Skin purging versus true acne is one of the biggest questions (and confusions) in skin care. If you regularly try new skin care products, you’ve probably seen small pimples pop up after using something that didn’t quite get along with your skin type. That’s called “skin purging,” which is caused by your skin adjusting to new active ingredients and essentially “detoxing” your skin. But purging may look a lot like typical breakouts; one signifying you should stop using the product immediately, while the other means you should stick it out. But how do you know which one is happening to you?
I spoke to board-certified dermatologists about the differences between the two and when you can expect the pimples and redness to clear up.
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What’s the difference between skin purging and breakouts?
Though acne and skin purging are nearly identical in appearance, the timeline is where the main differences lie. Typical acne can appear as blackheads, whiteheads, pustules, cysts or nodules that happen without a clear trigger, while skin purging is temporary and directly tied to starting a new active ingredient that increases cell turnover (most commonly a retinoid), says Dr. Mamina Turegano, a triple board-certified dermatologist, internist and dermatopathologist. Purging usually results in smaller breakouts (like whiteheads or blackheads), but it can look like any type of acne.
Purging usually happens within two to six weeks of starting a product and shows up in your usual acne-prone areas. The key difference is that purging improves over time, usually within four to six weeks. However, “if breakouts continue beyond eight weeks, spread to new areas or are accompanied by burning, itching or worsening redness, it’s more likely irritation or true acne — and that’s when I recommend seeing a dermatologist,” says Turegano.
In short, if stopping a product leads to quick improvement, it is likely purging; if breakouts persist or worsen, it’s more likely true acne and worth seeing a dermatologist for a personalized plan.
How do you treat skin purging versus breakouts?
Treating skin purging is much different than treating breakouts; the former requires gentle, calming ingredients that support and repair your skin barrier, while the latter needs acne-fighting ingredients to clear up pimples and inflammation. “Acne usually needs targeted therapy to reduce inflammation and prevent new lesions, whereas purging is a short phase you ride out with supportive care,” says Turegano.
Here’s what dermatologists suggest for each concern:
- Skin purging: Technically, you can’t “treat” purging directly, but certain ingredients can make it much easier to get through. Look for calming, skin barrier-supporting ingredients like ceramides, glycerin, niacinamide (at low percentages), panthenol and hyaluronic acid to help reduce irritation while your skin adjusts, says Turegano. Stick with the active if the purge is mild and expected, but slow down if irritation creeps in, says Turegano. Keep the rest of your routine boring: use a gentle cleanser, moisturizer and sunscreen, and avoid piling on more actives.
- Breakouts: You’ll need a combo approach tailored to the type and severity of acne: benzoyl peroxide to kill bacteria, salicylic acid to unclog pores and sometimes hormonal or prescription therapies, says Turegano. There are a variety of other anti-inflammatory or anti-bacterial ingredients that can be helpful, including sulfur and retinoids. “If breakouts last longer than six to eight weeks, spread to new areas, become more severe or feel painful or itchy, it’s time to see a dermatologist,” says Turegano.
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Best treatments for skin purging
Best cleanser
If you’re experiencing skin purging, Turegano recommends stripping down your skin care routine and using a gentle cleanser that’ll support your skin barrier. This one from La Roche-Posay is a favorite among our sensitive skin staffers. “This [cleanser] is the rare face wash that actually feels like it’s helping, not stripping everything away and calling it a day,” says NBC Select editorial director Lauren Swanson. “It cleans without foam, doesn’t sting and leaves my skin calm, hydrated and quietly relieved.”
Best moisturizer
This expert-recommended cream has all of the ingredients Turegano recommends for skin purging: ceramides to support the skin, panthenol to reinforce the barrier and prevent water loss, and glycerin to add moisture. It has a thick and creamy consistency that’s hydrating and soothing, so you can put it directly on red, irritated and patchy areas of your skin, according to the brand. You can also purchase this moisturizer in a mini travel size.
Best sunscreen
Round Lab’s Birch Juice sunscreen earned the No. 1 spot on our list of 100 best face sunscreens, and it was a top pick in our roundup of 100 best sensitive skin care products. “As someone with sensitive skin who leans on the drier side, my favorite thing about the Round Lab formula is that it’s genuinely soothing and feels like I’m wearing a thin layer of hydration on my skin, so I didn’t have to layer on my regular moisturizer,” says NBC Select editorial projects manager Rebecca Rodriguez. It’s fragrance-free and has calming panthenol and niacinamide. Best of all, it doesn’t leave a white cast or a greasy residue on your skin, says Rodriguez.
Best serum
This Aveeno serum is one of my favorite products for my sensitive, rosacea-prone skin, and it’s one I used when I was dealing with my skin purging from retinol. It’s lightweight, fragrance-free and absorbs quickly, so I can layer my moisturizer and sunscreen on top without worry. The serum also comes recommended by NBC Select senior editor Nikki Brown due to its creamy texture and stripped down, calming formula.
