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Dermatologist Dr Dray on how to tell the difference between skin PURGING VS IRRITATION. What is skin purging and why does it happen? How long does purging last? What is the difference between purging vs breaking out? How to prevent skin purging and how to treat skin purging.

Well hey guys in today’s video i’m going to be talking about purging today i’m going to talk about what purging is how to know the difference between purging and irritation how to prevent purging and how to treat purging purging refers to a skin reaction to an ingredient that exfoliates the skin and it basically is the transient worsening of acne due to the

Increase in skin cell turnover this happens with ingredients that are basically chemical exfoliants or retinol chemical exfoliants include alpha hydroxy acid and it also includes beta hydroxy acid or salicylic acid and benzoyl peroxide another ingredient that exfoliates the skin and then of course retinol as these ingredients exfoliate they slough off the top

Dead layer of skin cells allowing new healthier skin cells to come to the surface but with that they can bring along any subsurface acne you may see that you’re getting more pimples and that’s what’s referred to as purging this process does not occur because the ingredient causes more acne it occurs because the ingredient brings about acne that already existed

You just couldn’t see it acne starts under the skin as a micro comedo and then with time that pore becomes more plugged up and inflammatory cells come in and that’s why you get redness and pustules sometimes you get blackheads you get whiteheads eventually but with the retinol or the chemical exfolia because it’s increasing skin cell turnover it’s going to

Expedite the appearance of that lesion that is sitting under the skin the good news is that the purging process is temporary it typically lasts around two to three weeks in which you’re going to notice more pimples the acne that you’ll start seeing during this purging process you may note is different in appearance than the acne that you typically get it may be

More red inflamed you may have more pustules which are those little pus filled bumps and the reason for this is that the retinol or the chemical exfoliant that you’re using because it increases skin cell turnover one thing that happens is that you also end up losing a lot of water out of the skin that leads to dryness and more irritation and more inflammation in

The skin so your acne may become temporarily a little more inflammatory and may look a little angrier so to speak than your baseline acne now not all skin reactions that happen when you start a chemical exfoliant or retinol not all of them are purging so how do you tell the difference between purging and irritation well think about the duration purging which is

The transient worsening of acne it should really only last two to three weeks i read sometimes on you know different internet forums or even in the comments people will say i’ve been purging for months now that’s not purging off the bat purging should not last that long should really only last a few weeks anything longer than that it’s probably that the product

Is too irritating and you should check in with your dermatologist to reassess if that’s right for you it may be something else in the product or the prescription that you’re irritated by or maybe something else that you’re using at the same time another way to tell the difference between purging and irritation is the location of the breakout if you’re having

Breakouts on areas of the face for example that in the past you never had breakouts chances are that’s actually irritation because remember the ex the exfoliant or the retinol it’s really just accelerating the rate of appearance of existing acne so if you’re getting breakouts in areas that you never had acne before that’s more likely irritation if you’ve developed

A reaction to a new product and you’re wondering is this irritation or is this purging take a look at the ingredients ingredients that can cause purging are going to be chemical exfoliants and retinol so things like alpha hydroxy acid beta hydroxy acid benzoyl peroxide and retinol retinaldehyde adaptolene tretinoin to zeratine or tazerac these ingredients are

Prescription medications they increase skin cell turnover so they’re likely to be associated with purging now they can cause irritation as well but if you’re using a product that doesn’t have those things in it like a moisturizer uh more often than not that’s going to be an irritant contact dermatitis to to something in the product maybe it you know is is too

Occlusive and it’s causing an irritant acne like reaction all right so now that you have an idea of what purging is and how it differs from irritation how can you prevent purging that two to three week period of time of worsening of acne when starting a chemical exfoliant or retinol truthfully you can’t prevent it and you know just kind of reconcile with the idea

That the purging process is a manifestation that the ingredient is at least working for your skin however there are some things that you can do to minimize the extent the severity if you will of purging first of all make sure that you are moisturizing consistently i recommend actually amping up your moisturizing game a few weeks before starting a retinol to make

Sure that the skin barrier is hydrated and healthy you don’t want to start retinol or retinoid or a chemical exfoliant on dry skin that will increase the risk of irritation and add to the trans epidermal water loss so that’s going to make the purging process more inflammatory for you the other thing to do is to avoid excessive sun exposure and protect your skin

