Ask a Derm: Is My Skin Purging or Just Breaking Out?

With so many types of acne, it can be hard to decipher the root cause of your pimples. One common cause of breakouts? Skin purging—a skin reaction that occurs when introducing a new product into your routine that increases cellular turnover, like retinols and chemical exfoliants. When shedding dead skin cells is accelerated, it can bring oil and bacteria from deep within your pores to the surface of your skin, resulting in breakouts of pimples and cysts. The good news about skin purging is that it’s temporary, the side effects are shorter than your standard breakout, and it’s ultimately a sign that the products you just introduced to your face are working. 

Ahead, we spoke with three dermatologists about how to identify a skin purge, how to treat it, and how skin purging differs from a standard breakout.

What Is Skin Purging?

"Skin purging refers to your skin's reaction to a specific active ingredient that triggers cell turnover,[causing] your skin to exfoliate and bring congestion to the surface," says board-certified dermatologist Dr. Sapna Palep. Skin purging most commonly occurs in reaction to chemical exfoliants and retinoids your body isn't used to yet.

What Causes It?

Because a purge tends to signal a speed-up in the skin exfoliation process, often, you’ll notice what may be minor acne symptoms. The ingredients that lead to skin purging promote skin cell renewal by exfoliating. Generally, it’s said that the skin renews itself approximately every 28 days, but a retinoid or acid will speed up that process, which can result in breakouts. “A skin purge is the process of the skin cleaning out its pipes,” explains Dr. Palep. “Products or ingredients that increase your cell turnover, cause your skin to exfoliate, and bring congestion to the surface are known to cause purging.” 

What Does Skin Purging Look Like?

It may seem like the product is “making” your skin break out, but because the ingredients that lead to skin purging exfoliate skin—in turn leading to the production of new cells—what often happens is that acne symptoms that were already forming under the surface pop up sooner than they would have. The pimple was already there; it sometimes takes weeks to see it on your complexion. A purge speeds that process up, and often results in various types of acne, which all fall under the umbrella of "inflammatory acne:"

• Pustules
• Papules
• Nodules
• Cysts

Inflammatory acne covers a wide range of acne types, as most acne symptoms, like pimples, appear as the result of an inflammatory response from the body. When excess oil, called sebum, mixes with debris, like dead skin cells, inside a pore, it sometimes creates bacteria known as P. acnes. When your body detects this bacteria, it sends white blood cells into the area to attack the foreign substance, like if you had a cold or a scrape on your skin. This is called inflammation, which is why pimples look the way they sometimes do—red, swollen, and pus-filled.

When certain ingredients, like retinol, work on your skin, they don’t actually cause bacteria to be pushed out of your pores, but rather turn over your skin cells by exfoliating, which can irritate already inflamed skin. “A purge is not necessarily extracting bacteria, just simply removing the inflammation that is causing your acne so that your skin can start to clear itself,” says Dr. Palep. “The topicals that routinely cause your skin to purge are vitamin A and alpha and beta hydroxy acids.”

Can You Prevent It?

"The best way to minimize the effects of skin purging is to ease into new skin care products," Dr. Camp says. Starting slowly helps the skin develop a tolerance to the product before using it on a more regular basis. "When discussing the use of a retinoid, I tell patients to apply a pea-sized amount to the face every 3rd night for one month, then every other night for one month, then as tolerated," Dr. Camp says.

And before you choose a new product, always look at the ingredients and compare notes with other products that haven't worked so well for you in the past—your complexion might not be compatible with a certain chemical or component. "There are a few active ingredients that can be an issue for some people, like chemical sunscreens, benzoyl peroxide, salicylic acid, that will always be a problem for them, no matter the formulation," says Dr. Elizabeth Tanzi, founder of Capital Laser & Skin Care and associate clinical professor of dermatology at George Washington University.

How Long Does a Skin Purge Last?

"In general, [skin purges] last a few weeks before subsiding, Dr. Camp says. It's important to note that skin purging may not begin at the start of using a new product; it may take a few days or weeks before you spot skin changes related to purging.

Skin Purging vs. Breakouts: How They Differ

"Breakouts represent changes related to acne, a skin condition triggered by excess oil, skin bacteria, clogged pores, and inflammation, [while] purging represents skin changes related to the start of a new product or skincare ingredients," Dr. Camp says.

A breakout on your skin after introducing a new product may not be a sign of a purge but could be a standard breakout, and there are a couple of things you can keep in mind to help you spot the difference.

• Duration: The first sign to look out for is the breakout duration. “The life cycle of the acne (that occurs during a purge) is faster than a regular breakout. It will heal much quicker than in a typical breakout,” says Dr. Palep. “If you start a new product known for purging, but the breakouts are lasting longer than four to six weeks, then it may signal the product is not working for you or actually making things worse.”
• Location: Purges also tend to trigger breakouts in the spots where you normally see acne symptoms, so if you’re irritated in new areas, it’s probably not purging. 
• Active Ingredients: Another thing to keep in mind when navigating whether your skin is purging or breaking out is the active ingredients in the product you’re applying to your skin. Skin purges typically result from chemicals that exfoliate your skin, like retinols, alpha and beta hydroxy acids, and acne-fighting ingredients like salicylic acid and benzoyl peroxide. So, if your skin is breaking out after using something like a hydrating oil, sunscreen, or something that can clog pores, like a comedogenic makeup formula, you likely have a traditional breakout on your hands rather than a purge. 

When adding a new skincare product to your routine, it’s important to remember that not all reactions are technically a skin purge. Sometimes, the product you’re using may irritate your skin for a different reason, such as clogging your pores, which can lead to acne, or triggering an allergic reaction, which may result in irritation.

How to Treat Skin Purging

When treating your skin during a purge, the best thing you can do is the least satisfying answer anyone wants to hear—you have to wait it out. In the meantime, treat your skin the same way you would a regular breakout: keep your skin hydrated, resist the urge to pick or pop any inflammation, and because most purge-causing ingredients lead to skin sensitivity in the sun, limit exposure and wear sun protection when you’re outside.

Dr. Camp recommends using gentle cleansers and moisturizers that include soothing ingredients like niacinamide, hyaluronic acid, and ceramides "to prevent further skin irritation, calm the skin, and improve the integrity of the skin barrier."

When Should I Stop Using a Product That's Causing Skin Purging?

"If skin purging is causing significant skin changes such as swelling, pain, or cyst formation, or negatively impacting your day-to-day life, the product should be stopped," Dr. Camp says. "See a board-certified dermatologist for evaluation to ensure that the reaction is truly purging and not something different, such as an allergic reaction or skin infection."

The Takeaway

Skin purging is a skin reaction to introducing chemical exfoliants and retinoids in your skincare routine. During a skin purge, you may notice inflammatory acne breakouts that last a few weeks as your skin adjusts to the new ingredients. Skin purge breakouts differ from standard breakouts, as they typically have a shorter lifecycle, appear solely where you typically get acne and occur with exfoliating ingredients rather than hydrating ones. To prevent skin purging, introduce new products slowly, gradually upping the usage as your skin can tolerate. If a skin purge causes swelling, pain, or cyst formation, or disrupts your day-to-day life, stop using and seek a board-certified dermatologist.