Have you ever broken out in red rashy pimples within a few days or weeks after using a new product and thought it was acne?  Many who start using topical cosmeceutical or prescription products can have this experience and use acne products in an attempt to dry the breakouts only to discover that it makes their skin worse. This is because those “pimples” are not acne. What is happening is actually a compromised or disrupted skin barrier issue because the new product is too strong for your skin at the time.

The solution in this situation is counterintuitive because instead of using an acne spot treatment, you will need a barrier cream to help your skin recover. Once the skin returns to normal, within a few days, you can reintroduce the product again slowly over the course of a few weeks until it can be used again regularly without a reaction.

A side effect of using corrective products with high concentrations of active ingredients, vitamin A derivatives like retinol or tretinoin (Retin-A), and AHAs, is called retinoid dermatitis, retinoid irritation, retinoid reaction, or AHA reaction. This “dermatitis” can usually be characterized by redness, scaling, dryness, or itching; however rash-like pustules or swollen red “underground pimples” are also very common.

Corrective cosmeceutical and prescription products induce changes in the epidermis that lead to increased and altered cell turnover.  This means that the top protective layer of the epidermis is being shed faster than new cells are forming in the lower layers. This causes the skin barrier function to become “disrupted” and the compromised barrier can no longer adequately protect the cells underneath so the skin REACTS. The level of irritation reaction correlates with the potency of the applied product but there is a solution.

  • Recognize – a sudden appearance of pustular pimples. Immediately STOP using the product
  • Recover – apply barrier cream (or 1% hydrocortisone cream if you have redness / itching) 2-3x day for 2-3 days until skin returns to normal. Recommended are BiON Restorative BalmAquaphor, SkinMedica TNS Ceramide Treatment Cream.  Organic shea butter or coconut oil also work well.
  • Reintroduce – start using the product again gradually.  Apply every other day for first two weeks and then daily. Experiment with smaller doses. You can cut strength by mixing with a plain moisturizer. Find your ideal dose. Maybe you can only use the product 2-3x week on an ongoing basis.

Adjusting the timing, dose, form, and strength of topical product can influence the reaction.  However in some cases, even with repeated efforts at reintroducing the product, it may simply be too strong for your skin.  But you will never know how a product will work for you until you try…