Is Skin Purging Real? Here’s What To Expect When Treating Acne

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Having acne is a normal part of puberty and your teenage years, but when you’re still dealing with spots in adulthood it can be really frustrating. The good news is there are prescription acne treatments that can help clear your skin.

As a GP in Sydney, I have plenty of adult patients who are ready to start their acne journey. With the abundance of skincare routines readily available on the internet these days, I always advise them to look at ingredients and adopt a personalised acne treatment plan, including things like cleansers, moisturisers, sunscreens and prescription acne medications.

Types of prescription acne treatments

When it comes to fighting acne, you can find plenty of great cleansers and products over-the-counter at your local pharmacy. These will often contain salicylic acid or benzoyl peroxide, two acne-fighting ingredients that work well for mild cases of acne. However, if these types of products aren’t helping, you are experiencing side effects or if you have more serious acne, you may want to consider prescription-strength acne treatments like retinoids and antibiotics.

Both topical and oral antibiotics can be prescribed for acne in adults. They work by killing the bacteria that leads to pimples. They should only be prescribed for the shortest amount of time necessary to avoid building up antibiotic resistance.

Retinoids, such as tretinoin and adapalene, are another type of prescription acne treatment that is available as a topical cream or gel. Retinoids are a powerful acne treatment, working to increase the rate of skin cell turnover to shed away dead skin cells and uncover fresh, new skin. Because your skin cells are regenerating at a faster rate, there is less time for your pores to become clogged and turn into zits.

Everyone responds to treatment differently and it may take a few trials before identifying the most effective acne treatment regimen.  

Skin purging and retinoids

For some people, retinoids can be very effective in treating adult acne. However, they do come with a caveat – the skin purge (or sometimes referred to as the tretinoin purge). The word “purge” can sound scary when it comes to your skin, but it’s actually a normal part of the acne journey. 

Like I mentioned before, retinoids work by increasing the rate of skin cell turnover so that clearer, younger-looking skin can be surfaced. However, this process also means that everything that was in between the new skin cells and your current skin has to come to the surface first. This includes dead skin cells, bacteria, dirt and excess sebum that cause breakouts. 

That’s why when you first start a prescription acne skincare regimen with retinoids, your skin may get worse before it gets better. The tretinoin purge and skin purging in general is characterised by inflamed and swollen skin and breakouts. It is super important to continue with your acne treatment plan exactly as prescribed so that the prescription ingredients can do their jobs and unearth clearer, fresher skin.

How long does the purge last? 

Everyone’s skin and acne situation is different, so it’s hard to put a specific timeline for how long skin purging will last. Because retinoids work by shedding your existing skin cells and replacing them with new ones, typically the skin purge will last one full skin cell cycle, which can take about 4 to 6 weeks. 

Your skin’s response to new products is what causes the skin purge and can often be mistaken for breaking out. Skin purging is when you are adjusting to the retinoids and the acne-causing items between your old skin cells and new ones are being surfaced. Pimples might appear where you usually get them, but they’ll go away more quickly than they used to. This is a sign that the prescription retinoids are working!

However, if your skin is sensitive to something in the new product, you might experience a breakout instead. This happens when you get spots in a new area of your skin that you don’t usually, and they take longer to heal and go away. 

As you start your new prescription skincare routine, take note of all the side effects you’re experiencing and share them with your doctor. They can help determine whether your skin is purging or if you need to change treatments. 

Fighting acne and the journey to clear skin can be long but very worthwhile. If you’re purging, don’t get discouraged – keep using your products as your doctor has prescribed and you’ll be on the path to clearer skin. 

Dr Ai Nhi Bui is a registered GP and medical director at Rosemary Health, a digital service connecting Australians to quality healthcare online. With over 15 years of experience, Dr Bui has an interest in women’s health issues ranging from pregnancy care and sexual health to chronic conditions.