Best facial spray
If you’re looking for a light, creamy face mist to spray when your skin is red and irritated, this is the perfect one. I have very dry skin, so I’ll usually need some kind of refresher throughout the day to keep my redness and dry patches at bay. This mist has a milky texture that feels both hydrating and lightweight, and it doesn’t leave my skin feeling or looking too wet afterward.
Best treatments for breakouts
Best overall for acne
I’ve written about acne treatments for many years, and one treatment routinely recommended by experts is Differin Gel. It has 0.1% adapalene, an over-the-counter retinoid that treats breakouts and acne. It’s particularly great for stubborn cystic acne since it reduces inflammation, deep cleans pores and prevents new breakouts from forming, experts say. Apply a thin layer of the gel all over your face in the evening, according to the brand.
Best acne cleanser
This cleanser has 4% benzoyl peroxide, which Turegano recommends as one of the best acne-fighting ingredients for those dealing with breakouts. It also combines key ingredients like ceramides, niacinamide and hyaluronic acid to calm your skin and help it retain moisture, experts say.
Best pimple patches
These Peach Slices overnight pimple patches come recommended by NBC Select editorial intern Kalohe Danbara, who uses them whenever she notices a breakout popping up. “I’ll put these on over any spots before I go to bed and, most times, I’ll wake up with the blemishes nearly gone,” she says. Each patch has hydrocolloid, a gel that absorbs dirt, debris and pus, according to the brand. It’s a great way to cover pimples and avoid picking at your skin (which can lead to scarring), says Danbara.
Best acne spot treatment
This spot treatment paste is a favorite of NBC Select editorial operation associate Jem Alabi, who was encouraged to use it by a Sephora employee. “I find that the paste is most successful for pimples under the skin, and it makes the swelling go down,” she says. “The tube is small but I’ve had it for years and I’m not even halfway to being done.” The paste combines clay and sulfur (another ingredient recommended by my experts) to absorb excess oil on your skin, plus azelaic acid, a gentle acne-fighting ingredient for those with sensitive skin.
What is skin purging?
Skin purging is a temporary breakout that happens when an active ingredient increases skin cell turnover, which pushes clogged oil, debris and keratin in your pores to the surface more quickly, says Turegano. That means breakouts can look worse before they get better.
When your skin purges, either due to using a new product or stopping the use of another, it will usually look like an acne breakout with whiteheads, blackheads and pimples in predictable breakout zones, says Dr. William Huang, a board-certified dermatologist and professor at UNC School of Medicine. It’s different from irritation, which will typically look red, scaly and dry, with an itching and burning sensation, he says.
However, there is no real science behind purging. “There are times when medications might be irritating at the beginning of use, like tretinoin or other retinoids, but become more easily tolerated with further use,” says Dr. Amy McMichael, a board-certified dermatologist and professor at Wake Forest University School of Medicine. “If you start a new over-the-counter topical, and irritation occurs, that is a reason to stop that product and get recommendations from your board-certified dermatologist for your skin.”
Frequently asked questions
Purging usually improves within a few weeks. Irritation or true acne, on the other hand, tends to worsen or spread over time, says Turegano.
Yes, and it’s actually very common. “You can have baseline acne from hormones or inflammation while a new active is bringing existing clogs to the surface,” says Turegano. “That’s why context matters: when the breakouts started, where they’re showing up and what you recently added to your routine.”
Strong active ingredients are the most likely to cause your skin to purge. That includes prescription retinoids, alpha hydroxy acids (like lactic and glycolic acids) and beta hydroxy acids (like salicylic acid).
People who are more acne-prone to begin with are also more likely to experience purging, especially if they already have clogged pores under the surface, says Turegano. “It tends to happen in predictable breakout zones,” she says. Acne, on the other hand, is more likely driven by hormones, inflammation, genetics or lifestyle factors. Most importantly, it doesn’t resolve just by “waiting it out,” says Turegano.
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Meet our dermatologists
At NBC Select, we work with experts who have specialized knowledge and authority based on relevant training and/or experience. We also take steps to ensure all expert advice and recommendations are made independently and without undisclosed financial conflicts of interest.
- Dr. Mamina Turegano is a triple board-certified dermatologist, internist, and dermatopathologist.
- Dr. William Huang is a board-certified dermatologist and professor and vice chair for strategic initiatives for the department of dermatology at UNC School of Medicine.
- Dr. Amy McMichael is a board-certified dermatologist and professor of dermatology at Wake Forest University School of Medicine.
Why trust NBC Select?
I’m an updates editor at NBC Select who has written about beauty and personal care for over five years. In that time, I have thoroughly reported on acne treatments and spoken to dozens of board-certified dermatologists on the topic. For this story, I interviewed three dermatologists about the causes of skin purging, how it differs from typical breakouts and the best treatments for both skin concerns.
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