Is It Normal for Acne to Worsen in the First Month of Using Retinoids?

Topical Retinoid (Tretinoin)

Is it normal for acne and pimples to worsen and become red and swollen during the first month of using first-generation retinoids?

Penny, 20~29 year old female. Ask Date: 2018/05/16

Dr. Wu Yuxin reply Dermatology

Without actually seeing the lesion, it is impossible to determine the issue.
You should consult your prescribing physician, as they are most familiar with your condition.

Reply Date: 2018/05/16

More Info

When starting treatment with retinoids, such as first-generation retinoids (like tretinoin), it is not uncommon for some individuals to experience an initial worsening of acne. This phenomenon is often referred to as "purging." During the first month of using retinoids, the skin undergoes a process of accelerated cell turnover, which can bring underlying clogged pores and acne to the surface. As a result, you may notice an increase in the number of breakouts, redness, and inflammation.

This initial reaction can be concerning, but it is generally considered a normal part of the treatment process. The retinoid works by promoting the shedding of dead skin cells and preventing the clogging of pores, which is a key factor in acne development. While this purging phase can be frustrating, it often leads to clearer skin as the treatment continues. Most dermatologists advise patients to be patient and consistent with their retinoid regimen, as improvements typically become noticeable after the initial adjustment period, usually within 6 to 12 weeks.

It is essential to follow the instructions provided by your healthcare provider regarding the application of retinoids. Start with a lower concentration and gradually increase usage as your skin adjusts. Additionally, using a gentle cleanser and moisturizer can help mitigate irritation and dryness that may accompany retinoid use. If the redness and swelling become severe or if you experience significant discomfort, it is advisable to consult your dermatologist. They may recommend adjusting the frequency of application or switching to a different formulation that may be better tolerated.

In summary, experiencing an increase in acne and redness during the first month of using retinoids is a common occurrence and can be viewed as a part of the skin's adjustment process. With continued use, many individuals find that their skin improves significantly, leading to clearer and healthier skin over time. Always communicate with your healthcare provider about your experiences and any concerns you may have during your treatment.

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