image is from The Revelist
It’s a good question — what is my skin really doing? Because there is a difference between a purge, an allergic reaction, and a full on acne flare. They can all take on such similar characteristics, and yet they all need to be cared for differently. You don’t want to tackle a breakout with the ingredients you’d use to tackle allergy inflammation. You don’t want to be using the ingredients you’d use for acne on rosacea.
Our goal is to continuously help you develop an intimate understanding of your body’s largest organ — your epidermal layers. We want you to feel confident in understanding what your skin needs at any given time. While learning the language of your skin, may this guide be one you can turn back to when you’re curious as to what your skin symptoms are really pertaining to.
A full on breakout is what happens from one of four scenarios:
- There is an internal hormonal imbalance manifest as excess sebum production in pores.
- There are too many keratinocytes (dead skin cells) that are not being turned over quick enough so they collect with sebum in follicles, causing congestion. This process of turnover is called follicular epithelial hyperfoliation.
- There is an overgrowth of P.acnes bacteria (as well as other microbes) on the stratum corneum (outermost layer of skin).
- There is an immune system dysfunction in which the body is not handling the site of an infection properly. Either inflammatory cytokines release free radicals into the infection, or white blood cells are unable to kill bacteria after eating them.
See the below example of types of pimples —
* graphic is from Shutterstock
Do you catch the consistency in each scenario? Every breakout is fundamentally a clogged comedo (hair follicle / pore).
A breakout is characterized by whiteheads, pustules, papules, and cysts that come to a head.
A skin purge differs from a breakout in that it is a product-induced ramp up of the follicular epithelial hyperfoliation process (dead skin cell turnover).
A purge happens when you start using active ingredients that your skin has either never used before, or it’s just been a while and so it’s adjusted to receive something different. Every 28 days, keratinocytes (dead skin cells) renew themselves completely — this is the average process for clear, balanced epidermal layers. When introducing a new product, especially one with active ingredients, the rate of keratinocyte turnover speeds up through exfoliation and can bring (even unseen) congestion to the surface.
This is a positive process — it’s one you’re signing up for when introducing a new product with the intention of remedying, nourishing, and protecting your unique skin. However initially, this may not feel like a positive process as the epidermal layers recalibrate to deeper exfoliation and undergo a process of renewal much quicker than they are used to.
Examples of active ingredients that could cause a purge are:
- Salicylic acid and BHAs (beta hydroxy acids)
- AHAs (alpha hydroxy acids)
- Retinoids / Retinols
- Oil cleansing
- * physical exfoliants like an exfoliating stone or gua sha aren’t going to cause a purge, as they only target the stratum corneum. Only active ingredients will cause a purge because they work in the deeper layers of skin tissue, follicles and cells.
A purge is going to look similar to a breakout, but you know it’s different than a breakout because it is completely product-related. Meaning, it is not a result of diet, hormone, stress, etc, and it should get visibly better after 28-30 days. It is the direct result of using a new product that is stimulating cell turnover and renewal.
Purges are likely to happen in places where you are used to breaking out, however they won’t be quite as severe as an acne flare. The whiteheads and papules of a purge don’t often come to a head. Whatever you do, do not pick at them. I repeat: Whatever you do, do not pick at them. Let them be.
If what you feel is a purge continues on or gets worse after 28-30 days, then it’s likely not a purge but rather hormone related acne. If you are being consistent with what products you’re using (meaning, nothing very much has changed in your routine during that time) then it’s time to look deeper into lifestyle factors that could be contributing to the symptoms such as stress, sleep, diet, movement, mental wellbeing, emotional wellbeing, etc.
If after 28-30 days your symptoms do get better and are clearing up, then you experienced a purge. Which again, is a positive process of clearing out dead skin cells and debris. Though the purge process is not ideal, mending symptomatic skin conditions with clean, active products is well worth it in the long run.
AN ALLERGIC REACTION
An allergic reaction looks much different than a breakout or a purge in that it consist of a redness and discomfort more similar to a rash than that of clogged pores. An allergic reaction will consist of swelling, itching, burning, rashes, blotchy patterns, tiny bumps or blistering. The skin may feel hot, itchy, dry, scaly, rough or raw and it may happen in places where you’re not used to having breakouts. It may also happen in multiple places at once.
An allergic reaction is an immune response to inflammation that can occur from product use, or from a lifestyle factor. I personally am very sensitive to too many carbs or sugar, and multiple times when I have eaten a bit too much rice, my skin has manifested the same exact rosacea-type rash on the entire left side of my face. It lasts for about a week with hot, itchy, tiny red bumps, and when I cut sugar, it disappears.
Every body is different. Life is wonderfully complex. The beauty of becoming intimate with your own temple and skin is that you get to understand the unique intricacies of how your body responds to certain influences — what makes it feel at home and what makes it feel disturbed. Highly uncomfortable though they may be, allergic reactions are brilliant, blessed signals of our immune system to tune deeper into what isn’t currently serving us.
If the reaction is product related, you will know because the irritation will occur within 24 hours (usually much less, like within the hour) of using the product. (*Before beginning a new product, especially one with active ingredients, it is always wise to do a patch test first before going full in on your entire face.) If the reaction is lifestyle related, it is a bit trickier to know what could have caused it. If this is where you currently are, take heart and be so gentle with yourself. The immune system does not respond well to stress and anger, so tame the fire with the coolness of breath and peace. Use your own intuition and education about what could be out of balance, and gently self-correct from there.
I hope this guide brought you some clarity as to what is going on with your skin. Our skin can be our greatest road map and teacher when we take the time to really listen in and make the various adjustments it needs in response. We are all unique creatures of divine design and deserve to care for our unique temples without judgement, projection, or shame in any way. Do what is right for you, and allow this to continuously transform and unfold over the course of time.