So you’ve started a new retinoid for your skin, as recommended by your dermatologist, and you might be feeling a little curious about what to expect. While you’ve read the beneficial effects that retinoids can bring, you may have also read about some of the more difficult parts of treatment, including skin purging and side-effects. Don’t worry, it’s normal to have loads of questions when starting any new treatment.

Fear not, we’ve got you covered. Here are our answers to the most frequently asked questions about retinoids.

What are retinoids, and why can it cause skin purging?

Retinoids are treatments that are man-made forms of vitamin A [1]. They are used for certain skin conditions because of how they regulate skin cell turnover. This has important roles in acne and hyperpigmentation treatment, as well as in reducing the signs of ageing, such as improving the appearance of fine lines and wrinkles by stimulating collagen production [3].

“Skin purging” is a term used to describe an initial flare of acne at the start of treatment with a retinoid before their skin starts to improve. This can be frustrating when it first happens, but this tends to settle within a few weeks. Due to its effects on increasing cell turnover, dead skin cells and oils which block pores will be brought to the skin’s surface temporarily. This may lead to a breakout, but will only be temporary and treatment should be continued.

How do retinoids affect the skin? What do they do?

Retinoids primarily affect the regulation of skin cell growth and speed up skin cell turnover. They are easily absorbed by the skin and work to improve skin function as well as appearance. Retinoids are scientifically proven to have beneficial effects on skin inflammation and work to prevent and treat acne spots and comedones (blackheads). They also work to improve fine lines and wrinkles by increasing the production of collagen and softening rough, sun-damaged skin. [4].

What is purging and how long does it last?

Purging is the temporary initial worsening or breakout of acne when first starting to use retinoids. This happens due to the process of increasing skin cell turnover, which can unblock pores leading to more spots than before.

Purging can be frustrating when it initially happens but don’t worry too much, thankfully it shouldn’t last long. Within two to three weeks, most people’s skin will have settled and you will hopefully be beginning to see the helpful effects of the retinoid on your skin, so hang in there! [6]

Do some retinoids cause purging more than others?

Not all retinoids are made equal. The main differences are how many steps it takes for them to be converted by our skin into the active component: retinoic acid, which has the beneficial effects.

As prescription strength retinoids such as Adapalene or Tretinoin are stronger than over-the-counter retinols, they are more likely to irritate your skin and lead to purging This is because the retinoids speed up the turnover of your skin cells. The dead cells will be removed quicker than normal, which can lead to redness and irritation.

The stronger the retinoid is, the more skin purging or side-effects you will most likely experience, so it’s really important to strike a good balance. This is where strong advice from our dermatology team at Dermatica comes into play!

Can you avoid purging, and does purging mean you’re doing something wrong?

Purging is a totally normal reaction when beginning retinoid treatment, so if you’re experiencing it, it doesn’t mean you’ve done anything wrong or the treatment isn’t working. There are also easy ways to help make the purging process less of a bother.

As part of your personalised plan, it is likely your dermatology team at Dermatica will start with a lower dose of retinoid – and build up the dose gradually as your skin adjusts. So, for example your clinician might recommend applying the cream or gel once daily to begin with. If you have irritation, they may recommend to reduce the frequency gradually, but they’ll guide you through this process. It may take some time to adjust to the new treatment.

Additionally, you may wish to apply a layer of moisturiser as a barrier to sensitive sites such as around the eyes and mouth to avoid retinoid coming in contact with these areas. Applying a small amount of a layer of moisturiser first before the retinoid treatment can also help to ease side effects.

If you have any questions about the purging you’re experiencing, our experts at Dermatica are always happy to answer any questions you have.

What skincare routine should you use to protect and nourish your skin without clogging pores?

Maintaining a good skincare routine is really helpful to minimise the purging you experience, and help your skin to tolerate the product and get maximum outcomes.

You’re probably aware that you need to protect your skin from the sun to prevent signs of ageing and skin cancer. When using retinoid treatment, it becomes even more important to be disciplined with your sunscreen. We would strongly recommend a sunscreen which protects against UVA and UVB at a minimum of SPF 30.

Keep up your skincare routine. Cleanse your skin before applying your retinoid and make sure to moisturise your skin at least once daily. If you experience side effects from your retinoid such as dry, flaky skin, using a thicker moisturiser more regularly is advisable. Retinoids themselves are exfoliating by nature, so we recommend avoiding exfoliating until you feel you can tolerate it, and to always avoid physical exfoliants (cleansing brushes, scrubs) as they might lead to further breakouts or irritation.

References:

[1] https://www.mountsinai.org/health-library/supplement/vitamin-a-retinol Date accessed: 01/12/2022
[2] “National Psoriasis Foundation” Date accessed: 01/12/2022
[3] https://www.webmd.com/beauty/ss/slideshow-retinoids-for-aging Date accessed: 1/12/2022
[3] Zasada M, Budzisz E. Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments. Postepy Dermatol Alergol. 2019 Aug;36(4):392-397.
[4] https://skinwellness.com/learn/the-ultimate-guide-to-understanding-the-hierarchy-of-retinoids/ Date accessed: 01/12/2022