?

See a dermatologist for large, painful spots deep in the skin, scarring, or dark marks left after acne clears. Arrange a review if treatment is not helping after several weeks or your skin is not clearing within a few months. If you are pregnant or trying to become pregnant, speak to a dermatologist before treating acne yourself. Retinoids also need extra care with eczema because their drying effect can make it worse.34