What on earth is skin purging?

By Dr. Hannah Sivak | August 28, 2021

But first: what is purging? It’s the forced removal of something undesirable, like poison, or political enemies. It’s not a nice word and I don’t like to hear it used for anything, including the skin.

Our body has organs that work in concert to keep the dynamic balance that is life. Quacks that pretend to know better than our kidneys or colons or livers are likely to end hurting us while they fill their pockets. It is important that we remember that some people have no problem lying through their teeth and if they have the “talent” they can convince anybody of anything. Ask for credentials, trust but verify. Naivety may be endearing but it is also dangerous.

You can’t purge skin of acne, you can’t use vitamin C to detoxify or purge your skin. You can’t purify your body with niacin, saunas, or exercise to purge it of toxins. There is no data proving anything of the sort. You don’t hear about the failures of these “methods” until somebody dies, but people are fascinated by all things “detoxify” and will waste their money on the quacks promoting these practices.

Where is this fascination with purges coming from? From the time when “medicine” used to kill patients rather than cure them. Physicians used bloodletting with the objective of removing a good part of the patient’s blood. To “draw” infections out of the body these “physicians” burned and used caustic substances on the skin. They administered emetics to induce vomiting, and purgatives like calomel to “purge the bowels”. A purge can quickly kill a patient with an infected appendix. Writing this paragraph, I feel so happy to live now and not in 1860, or even 1930. These are the days of science-based medicine, of antibiotics and vaccines.

Forget about the “four humors” theories of ancient Egypt later adopted by Greek “medicine”. You can go to ancient Greeks for philosophy, but please don’t go to them for medicine. Humorism began to fall out of favor in the 1850s with the advent of germ theory, which was able to show that many diseases previously thought to be humoral were in fact caused by microbial pathogens. Unfortunately, some people are still living in the 1850s.

Purging the skin?

Some people make money out of selling devices that extract sebum from the pores using a pump. True, the pores will immediately make more sebum, and some blood vessels will break in the process. It makes for lots of views on Tiktok, though.

What to do instead

Take advantage of scientific and medical progress. Don’t regress to XVII century’s practices.

One thing you can do is accelerate skin renewal with retinoids, which can be useful for keeping pores open and less likely to evolve into comedos. What you are doing here is accelerating a normal process, rather than interfering with how the skin does its thing. So go ahead and use retinoids and epidermal growth factor. But unless something goes wrong (you will notice!) trust your skin, just as you should trust your body.

Actives like quercetin and fisetin seem to help tissues remove old and sick cells that “refuse” to die; they are called senolytics. Apocynin and ROS* terminator will help maintain the dermal-epidermal junction. Apocynin promotes the synthesis of a COL17A1 crucial for the anchoring of newly formed stem cells, and its end effect will be to accelerate healing, delay aging, and promote skin health. There are many inhibitors of melanin synthesis and accumulation, and you can use them together.

The skin is exposed to an ever-changing environment, including pH, temperature, moisture, sebum level, oxidative stress, diet, immune cells, and exposure to infectious. The skin has a high turnover of cells as it is stressed continuously by the environment. Human skin has evolved to perform “clever” housekeeping in a way that is optimal for survival, cellular functioning, homeostasis, and immune tolerance. Your skin is “purging” its dying cells all the time by autophagy. Let it be. Remember: you are not more clever than nature.