It can range from minor pimples to cystic acne, as well as dryness, redness, and peeling. Also, it is important to remember that retinol isn't the direct cause of acne.
You might also get more breakouts once you start using retinoids. Keep calm and stick with it. “It's common to see acne get worse before it gets better, as the retinoids can cause a mass 'purge,'” says Robinson. Basically, as skin cell turnover increases, new clogs rise to the top.
Retinol is a natural vitamin A derivative often found in anti-aging creams. It can also be an effective ingredient for treating acne and acne scars.
Hormonal changes, including those caused by menopause, menstruation, pregnancy, and certain medical conditions like polycystic ovarian syndrome (PCOS), can be triggers for cystic acne.
Skin purging happens when new ingredients, like retinol, promote increased cell turnover, which causes clogging and worsening breakouts. This is particularly the case as oil and debris that is trapped deeper underneath the skin comes to the surface.
In general, retinol is one of the more gentle varieties of retinoids, however, “if you're going to experience shedding it will begin on day three to five of daily night time use, and this usually continues for about five to 10 days depending on your skin type and the percentage of retinol you've used,” adds Ejikeme.
Purging is slightly different, appearing on the skin mostly as blackheads or small skin-coloured bumps just under the surface of the skin. But it is also possible for purging to cause similar spots to a breakout, too.
Acne in the jawline region is caused by sebaceous glands producing excess oil (sebum) due to hormonal stimulation. This sebum gets trapped in the follicle leading to clogged pores. Bacteria will then start to proliferate in the clogged pore because there is no oxygen in there to control the bacterial growth.
When androgen hormones become too high, there is an increase in sebum production (sebum is the oil in your skin that causes acne). So, when your body starts to develop more oil in the skin it can result in breakouts and cysts.
Best overall cystic-acne treatment
He recommends Differin, the only prescription-strength retinoid that's available over the counter. “Differin should be the first OTC product someone with cystic acne should use,” adds Dr. Samer Jaber, the founder of Washington Square Dermatology.
That's right: It may be tempting to stop using said retinoid or exfoliating acid altogether, but resist. “If it's an Rx retinoid from your doctor, they gave it to you for a reason,” Mraz Robinson says. “Stick through this 'it gets worse before it gets better' phase.”
Sebaceous cysts also have been successfully treated with retinoids such as isotretinoin. More recently, lasers have been used with success in treating sebaceous cysts. Infected cysts may require treatment with an antibiotic.
Peeling, redness, and irritation are common onset reactions for some people when they first start to use retinol. Some reactions get so bad that the common term used to describe the list of effects has been dubbed the “retinol uglies”. Note from a skincare expert: Many things in life get worse before they get better.
Not unlike a society quietly bubbling with rage, the bad stuff lurking in your pores needs to come out at some point. As your skin starts getting accustomed to the retinol, in the first two to four weeks of use, your cell turnover will increase and your pores will... well, purge, and all breakout hell will break loose.
Dermatologist Dendy Engelman, M.D., considers whiteheads and blackheads “mild” and therefore, “over-the-counter products that contain ingredients such as salicylic acid, benzoyl peroxide, and retinol should do the trick.” According to Dr.
Warm compresses and acne stickers can help to bring a pimple to a head so that the sebum, dead skin cells, and bacteria can exit to the skin's surface. Using ice can relieve inflammation. If blind pimples occur frequently or are particularly inflamed and painful, a person should seek advice from a dermatologist.
“Cystic acne is commonly increased in your thirties as this is when the skin is most susceptible to hormonal changes. The hormonal shifts affect the oil glands and sebaceous glands in the skin,” Dr. Purvisha Patel, board certified dermatologist and founder of Visha Skincare adds.
You can tell if acne is hormonal or bacteria by its severity if flare-ups occur during hormonal imbalances, and whether topical treatments resolve the issues, or if systemic medications are needed.
“If you're overusing your retinol, or if you're using a retinol that's too strong for you, it can lead to peeling, irritation, and excessive dryness, which may have led to retinol's association with skin thinning,” she says.
Generally, it takes a few weeks to see results, but some OTC options may require months of regular use. Most dermatologists said you'll need to use retinol for a few weeks before you see results, but you should see improvements by 12 weeks with most products.