Am I purging or breaking out? Retinal, turnover and the few-week rule

What is purging?

Retinoids speed up the rate at which skin cells are made and shed. In 1994, Saurat and colleagues measured it directly for retinaldehyde: dose-dependent increases in epidermal thickness and in Ki67-positive proliferating cells. When turnover accelerates, the microcomedones that were quietly forming under the surface reach it sooner, all at once, instead of over the coming weeks. That is a purge. It is your existing congestion on a faster schedule, not new congestion the product created.

How do you tell purging from a reaction?

Location and direction.

• Purging: in the places you usually break out. Reaction: in new places, or everywhere.
• Purging: spots come and go quickly. Reaction: stinging, burning, tight or itchy skin that lingers.
• Purging: settles within a few weeks of consistent use. Reaction: gets worse the longer you continue.
• Purging: only from things that speed turnover, like retinoids and acids. A moisturizer or cleanser does not purge; if it breaks you out, it is a reaction.

How long does purging last?

A few weeks is the honest answer, and the retinoid trials support patience rather than a precise number. In the 1998 comparison of 0.05% retinaldehyde with 0.05% retinoic acid in 125 patients, retinaldehyde was well tolerated throughout while the retinoic acid group had more irritation; results on wrinkles were measured at week 18 and the trial ran to 44 weeks. If your skin is still getting worse after a month, that is not a purge and you should change something.

What should you do while it settles?

Do not add anything. New products during a purge make it impossible to know what is happening. Drop retinal to two nights a week if you were using more. Apply your barrier cream first on retinal nights, as a buffer, until things calm. Keep exfoliating acids and benzoyl peroxide to the other nights: compounding irritation has no evidence of compounding benefit. The one exception in the literature is a 2009 French study that deliberately paired retinaldehyde with glycolic acid in adult acne, so the pairing is not forbidden, it is just not for a face that is currently sore.

• Nothing new for four weeks.
• Retinal at two nights a week, barrier cream first.
• Acids on the other nights, or not at all for now.
• Sunscreen every morning, always.

When should you see a dermatologist?

If it is spreading to new areas, if it hurts, if it has not settled after a month of the plan above, or if what you have is acne rather than the occasional breakout. Our products are not acne treatments, and a dermatologist has ones that are.

What we made with it

Coming of Age is 0.1% retinal with squalane, unfragranced, for the night. Baby's Bottom is the barrier cream that goes over it, or under it as a buffer while your skin adjusts. Clean Slate is the cleanser that stays gentle through all of it. That is the whole purge kit, and none of it is new.

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