Retinoids: Why Skin Purges And How Long It Lasts

If you’ve just started using retinoids to treat your skin,or are simply researching possible side effects, you may have heard about skin purging. It’s important you have all the information (directly from dermatology experts) when beginning any new treatment. So we’ve enlisted Dr. Shendy Engelina, Consultant Dermatologist and Clinical Lead here at Dermatica to answer some of our most frequently asked questions about retinoids and skin purging.

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

Retinoids are a group of active ingredients with decades of clinical research and evidence behind them. They are man-made or synthetic forms of vitamin A, used to treat or target certain skin conditions because of how they accelerate skin cell turnover.[1] 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 preventing and treating acne spots and comedones (whiteheads or blackheads). They also work to improve fine lines and wrinkles by increasing the production of collagen and softening rough, sun-damaged skin. [2]

‘Skin purging’ is a term used to describe an initial flare of acne at the start of a retinoid treatment, before the skin starts to improve. This is because retinoids speed up the rate at which our skin cells turnover (or renew), so dead skin cells and oils which previously blocked the pores are brought to the skin’s surface faster. It can be frustrating when it first happens, but it tends to settle within a few weeks and treatment should be continued if tolerated.

How long does skin purging usually last?

Purging is the temporary initial worsening or breakout of acne when first using retinoids. It can last between two to eight weeks but you should notice improvement from around six weeks onwards. [3]

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 form: retinoic acid, which has beneficial effects. For example, retinol is inactive, so it has to convert first into retinaldehyde and then into retinoic acid on the skin in order to activate it. Retinal needs to go through just one step to become its active form (retinoic acid), so it works faster than retinol.
Prescription strength retinoids such as Adapalene or Tretinoin are the strongest and fastest-acting. They are already in active forms, so they don’t need to go through any conversion steps on the skin.

The stronger the retinoid is, the higher the risk of skin purging or side-effects, so it’s really important to strike a good balance and be guided by your skin tolerance. This is why it’s important to stay in contact with our dermatology team at Dermatica – to ensure the strength and frequency of your personalised formula is right for your skin.

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

Purging is a common side effect when beginning retinoid treatment, so if you’re experiencing it, don’t worry. It doesn’t mean you’ve done anything wrong or that the treatment isn’t working properly. There are also things you can do to help manage the purging better.
Here at Dermatica, we recommend applying your retinoid formula just once daily at night to begin with. Depending on your tolerance and skin type, you might start with a lower strength of retinoid, then build up gradually as your skin adjusts.

If you experience some reactions like irritation or dryness, our dermatology experts may suggest ‘sandwiching’ your formula. This just means applying some moisturiser to your skin before using your formula, and again afterwards to act as a buffer against irritation and dryness, while still allowing the retinoids to deliver their skin benefits.
Our dermatology team might also suggest reducing the frequency with which you apply your formula from daily to a few times a week, then build up to every day once your skin adjusts.

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

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

Maintaining a simple skincare routine is really helpful to manage the purging you experience, and help your skin to tolerate the product and get the best possible results.
Keep up your daily skincare steps with gentle cleansing and moisturising at least twice a day. If you experience side effects from your retinoid such as dry, flaky skin, using a richer moisturiser more regularly is advisable. Retinoids themselves are exfoliating by nature, so we recommend avoiding additional exfoliating ingredients (physical and chemical) until your skin is used to the Retinoids.

Finally, when using retinoid treatment, your skin will be more sensitive to sunlight. Therefore, it becomes even more important to be disciplined with your sunscreen. We strongly recommend sunscreen of at least SPF 30+ which protects against UVA and UVB (broad spectrum), even during cloudy days.

References:
1. Zasada M, Budzisz E. Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments. Advances in Dermatology and Allergology [Internet]. 2019;36(4):392–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791161/
2. Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clinical interventions in aging [Internet]. 2006;1(4):327–48. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/
3. Retinoid-Induced Flaring in Patients with Acne Vulgaris: Does It Really Exist? The Journal of Clinical and Aesthetic Dermatology [Internet]. 2008 May 1 [cited 2023 Dec 7];1(1):41–3. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989803/