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Skin Purging or Breakout? Here’s How to Tell the Difference

You’ve eagerly started a new skincare routine with the promise of glowing, flawless skin. But instead of waking up with a complexion that rivals any skincare ad, you’re faced with a breakout straight out of a nightmare. You may wonder, “What gives?”

Welcome to the world of purging — a phase that, while not as terrifying as its cinematic namesake, can be horrifying nonetheless. Skin purging is different from standard breakouts. It is usually shorter in duration and may be a sign that your products are doing what they should. 

If you are unsure if your new skincare products are to blame for your recent breakout, Rebecca Thiede, MD, a dermatologist with Banner – University Medicine, helps clear up the differences between breakouts and skin purging.

Skin purging versus breakouts

Imagine your skin going through a spring-cleaning phase. This is what skin purging is all about. 

“When you start a new skincare product or regimen, your skin increases cellular turnover, prompting your skin to shed skin cells faster,” Dr. Thiede said. “Ingredients like retinoids, AHAs (alpha hydroxy acids), BHAs (beta hydroxy acids) and some types of vitamin C can trigger purging by bringing hidden pimples to the surface of the skin faster than usual.”

This means that all that gunk lurking beneath your skin’s surface – think trapped oil, dead skin cells – is brought to the forefront, resulting in your new pimple pals. 

Unlike purging, regular breakouts aren’t related to increased cell turnover due to an active ingredient. Instead, they are often caused by external or internal changes that affect your skin’s balance. 

“Regular breakouts are typically caused by clogged pores due to oil (sebum), bacteria, dead skin cells and sometimes hormonal changes or stress, which do not accelerate the skin renewal process,” Dr. Thiede said. 

How to tell if you are purging or breaking out

When it comes to whiteheads, blackheads and zits, it can sometimes be difficult to pinpoint who or what is to blame. Dr. Thiede said it comes down to location, duration and appearance. 

Location

Purging usually happens in areas where you frequently get pimples. “Because these products speed up cell turnover, they can make pre-existing microcomedones (tiny, unseen blemishes) surface more quickly,” Dr. Thiede said.

Breakouts can happen anywhere on the skin, regardless of whether it’s an area you are prone to getting acne or not. They might appear in new or random spots without any rhyme or reason.

Duration

“Purging usually follows a predictable duration, typically anywhere from four to six weeks,” Dr. Thiede said. Since purging occurs because your skin is adjusting to a new product, it shouldn’t last longer than how long it takes for your skin to renew itself (about 28 days for most people). 

“The duration of a breakout can vary and might not improve as quickly as purging,” Dr. Thiede said. “They may continue to happen if the underlying causes, like hormonal imbalances, stress or improper skincare, aren’t addressed.”

Appearance

The blemishes caused by purging are usually smaller, come to a head quicker and heal faster. Breakouts, however, can vary widely in appearance, including blackheads, whiteheads, deeper cystic spots or hormonal acne along the jawline. They might heal slowly and can range in size and severity. 

Managing skin purging and breakouts: Tips for clearer skin

We will all face a dreaded zit or two – whether we are a tween, teen or adult (Yes! Adult onset acne happens too!). They can be frustrating and annoying, but here are some tips that may help reduce purging and breakouts:

  1. Be patient: If you’re dealing with a skin purge, the best course of action is often patience. Give your skin time to adjust to the new product. Resist the urge to pick or squeeze blemishes or add more new products to your skin routine, as these can slow the purging process and healing. “If the issue persists beyond six weeks, talk to your health care provider or a dermatologist,” Dr. Thiede said. 
  2. Introduce new products slowly: If you use an anti-aging treatment like retinol, try using it once or twice a week before gradually increasing how often you use it. This gives your skin time to adjust to the product and build tolerance while reducing the chance of skin purging.
  3. Use a gentle cleanser: Harsh or abrasive face washes can do more harm than good. A gentle, hydrating cleanser helps whisk away dirt, grease and grime without stripping the skin of moisture. 
  4. Maintain a healthy lifestyle: Eat a balanced diet of fruits, vegetables, lean proteins and whole grains. Limit sugary and processed foods. Drink plenty of water throughout the day. Prioritize sleep and find ways to lower your stress levels.
  5. Change your pillowcase: Your pillow absorbs dead skin cells, oils, sweat and more as you sleep, which can clog your pores. Change your pillowcase often.
  6. Wear sunscreen: Your skin is vulnerable to the sun. Protect your skin from harmful UV rays by wearing sunscreen. It prevents sun damage and dark spots (post-inflammatory hyperpigmentation) that can occur when acne is healing.  
  7. Moisturize regularly: Keep your skin hydrated, even if you’re experiencing breakouts. Look for non-comedogenic, oil-free moisturizers to prevent clogging pores.
  8. Talk to a dermatologist: If you’re unsure if it is purging or a breakout, talk to your provider to find out the cause. Similarly, if you experience an adverse reaction – burning, redness or intense itching – stop using the product right away and see your provider. “This might involve changing your skincare routine, diet or lifestyle,” Dr. Thiede said. “You may need a prescription medication to target the issue causing your acne.”

Takeaway

While a skin purge can be upsetting, it’s not as dreadful as it may sound. It is a normal response to a new skincare routine and is always temporary. 

However, if your skin concerns continue and you find your products aren’t working, then it’s time to see a dermatologist or a Banner Health specialist for advice. What works for one person may not necessarily work well for you. Your provider can help find the best approach to manage your skin purging and breakouts effectively.

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Dermatology