“During the skin purge, your skin speeds up the cell turnover faster than it's used to so the substances clogging your pores get pushed to the surface of your skin faster, so you may experience slight inflammation, contributing to additional breakouts,” says Dr. Fernandez.
Tretinoin speeds up the cell turnover process, which can bring dead skin cells to the surface. At the beginning of treatment, this can cause issues like clogged pores, dryness, flaking and peeling.
Many users experience increased dryness, redness, sensitivity, or even a slight increase in acne breakouts during the initial weeks of tretinoin use.
The original hydroalcoholic formulation of tretinoin (0.05%) was frequently associated with significant cutaneous irritation, with up to 20 percent of patients developing new papules and pustules during the first few weeks of treatment.
It doesn't happen to everyone, but many people find their breakouts worsen before they get better when they start using a retinol product. Of course (as with any new skincare product) you'll want to conduct a patch test 24 hours before using retinol for the first time.
Skin purging typically lasts anywhere between four to six weeks which is roughly in line with how long it takes for your skin cells to naturally turnover. During this phase, it might seem like your skin is getting worse but it should settle down and improve after you've passed this period.
Retinol purging is often not understood well. Users mostly think that retinol escalates skin breakout. However, the truth is that retinol only speeds up the process. Since it works by increasing the skin cell turnover, it also pushes oil and skin debris to the surface which are removed through acne.
Many tretinoin users experience a “purge” during the first several weeks of treatment. During this period, acne — the very problem tretinoin is supposed to treat — often gets worse, resulting in everything from the occasional whitehead to severe breakouts.
Again, tretinoin users specifically may experience symptoms of “purging.” As tempting as it is, do not pick at any red spots, squeeze or pop blemishes, scratch rough patches, or excessively touch other inflamed spots which might pop up.
After 4-6 weeks, your skin will get used to Tretinoin and will begin to be noticeably smoother and more even. Depending on how often you use Tretinoin, you may begin to see full benefits by this point. A lot of the initial irritation will settle down and true “retinization” of your skin is in full force.
If despite starting very slow and on a low dose, you still experience excessive dryness, irritation or purging, then consider applying a thin layer of your moisturiser first before the Tretinoin to reduce its activity.
How do I treat hormonal acne? Based on the severity of your acne, different treatment options are available to reduce sebum production, pimple formation and painful inflammation: Blackheads and whiteheads: Topical cream (tretinoin). Inflammatory acne: Topical retinoid and/or topical antibiotic and/or benzoyl peroxide.
Signs you should stop using tretinoin
“If your face is red, tender, or very parched and peeling, these are signs you're overusing your retinoid,” Dr. Ansell says—either you're applying too much, or too frequently.
In other words, when you use certain products, your skin is likely to look worse before it looks better. A purge can look like blackheads and whiteheads, and it's likely to appear in the places where you normally break out.
At the end of the 12-week study, which included 1,537 participants, researchers concluded that both the standard tretinoin gel and the tretinoin gel microsphere significantly reduced inflammatory and noninflammatory lesions vs the placebo group.
For those of us who do suffer from purging, it can look like: breaking out in pustules (pimples), the appearance of flaky, peeling skin, irritation and dry patches. Getting these symptoms can be demotivating, especially if you're already feeling unconfident about your skin.
If the skin purging stage is really troublesome, it can be helpful to decrease the frequency of your actives by alternating days of use. Stick with it - in time, things will likely improve. When the frequency of new spots starts to reduce, increase the frequency of your actives again.
This is because potent active ingredients like exfoliating acids, Tretinoin and other retinoids work in a way that makes purging almost unavoidable especially in people who are prone to acne breakouts.
Vitamin A can be unstable as an ingredient, and this can mean your skin will become more sensitive. There is often an initial phase when using retinoids for the first time, known by many as the 'retinoid uglies'. Essentially, your skin can see a decline before improvement during an adjustment period.
To tell if your new skincare product may be breaking you out, see if the ingredients pass the CosDNA test. If any of the ingredients in your product rank as a 3 or higher for acne, you're likely experiencing a breakout.
However, incorporating retinoids in your skincare routine can also cause clogged pores, redness, peeling, and breakouts—regardless of skin type. This is called retinol skin purging, and it's the stage where your skin may get worse before it gets better.
Using antioxidant serums can help. Vitamin c is the most popular serum but if you cannot tolerate it , you can use something with resveratrol and ferulic acid . Sunscreen is a must.
Three inexpensive moisturizers that our physicians love are Vanicream Daily Facial Lotion with Hyaluronic Acid, Neutrogena Hydroboost Gel, and The Ordinary Hyaluronic Acid Serum. All three of these are affordable, non-comedogenic,and blend well with tretinoin.
In short, the retinol sandwiching technique is as follows:
Apply a layer of moisturiser to damp skin. Allow this to dry completely. Apply your retinol. After giving retinol time to absorb, finish your skincare routine with a second layer of moisturiser.