Is Your Skin Breaking Out or Just Purging? Here's How to Tell the Difference

If you’ve introduced a new product into your skincare routine recently, a breakout is the last thing you want to see. Chances are you’ll write the product off immediately and stash it away, never to see your face again. But wait! Although it’s true that a new product might just be incompatible with your skin, your skin might actually be purging—and that’s actually a good thing.

So, how do you know if your skin is purging or breaking out? To help identify the situation, we spoke with dermatologists to understand the difference and how you can approach each situation. 

What is skin purging?

Whether you’ve heard of it or not, skin purging is incredibly common. In basic terms, it simply refers to the reaction some skin has to certain ingredients, namely retinols and acids. When you try a new chemical exfoliant, the top layer of your skin sloughs off and regenerates new skin, potentially bringing irritation and blockages (read: breakouts) to the surface. 

“When patients start a new active ingredient for acne, things can get worse before they get better,” says Caren Campbell, MD, board-certified dermatologist in New York City. “This is a known side effect for some patients of topical or oral retinoids like tretinoin (Retin-A) or isotretinoin (Accutane).”

While nobody likes to see it, purging is actually a really good sign! It means the medicine (oral or topical) is working, and your skin is cycling out debris and bacteria that have been causing your acne.

“Topical retinoids enhance cell turnover and act like pipe cleaners for your pores. In the process, they clear out blockages much more rapidly,” says Joshua Zeichner, MD, board-certified dermatologist in New York City. “Once you remove what’s blocking the pore and continue to use the topical retinoid, you can prevent blockages from developing in the future.”

What are breakouts?

On the other hand, you have your classic breakouts, which come in many different shapes and forms. You can experience papules or cysts (bumps), pustules (pus-filled bumps) or "whiteheads," and comedones or "blackheads."

As you’re probably well aware, breakouts are not a good thing. “Acne is inflammation that develops around your follicles. Individuals with acne produce high levels of oil and it gets trapped underneath sticky cells that block the pores,” says Dr. Zeichner.

Acne breakouts can be triggered by many different things, the most common being hormones, stress, and diet. These can all elicit an inflammatory response deep within your pores and create a perfect environment for bacteria to grow. 

What does skin purging look like?

The bad news is that skin purging can look almost identical to regular acne, inflammatory acne to be exact (i.e. pustules, blackheads/whiteheads, and cysts).

The good news: While the cause (or causes) of your breakouts can sometimes be difficult to pinpoint, telling the difference between skin purging and a regular breakout is actually very simple (despite the two looking very similar).

“Purging tends to be much more quick and severe and almost always after the introduction of a new product or medication,” says Dhaval G. Bhanusali, MD, board-certified dermatologist in New York City. “That said, they are transient unlike traditional breakouts, which may need long-term intervention to improve.” 

Skin purging also tends to happen around the same active ingredients, like retinols, alpha and beta hydroxy acids, and acne-fighting ingredients like salicylic acid and benzoyl peroxide. If your skin is breaking out after using something like a hydrating moisturizer, there’s a greater chance that you have a traditional breakout on your hands. 

In short, evaluate your routine and habits during the past couple days. Ask yourself if you’ve tried any new skincare products, medications, or have changed your diet or sleep schedule. This will help you determine any changes your skin might be adjusting to. 

How long does skin purging last?

A skin purge can last from two to three weeks, according to derms. Generally speaking, your skin’s temper tantrum should subside within four to six weeks of starting a new skincare regimen. If you start a new product that is known for purging, but the breakouts are lasting longer than 4-6 weeks, then it may signal the product is not working for you or actually making things worse.

How can you treat skin purging?

If your skin is purging, take comfort in knowing that your treatment is working and the breakout is only temporary. It’s best to be patient and wait for your skin to finish its cycle (or at least 4-6 weeks so you can help identify the issue). If the purging is too uncomfortable, talk to your dermatologist on what to expect and how to lessen the product’s effects until your skin regulates. If you’re using a topical, consider cutting back on the amount or frequency in which you’re using it. (For example, you can cut back to using retinol once a week before slowly increasing it to two to three times a week.) Carmen Castilla, MD, board-certified dermatologist in New York City, adds that in both cases (skin purging and breaking out), it’s important to support your skin barrier by using a gentle moisturizer.