We all love the Purge…the movie! Nobody likes a purge on their face. But I’m sure you’ve heard the term used to describe a series of breakouts before. But what is a tretinoin purge? And is it really true that your skin needs to get worse before it gets better?
2. The benefits of tretinoin for our skin
4. Is a skin purge from tretinoin normal?
5. What to expect from a tretinoin purge
For those that don’t know or have never heard of tretinoin, let me introduce you to what some dermatologists consider “the fountain of youth.” Tretinoin is a derivative of vitamin A, otherwise known as a synthetic version of the naturally-occuring vitamin. It is a retinoic acid that has many benefits for the skin, but is most commonly used to treat acne.
Now, there are several other terms people use when describing tretinoin or other things associated with tretinoin, and it can get extremely confusing at times, even for me. So, let’s break it down: retinoid is a class of chemical compounds that are "vitamers" or derivatives of vitamin A. It is an umbrella term that includes both tretinoin and retinol. The key difference being that tretinoin is a more potent retinoid. Because it is more potent, tretinoins are only available by prescription, whereas less potent retinols are available over the counter.
Tretinoin is, on average, twenty times more potent than a retinol. This is because tretinoin is pure retinoic acid. Retinol on the other hand is converted into retinoic acid only after it’s absorbed by the skin, and it requires the help of your skin’s enzymes to make it usable. Because tretinoin doesn’t require any conversions, it goes into effect almost immediately. Although tretinoin and retinol technically do the same thing, tretinoin does these things in a smaller amount of time, making people believe it is more effective.
The truth is, it’s specific to each individual person. In terms of reducing pimples, tretinoin works quicker, but because it’s so potent, it can also be more irritating to the skin. So, while a quicker recovery may sound more appealing to you, if you struggle with skin sensitivity, tretinoin may not be the best option. In this case, a less-potent retinol would be better. Although it works slower, the irritating effects would dramatically decrease, and you may find it gives you the same results without such drastic side effects.
Now that we are aware of what exactly tretinoin is, what all does it do for the skin? The answer can vary greatly, which is why it's one of the most widely used ingredients for any skin condition and skin type. The truth is, tretinoin and retinoids in general are used to treat several different skin conditions. The most common is acne, but it also works to treat fine lines, dark spots, sun damage, and to smooth rough textured skin.
It works by regulating skin cell turnover and stimulating collagen production. Collagen is the main protein in your skin’s structure, it’s what keeps our skin plump. And we naturally lose collagen and slow collagen production as we age, causing skin to sag and lose volume. Retinoids also increase blood flow and decrease inflammation.
So, what exactly does regulating skin cell turnover mean? Skin cell turnover or cell turnover in general is the process of producing new and healthier cells that replace existing cells that may have been damaged or compromised. This occurs naturally in our bodies, but does decline with age. If we produce new and healthy skin cells quicker, our skin issues will also correct themselves quicker. For example, if you have a pimple, increasing your cell turnover rate will allow the skin cells to replace faster and therefore the pimple will disappear in less time.
This is why tretinoin has become such a popular acne treatment over the years. But, when your skin cells replace themselves, all of the cells are replaced. Meaning using tretinoin doesn’t just help improve acne, but it also helps to improve fine lines, premature wrinkles, and textured skin.
You may have heard about a purge associated with tretinoin, but there are a lot of myths regarding the topic out there. Because tretinoin increases skin cell turnover, there is this idea out there that everything that is underneath your skin comes to the surface at once, which is where they coined the phrase “it gets worse before it gets better.”
While the logic behind this makes sense, it’s not necessarily true or at least not that simple. Many people believe acne is your skin’s natural purge of its toxins. But, as much as you think certain foods and drinks make you break out, the root cause of acne is simply clogged pores and hair follicles. So, your body isn’t necessarily getting rid of toxins when you start tretinoin.
But, your skin does have some sort of reaction anytime you introduce a new ingredient. So, if this is your first time using tretinoin or any retinoid, your skin will have a reaction, not necessarily good or bad. When people describe the first few weeks of using tretinoin as a “purge”, it’s actually just an adjustment period for your skin which occurs whenever you introduce any active ingredient into your routine.
Like I said, it’s not necessarily a purge but more of a period of adjustment while your skin learns how to stabilize with the addition of this new active ingredient. Actives, and more specifically retinoids, work at the most effective layer of skin.
Your skin has three layers: first is the fatty tissue that makes up your flesh, the middle layer is the dermis and the top layer is the epidermis which is the layer that we can see. The dermis is the layer that contains nerve endings, oil and sweat glands, and hair follicles. Because of this, the dermis is also where acne and pimples form due to clogged hair follicles and pores.
The reason actives work in the dermis layer rather than the top layer, is because they specifically target the source of acne. So, when introducing tretinoin to your routine, it immediately goes into effect in the dermis, which then eventually shows itself in the epidermis. This is why you may experience more breakouts on your face when first using tretinoin. But, once tretinoin begins to work its magic on the dermis, it will take some time for the results to appear visually on the top layer of our skin.
Because it’s just an adjustment period and technically not a “purge”, the amount of time it takes for skin to clear up varies from person to person. Typically, an adjustment period takes no longer than six weeks. Some people don’t experience breakouts at all after using tretinoin, it’s different for everyone.
Something to keep in mind if your skin is going through an adjustment period, you typically will “purge” in the areas that you usually break out. For example, if you have a more oily t-zone and tend to break out in those areas, introducing tretinoin in your routine will cause breakouts in that area specifically. As long as you continue to moisturize, use sunscreen and be patient, your skin will become clearer and healthier after the adjustment period.
If you’ve begun using tretinoin or any retinoid and your adjustment period has lasted for more than six weeks, or you’re experiencing a severe amount of breakouts especially in areas you don’t normally break out, stop using it and talk to your dermatologist, you may be on too high of a dose or need to switch to a less potent retinol. This is one of the myths associated with purging; it doesn’t need to necessarily get worse before it gets better.
Overall, tretinoin and retinoids in general are incredible ingredients that can help with a number of skin concerns. While there's tons of information on the internet about them and more specifically about the skin purge, it’s important to talk to your own dermatologist about what is best for you and your skin.
Written by Jordan Hammaren
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