Purging from Acne Products?

I have a question about the "purging" process that supposedly occurs when you start using certain acne products.  

A bit of history:  I had minimal problems with acne breakouts until about 6 months ago (I am 37 yrs old) when I started getting mild breakouts and blocked pores on my forehead and around my nose.  My dermatologist prescribed Differin, but after about 3 wks it started making my chin break out badly.  This kept up for several weeks and just got worse.  I stopped using the product.  I am now seeing an esthetician who specializes in treating acne.  She has me on a combination of 10% benzoyl peroxide, 10% glycolic and a 15% mandelic acid serum.  I have been on this regimen for about 3 weeks. My chin acne has cleared nicely, but I am getting tiny little breakouts on both sides of my mouth, along my temples and a few on my cheek (where I never break out).  These spots are very small and not inflammed - just tiny little hard plugs popping up.  I would say there are 10-12 of these total across my face and they all popped up during my second and third week of treatment.

I would like to know if "purging" is a real thing that happens with acne treatments?  It seems like all products claim to have "initial breakout" periods or initial purging.  If so, is this likely with any of the products I am using?  

Thanks!

[Alan Rockoff, MD]

Most acne treatments do not have such a "purging" tendency.  I'm not sure why you got so much worse with Differin.  For the most part, acne does what it would have done anyway for the first several weeks after a new therapy is started.  Sometimes this means worsening, sometimes improvement, and sometimes nothing much at all.

Take care.

Dr. Rockoff

[jerseyman]

Acne is a change in the skin that comes about as the hormones start to kick in, producing changes in the body. The hormones will cause an increased output of oil from the oil glands on the face, and this oil is chemically different. Because it's chemically different, it affects the canal of the oil gland and causes the cells to become thicker in the gland. This can cause a blocking of the canal leading from the oil gland to the surface of the skin, and two things can happen. First of all, if the cells swell up enough that they just totally block the pore, then the oil can't get out and it will form what is called the whitehead. In other cases the canal from the oil gland gets narrowed down, and some of the oil gets caught and is exposed to oxygen, which turns it dark - and that's a blackhead that will plug up the pore. The oil can't get out and pressure builds up because it is still being produced in the gland. Bacteria that are normally present rupture in the surrounding skin and causes inflammation, and that causes a zit or a pimple. It's not really an infection; it's a condition of the skin produced by the changing hormones. It is something that can be treated with a fair degree of success if patients understand what's going on.

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