Purging vs breakouts: how to tell the difference between the two

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Lucy Partington
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‘Purging vs breakouts’ is probably a term you’ve googled more than once – so we asked dermatologists to differentiate between them once and for all.

Breakouts, spots, blemishes, acne, whatever you call the pesky things that pop up on your face at the most inconvenient of times, it’s something everybody has likely had to contend with at various points throughout life. Whether it’s while you were a teenager or if it’s something that’s plagued you into adult life, know that you are not alone.

However, the big question is this: when is a breakout not actually a breakout? When is it actually considered as purging? And, importantly, what is purging and what causes it? 

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To save the constant Google searches (or is that just us?) we asked the experts all the vital questions, including what the actual difference between purging and breakouts is, whether the two should be treated differently and how long purging usually lasts.

Here’s everything you need to know.

 What is purging?

“Purging is the term given to the increase in spots and inflammation that has been described when starting a new treatment for acne,” explains Dr Tim Jollyman, clinical lead at Dermatica. “Many people notice when they start a new treatment for acne, the appearance of their skin temporarily worsens before it improves and they start to see the benefits of the new treatment. This is purging. If someone has started a new regime for acne and their acne has worsened as a result, it is likely to be purging,” he adds.

Is there any way to tell the difference between purging and breakouts through the visual appearance?

“New areas of congestion, increased white and black heads, small red breakouts can all be signs of purging,” says Dr Jonquille Chantrey, SkinCeuticals expert, surgeon and founder of One Aesthetic Studio. “Active ingredients increase cell turnover for the old skin to be shed and new to surface. In this process the congestion that is building is brought out faster.

Are there any specific ingredients or products that cause purging?

“The new introduction of a therapeutic ingredient to treat the acne can cause an initial purge. Retinoids such as tretinoin have been shown to produce this in a minority of patients,” says Dr Chantrey. “Other ingredients include Vitamin C, retinol and other topical acids,” she adds.

Dr Jollyman concurs, adding that purging is has also been associated with many different treatments, including microabrasion and laser therapy.

Is purging something to worry about?

“No, it can be normal and many patients will see it settle within the first month of continued use of the new active ingredient,” says Dr Chantrey. “A study showed that it was more common with the use of tretinoin alone than when it was combined with other topical ingredients that have an antibacterial mechanism of action.”

How quickly does purging start and how long will it last?

“It normally starts within a few days of initiating a new treatment and can last for up to six weeks,” says Dr Jollyman. “However, it is important to persist with treatment as the skin will improve in the longer term.”

However, purging can sometimes be a result of underlying acne. “This can happen in a small subset of patients and the inflammatory lesions could be the result of that acne overcoming the anti-inflammatory activity of the active ingredient. In those cases, we monitor the patients and adjust the products being used accordingly,” explains Dr Chantrey. 

Should purging be treated differently from blemishes?

“Purging is indistinct from acne and the additional blemishes with it should be treated in the same way,” says Dr Jollyman.

Dr Chantrey agrees, adding that, “Breakouts, acne, blackheads and whiteheads will have an underlying cause such as hormones and stress, while lifestyle factors such as incorrect makeup and skincare for the oily skin type can exacerbate it. A full medical consultation with a skin expert will determine underlying causes, but I tend to recommend SkinCeuticals Blemish and Age Cleanser, £40 and Blemish and Age Defense Serum, £90 as they have active ingredients that reduce the inflammation. They are also helpful in reducing the breakout purging that can occur when introducing new ingredients.”

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Lucy Partington

Freelance beauty editor Lucy Partington is obsessed with all things skincare, collecting eyeshadow palettes that she'll probably never use, and is constantly on the hunt for the ultimate glowy foundation.