Skin Purging Vs. Breakout: How To Tell The Difference

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What is skin purging?

“Skin purging” is a term some people use to describe an increase in acne after beginning a new skin care treatment, such as retinoids. However, it is a colloquial term rather than a medical one, and scientists have not studied the concept.

What scientists do know is that some active ingredients in skin care can cause irritation. Many people who start retinoids experience temporary symptoms such as:

dryness
flaking
peeling

This is a result of contact dermatitis, which may sometimes resemble acne, causing bumps on the skin.

Due to a lack of data, it is unclear whether people reporting skin purging are experiencing dermatitis or genuine acne.

An older 2009 study found no research to support the idea that retinoids temporarily worsen acne. However, the authors concede that some people may experience this. More research is necessary for experts to draw any conclusions.

What causes skin purging?

Supporters of the skin purging concept have several theories about why it may occur. Some say it is a result of toxins or impurities coming to the skin’s surface, resulting in acne. However, there is no evidence to support this.

Others claim that skin purging occurs due to increased skin cell turnover. Cell turnover is the process of shedding and new growth that the skin naturally goes through. As old cells die and shed on the skin’s surface, newer cells from deeper in the skin come to the surface.

This theory argues that increased turnover may speed up the development and healing of acne that was already forming under the skin when a person began treatment. This causes what appears to be a breakout. However, again, there are no studies to back this up.

Ingredients that speed up cell turnover include any that exfoliate the skin. These include:

retinoids such as retinol, retinaldehyde, and adapalene
alpha hydroxy acids
beta hydroxy acids

People may find these substances in products for:

acne treatment
reducing the visible signs of aging
reducing an uneven skin tone or hyperpigmentation

Purging vs. acne breakout

It is very difficult to say if a person’s acne is due to a skin care product or a regular breakout according to appearance alone.

However, people may be reacting to a specific product if the symptoms:

shortly begin after they introduce a new product to their routine
appear exclusively in the areas where they are applying the product
worsen when they use the product and improve when they stop

In contrast, symptoms that are a result of a typical breakout may:

affect other body parts beyond the treated area
continue even after a person stops using the product

Treatment for skin purging

Since there is no research on skin purging, there are no specific treatments. However, there are guidelines on what to do if a person experiences a negative reaction to a new product.

For new retinoids or acid products, some mild irritation is common, especially at the start of treatment. The symptoms may get better on their own. If they do not, people can try:

reducing how frequently they use the product
reducing the amount they use, starting small and working gradually upward
switching to a milder formula or lower strength
using a calming, nonirritating moisturizer for sensitive skin

The skin is particularly sensitive at this stage, so a person needs to avoid:

touching their face
scrubbing the skin
picking blemishes
peeling off the flaky skin

It is also essential to wear sunscreen every day for as long as a person is using retinoids or acids.

When to stop using a product

Stop using a skin care product right away if it causes more than just mild irritation. This could include:

severe dryness
skin cracking
skin that looks or feels raw
soreness or burning
many large or painful spots
discoloration
scarring

People should also stop using a product if it could be causing an allergic reaction. Potential signs include:

an itchy, stinging, or burning sensation
a rash or hives
puffy, raised areas of skin
itchy or watery eyes
blisters
cracked skin

If a product is worsening an existing condition significantly and affecting mental health, people may also want to speak with a dermatologist about trying an alternative.

How long does skin purging last?

Negative reactions to new skin treatments or ingredients can last varying amounts of time, depending on the cause.

For some, the reaction to ingredients such as retinoids is mild and temporary. For others who are more sensitive, it may continue until they stop using the product.

In the case of acne treatments, it can take up to 2 to 3 months for a product to clear spots, but people often see improvements after 6 weeks.

Preventing skin reactions

A person can minimize the side effects of new skin care products by slowly easing them into their routine.

The American Academy of Dermatology Association (AAD) recommends doing a patch test for new skin care products on a small area of skin, about the size of a quarter, for 7 to 10 days.

If the product does not cause any negative side effects, a person can start using it in other areas. However, it is still important to go slowly. Ingredients such as retinoids and acids often cause irritation to begin with.

A person may wish to begin by applying a retinoid once weekly and then increase it to two or three times weekly.

For exfoliating acids, a person needs to follow the instructions on the product label or the advice of their dermatologist.

Do not use acids or chemical peels more often than the instructions recommend, as this may damage a person’s skin.

When to contact a doctor

If a person is experiencing new or concerning symptoms after starting a new skin care product, they need to consult a doctor or dermatologist.

It is also important to speak with a doctor about any new symptoms that do not go away when a person discontinues the product.

In rare cases, individuals may experience anaphylaxis due to a cosmetic product, which is a life threatening allergic reaction that requires emergency medical attention.

Anaphylaxis: Symptoms and what to do

Anaphylaxis is a severe allergic reaction that can be life threatening. The symptoms develop suddenly and include:

hives
swelling of the face or mouth
wheezing
fast, shallow breathing
a fast heart rate
clammy skin
anxiety or confusion
dizziness
vomiting
blue or white lips
fainting or loss of consciousness

If someone has these symptoms:

Check whether they are carrying an epinephrine pen. If they are, follow the instructions on the side of the pen to use it.
Dial 911 or the number of the nearest emergency department.
Assist the person in moving from a sitting position to lying down. If they have vomited, turn them onto their side.
Stay with them until the emergency services arrive.

Some people may need more than one epinephrine injection. If the symptoms do not improve in 5 to 15 minutes, or they come back, use a second pen if the person has one.

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Summary

Skin purging is an informal term for a temporary increase in acne that some people observe when they begin using a new skin care product. Due to a lack of research on the topic, it is unclear if this is a common side effect or why it occurs.

However, doctors know that certain ingredients, such as exfoliating acids and retinoids, promote skin exfoliation and turnover. This can sometimes come with negative side effects, such as dryness and irritation.

For many, this is temporary and will get better on its own. However, if the reaction persists, gets worse, or causes distress, a person should contact their doctor about what to do.

Allergy
Dermatology
Cosmetic Medicine / Plastic Surgery

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

9 things to try when acne won't clear. (2023). https://www.aad.org/public/diseases/acne/diy/wont-clear
How to test skin care products. (2021). https://www.aad.org/public/everyday-care/skin-care-secrets/prevent-skin-problems/test-skin-care-products
Yentzer BA, et al. (2009). Do topical retinoids cause acne to "flare"? https://pubmed.ncbi.nlm.nih.gov/19746671/
Zasada M, et al. (2019). Retinoids: Active molecules influencing skin structure formation in cosmetic and dermatological treatments.https://pmc.ncbi.nlm.nih.gov/articles/PMC6791161/

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Medically reviewed by Sara Perkins, MD — Written by Rachel Ann Tee-Melegrito — Updated on January 24, 2025

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What is skin purging?

What causes skin purging?

Purging vs. acne breakout

Treatment for skin purging

When to stop using a product

How long does skin purging last?

Preventing skin reactions

When to contact a doctor

Anaphylaxis: Symptoms and what to do

Summary

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