From the sun with sunscreen and sun protective clothing sun drives more inflammation into the skin more irritation that’s going to make the purging process more inflammatory for you and also put you at risk for post-inflammatory hyperpigmentation melanocytes are going to be too active and you know that purging process can end up healing with a dark mark which

You don’t want and then the other tip to reduce the severity of purging is to go really slow with starting the active ingredient use just a small amount i think there’s this idea that you need a big glob but really you only need a thin film to cover the face in the case of treating the face same goes for any body site by the way um but yeah go really slowly and i

You know i recommend trying the ingredient once a week uh for a few weeks then increasing to maybe twice a week every other night then up to daily that slow introduction allows your skin to kind of get used to some of the drying and irritating parts of the topical and so it’s going to reduce the severity of the purging process can be less inflammatory if you go

Really slowly and conservatively versus going all at once and make sure you scrutinize your other skincare products before starting a chemical exfoliant or a retinol make sure you’re not already using ingredients in your skincare routine that exfoliate the skin for example some moisturizers may have alpha hydroxy acids in them which can lightly exfoliate that’s

Going to potentially exacerbate the severity of the purge when say for example you start a chemical exfoliant or a retinol you’ve already got a chemical exfoliant on board but if you’re coming here and you already are in the throes of purging how do you treat purging truthfully you kind of have to just wait it out and be patient as i said it should only last

Two to three weeks if it lasts longer than that definitely check in with your dermatologist to reassess what it is that you’re doing make sure that there are you know isn’t something else in your routine or some other ingredient that is aggravating your skin don’t pick pop squeeze or manipulate anything on your skin ever but if you’re going through the purging

Process and you start squeezing or trying to extract really that that’s just going to make your skin angrier and rebel and it’s going to make things more inflammatory it’s going to push you over to that irritant dermatitis side of things and it’s going to last end up lasting longer for you so don’t manipulate your skin with any tools or devices really make sure if

You are in throws especially of a purge that you are being very diligent with the sun protection because again you don’t want that purge to heal with any hyperpigmentation you don’t want to drive excessive inflammation into the skin through sun exposure so make sure that during during i mean all the time make sure you’re protecting your skin from the sun but you

Can see how it’s really important in this setting in particular and then of course continue to moisturize i think people are very fearful of moisturizers that they’re going to break them out even further they’re going to clog pores but truthfully remember as your skin is exfoliating you now have a barrier defect going on that needs a dressing with a moisturizer

Because that barrier defect is going to cause you to have more water loss out of the skin more dryness more irritation that’s going to lead to more peeling and aggravated skin so you want to make sure that you’re moisturizing and i recommend starting on a clean face that you have already moisturized before applying the chemical exfoliant or retinol that way you

Are setting yourself up for success because if you put it on dirty skin or skin that you’ve just washed and not moisturized the skin barrier is impaired and you’re more likely to develop irritation so do it that way it doesn’t interfere with the penetration of the active ingredient to do it that way it reduces irritation this isn’t going to stop or get rid of

Purging but it’s going to make it more bearable it’s going to make it less inflammatory and then it’ll be over and you know it’s a good sign if in a sense because it shows you that the active ingredient is actually getting in and facilitating that skin cell turnover so it’s a good thing but hopefully these tips help in reducing the severity and then the last tip

For dealing with purging is make sure that you are not over cleansing and by over cleansing i mean washing your face multiple times a day using harsh cleansers that strip the skin barrier using hot water to wash your face all of these things they’re just gonna you know they’re gonna strip away your lipid barrier even further they’re gonna cause you to have more

Water loss out of the skin they’re gonna worsen that dryness and irritation so i mean obviously you do need to wash your face but just keep it to like once a day in the evening time to remove sunscreen cosmetics dirt etc and stick to a gentle cleanser using of course lukewarm water as i suggested good news though if you are going through purging you know it is again

Just temporary it’s not causing the acne it’s really just bringing acne to the surface that was already there but if it lasts longer than three weeks definitely check in with your derm that’s not typical and it’s a sign that maybe something else is going on so i hope this video was helpful to you guys in terms of clarifying the differences between purging and

Irritation and how to deal with purging and if you like this video give it a thumbs up share it with your friends and as always don’t forget sunscreen and subscribe i’ll talk to you guys tomorrow bye you

Transcribed from video