can aha cause purging?

British Vogue enlisted the help of general medicine consultant and expert aesthetic physician, Dr Ifeoma Ejikeme, to explain what skin purging is, how to distinguish it from an ordinary breakout, and how to deal with it.

“Skin purging occurs when a product or process speeds up the skin’s cell turnover, leading to tiny open or closed comedones that usually manifest as white heads on the skin.”

“Skin purging is not a name you will see in the scientific journals, but it is well recognised in clinical practice. You will usually see terms like ‘inflammatory lesions’, or ‘inflammatory acne’, associated with ingredients which increase the skin turnover. Ingredients like retinoids, AHAs, BHAs, PHA, chemical peels and even lasers can prompt skin to purge.”

“It can last from four days to six weeks, but on average, you can expect it to occur for around two weeks.”

“Purging is neither good nor bad. It can happen after using excellent products but, equally, it also frequently occurs when the skin barrier is compromised prior to starting with a product or treatment. The risk of purging can be reduced if you first repair the barrier function, then slowly start the treatment or introduce the product.”

Read more: 20 Of The Best Retinol Creams & Serums For Every Skin Type

“Breakouts and skin purging are a continuum of each other. With breakouts there is initially a clogged pore which gets inflamed, leading to open or closed comedones. With purging, this process is accelerated and there is usually a precipitant such as a new product or treatment. If you keep going with the product or treatment, you can expect your skin to get better.”

“If the skin barrier is compromised when you see purging then start ingredients which help with barrier repair, such as ceramides and hyaluronic acid in a non-comedogenic formulation. If you are using a treatment or product continue with a slower approach.”

What Causes Skin Purging?

Simply put, skin purging is your skin’s reaction to certain active ingredients, particularly acids, anti-acne ingredients, and retinols, found in several skincare products. These ingredients have the ability to slough off dead skin cells from the pores. This, in turn, speeds up cell turnover, allowing the cells to regenerate sooner than usual. In addition to removing dead cells, these active ingredients also loosen up and remove congestion deep within the skin and push it outward onto the surface. This results in tiny bumps or microcomedones (blackheads and whiteheads). These microcomedones are present deep in the skin and emerge to the surface when cell turnover is accelerated. Also, you may notice your skin flaking and peeling as it purges. Purging commonly occurs around the areas prone to breakouts, such as the chin, nose, and forehead.

What Causes Break Outs?

Acne breakouts are typically a result of excess oil production by sebaceous glands, clogged hair follicles, inflammation, and bacteria. Hair follicles are adjacent to oil glands and may get blocked and bulge due to the collection of oil, bacteria, and dead skin cells. The bulge produces whiteheads, which may darken and lead to blackheads. When the bulge or pores are congested with bacteria, it turns brown and emerges as acne. Breakouts generally appear on the areas of the body with most oil glands, like the face, chest, shoulders, and upper back. In addition, certain conditions can worsen acne breakouts, including hormonal fluctuations, stress, medications, picking pimples, certain makeup or skincare products.

During a Skin Purge

You may at times get a pimple after trying out new products. The pimples that appear on your skin after you add a new product into your skincare routine are actually the acne symptoms that were already forming underneath the surface of your skin.¹  The new ingredients only make them pop up before they would typically have. A skin purge speeds up the process of breakouts appearing on the skin's outer surface, causing different types of pimples.²  These pimples commonly take the form of blackheads, whiteheads, pustules, and cysts.

Difference Between Purging and Breaking Out

As mentioned earlier, many of us make the mistake of thinking skin purging and breaking out are the same thing. This misunderstanding can affect the way you treat or try to prevent them. It is important to remember that the reactions you are experiencing after you start using a new skincare product may not be related to skin purging. The product may be aggravating your skin for a different reason, such as clogging your pores and causing acne or simply accelerating an allergic reaction and leading to skin inflammation. So, a bump you might see on your skin after adding a new skincare product may not be a sign of a skin purge but a regular acne breakout.

Here are a few things that can help you differentiate purging from standard breakouts:

Which Ingredients Can Cause Skin Purging?

To help understand when a skin purge can occur, it’s important to be cautious of all the ingredients that can lead to purging. As discussed earlier, any ingredient that increases the speed of cell turnover can cause purging. So, pay attention to the manufacturer’s instructions about the potential side effects of a product.

Here are the commonly used active ingredients and treatments that can amp up cell turnover and pave the way to skin purging:

What Helps to Reduce Purging?

Well, the answer to this question may not be what you would want to hear when your skin is acting up. Nevertheless, your best course of action is to wait until your skin passes through the phase of purging. Depending on how congested your skin is, it may usually take 2 to 3 weeks for skin purging to subside. Purging is considered to be a sign of your skincare products doing their job effectively. So, be patient and wait for your skin to return to its normal shape.

However, you can do a few things to soothe skin irritation, redness, and dryness. Treating skin irritation due to purging is similar to the way it’s done during regular breakouts. Here are some things you can do to make the purge period less uncomfortable and reduce the severity of skin purge:

Preemptive Approach to Managing a Skin Purge

Besides treating irritation and flakiness, you can take some preemptive measures to reduce the severity of a skin purge. If you’re about to start using a new product that contains an ingredient that can cause purging, incorporate it slowly into your skincare routine. It is recommended to begin with a lower concentration, start with a smaller quantity, and apply it less often. Then, you can gradually get to the recommended usage by increasing the concentration and amount of the product. This mechanism will allow your skin to develop tolerance toward the ingredient, reduce irritation, and speed up recovery.

Also, using gentle skincare products and keeping the skin adequately hydrated and protected can help prevent skin aggravation. In addition, it is commonly recommended to use a mild cleanser and follow with a moisturizer consisting of humectant and anti-inflammatory ingredients.

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Final Thoughts

Skin purging occurs when you add a new skincare product into your skincare routine. It may look like typical acne breakouts, but the conditions are different, with different durations, causes, and treatments. The good news is that purging isn’t permanent and isn’t there to stay for long. It’s just the skin going through a cycle in response to certain ingredients applied to the skin. Luckily, there are numerous measures you can take to manage and control irritation, dryness, and itching due to a skin purge. In addition, skin purging isn’t as gruesome and dreadful as it may sound. It only signifies that the products you’re using are performing their intended duty.

Ingredients like retinoids, AHAs, BHAs, PHA, chemical peels and even lasers can prompt skin to purge.”