Why Does Skin Get Worse Before It Gets Better
Have you ever started a new skincare routine or treatment for acne, eczema, or another skin issue, only to notice your skin looking redder, itchier, or more irritated right away? This frustrating phase happens often and has a name: it is called purging or an initial flare-up. Your skin seems to get worse before it improves because treatments kickstart natural healing processes that bring hidden problems to the surface first.
Think of your skin like a cluttered closet. When you start cleaning it out, everything looks messier at first as you pull items into view. The same goes for your skin. Many conditions like acne or eczema involve clogged pores, built-up dead cells, or inflammation deep below the surface. Strong treatments, such as retinoids for acne or steroids for eczema, speed up cell turnover. This pushes out debris faster than your skin can shed it normally, leading to breakouts or redness temporarily.
For acne, ingredients like retinols thin the top layer of skin to unclog pores. Bacteria and oil trapped inside rush out, causing new pimples in areas that were already prone to them. This purge phase usually lasts two to six weeks, depending on how backed up your skin was. Eczema works similarly. When you apply a new moisturizer or anti-inflammatory cream, it might disrupt the skin barrier briefly, letting irritants or bacteria cause a short-term flare before the barrier strengthens.
Stress plays a big role too. Starting treatment can feel exciting or worrying, and stress hormones like cortisol ramp up inflammation, making skin react more. Nighttime often worsens this because skin repairs itself while you sleep, but scratching from itchiness introduces bacteria and delays healing. Environmental factors add fuel. Dry air, allergens like dust mites, or even weather changes dry out skin, increasing water loss and triggering cytokines, which are chemicals that boost itching and swelling.
Infections can sneak in during this phase. Eczema-prone skin often has too much Staphylococcus aureus bacteria, and any barrier weakness lets it overgrow, worsening redness. Fungal or viral issues might pop up too, especially if you scratch and spread germs from your hands or nails.
The good news is this worse-before-better stage passes as your skin adjusts. The rapid turnover clears out junk, balances your microbiome, and builds a stronger barrier over time. Patience is key, along with gentle care like moisturizing often and avoiding known triggers such as harsh soaps or certain foods.
Sources
https://harlanmd.com/blogs/smartlotion-blog/possible-triggers-of-skin-eczema-to-watch-out
https://www.youtube.com/watch?v=lCsigC-QQlg
https://www.bangkokhospital.com/en/bangkok/content/get-to-know-3-symptoms-of-atopic-dermatitis
