Why It Gets Worse Before It Gets Better (a.k.a. Skin Purging)

Why It Gets Worse Before It Gets Better
Starting acne treatment can feel frustrating, especially if your skin flares up right after you begin. But this temporary reaction is common, and it’s a sign that your treatment is active beneath the surface. This process is called skin purging, and it often happens before your skin begins to improve.

What is skin purging?
Purging happens when treatments increase your skin’s natural cell turnover rate. Ingredients like tretinoin, adapalene, and benzoyl peroxide help clear out clogged pores, but this can push existing buildup to the surface faster. The result is a short-term increase in breakouts in areas where you usually get acne.

Unlike a reaction to a product that doesn’t suit your skin, purging tends to be temporary and predictable. It often includes small whiteheads or red bumps that come and go more quickly than your usual breakouts.

How long does purging last?
Purging usually starts within the first one to two weeks of treatment and can last two to six weeks, depending on your skin and the ingredients in your routine. For many people, it fades by the end of the first month.

If your breakouts are getting worse after six weeks, or if they appear in new areas where you don’t usually get acne, it might not be purging. In that case, talk to your provider.

How to manage it

• Stick with your routine unless your provider tells you to stop.
• Avoid adding new exfoliants, masks, or treatments during this time.
• Use a gentle, non-comedogenic moisturizer to reduce dryness.
• Keep using sunscreen daily to protect your skin barrier.
• Be gentle with your skin and resist the urge to pick or scrub.

How to tell the difference between purging and irritation

• Purging happens in areas where you already break out and usually begins soon after starting treatment.
• Irritation or a bad reaction can include burning, itching, swelling, or breakouts in unusual places.

If you’re unsure, it’s always a good idea to check in with your provider.

Purging can be discouraging, but it’s a normal part of the healing process. Once it passes, you’ll start seeing clearer, calmer skin.

Sources to learn more:
Mayo Clinic | National Institute of Health | Johns Hopkins