Tretinoin purge: what it is, how long it lasts, and what helps

Many people start tretinoin hoping for clearer skin, and then see more breakouts in the first weeks. This is often called a "purge". It is common, it is usually temporary, and it is often a sign that the treatment has started to work.

What a purge is

Tretinoin is a topical retinoid. It speeds up how fast your skin renews itself. Clogged pores that were already forming under the surface come up faster than they would on their own. For a short time, you can see more small bumps, whiteheads and blackheads than usual.

The same thing can happen with other retinoids, such as adapalene and trifarotene.

Purge or a new problem?

A purge and other skin reactions can look alike. These signs help you tell them apart:

• A purge shows up where you usually break out. The spots come and go faster than your usual breakouts.
• Irritation looks like dryness, flaking, redness, stinging or a tight feeling. It can be anywhere you apply the cream.
• A new breakout pattern shows up in places where you do not usually get acne, or it keeps getting worse after the first weeks.

If you are not sure which one you have, send a photo to your Care Team.

How long it lasts

For most people, a purge settles within the first weeks of treatment. Results from tretinoin build slowly. Your clinician usually checks your progress after a few months of steady use.

What helps

• Use it as prescribed. A thin layer is enough. More cream does not work faster, and it can cause irritation.
• Keep your routine simple. Use a gentle cleanser and a plain moisturizer. Stop scrubs and other strong products unless your clinician says otherwise.
• Protect your skin from the sun. Retinoids can make your skin more sensitive. Use sunscreen every day.
• Do not pick. Picking can leave marks that last longer than the breakout.
• Do not stop on your own. If your skin is very irritated, ask your clinician first. They can change how often you apply it, or change the product.

When to message your clinician

Message your Care Team if:

• your skin burns, swells or blisters;
• the breakouts are deep and painful, or they keep getting worse;
• you are pregnant, are planning a pregnancy or are breastfeeding. Tretinoin is not used in pregnancy.

Your clinician can change your plan. Options include another retinoid, a combination product, or a different type of treatment.