Patient guide · Starting medical-grade skincare

Your skin is responding.

Here's how to read it.

Medical-grade actives change how your skin behaves, and in the first weeks you can feel them working. Most of what you notice is expected and temporary. A small part is not. This guide shows you the difference, and exactly what to do about each.

Check what I'm feeling See the first 12 weeks
  • ≈4 wksOne full renewal of the skin's surface in young adults. Slower as we age.
  • 2–6 wksThe usual adjustment window while your skin barrier adapts.
  • 12 wksWhen results are typically clear. Consistency matters more than strength.
Three possible readingsMost read here
Skin response guide

Similar signs.

Different meaning.

After starting active skincare, the most useful clues are intensity, dominant sensation, distribution, and whether the skin is settling or getting worse.

Read the pattern
01Intensity
02Sensation
03Distribution
04Direction

01 / ADAPT

The skin is adjusting.

A mild, local and short-lived response can occur when a correctly used active changes cell turnover, unclogs pores or increases exfoliation. It should remain tolerable and trend toward improvement—not intensify.

Recommended response Monitor

Mild · local · improving

  • Brief, mild tingling or warmth after application.
  • Light dryness, tightness or fine flaking.
  • Mild, temporary redness.
  • With some acne treatments, a short initial increase in spots in usual breakout areas—often called “purging.”

Mild peeling that continues for a few days can still be expected when it remains comfortable and is improving.

02 / BARRIER

The barrier is overloaded.

Irritation is a non-allergic injury response. It happens when the combined dose, frequency or product mix exceeds what the skin can tolerate at that moment.

Recommended response Pause

Burning · tender · worsening

  • Burning or stinging that persists, intensifies or returns with water or moisturiser.
  • Pronounced redness, darker discolouration, tenderness or a raw, shiny surface.
  • Marked peeling, cracking, swelling or sensitivity to touch.
  • A reaction concentrated where the product was applied.

03 / IMMUNE

This is not an adjustment.

An allergic reaction is an immune response to a specific ingredient. It may appear after a product was previously tolerated and can extend beyond the exact application area.

Recommended response Stop

Itchy · swollen · spreading

  • Intense itching that is often more prominent than stinging.
  • Hives, raised welts or sudden swelling.
  • Swollen eyelids, lips or face.
  • Clusters of bumps or blisters, weeping, oozing or crusting.
  • A rash that spreads beyond where the product was applied.
The first twelve weeks

Discomfort peaks early. 

Results build underneath.

How your skin feels and what is changing don't move together. The uncomfortable part comes first, which is exactly when people are tempted to stop. Drag through the weeks to see what is happening in your skin.

Week 0
How it feels What's changing in your skin Where people are tempted to stop

Illustrative, not measured data. Every skin moves at its own pace: skin that has never been exfoliated often peels more visibly at first, and older skin renews more slowly.

How it feels
Noticeable
What's changing
Building underneath

AdjustmentWEEK 3

In your skin

Surface cells shed faster than usual and the barrier is temporarily more permeable, so moisture escapes more easily.

You may notice

Dryness, tightness, flaking around the nose, mouth and chin, a pink tone, tingling, and possibly purging spots.

What to do

Hold your frequency. Moisturise generously, wear SPF 50 every morning, and leave flakes to shed on their own.

Spot the difference

Same feeling, different meaning.

Most expected reactions have a look-alike that needs attention. Learn the six pairs below and you will be able to read almost anything your skin does.

Peeling or blistering?PAIR 1
EXPECTED

Fine, dry flakes

Papery flakes that lift and shed, mostly around the nose, mouth and chin. The skin underneath is intact.

STOP

Fine, dry flakes

Papery flakes that lift and shed, mostly around the nose, mouth and chin. The skin underneath is intact.

Pink tone or spreading rash?PAIR 2
EXPECTED

An even pink tone

Mild pinkness only where you applied, fading within a few hours.

STOP

An even pink tone

Mild pinkness only where you applied, fading within a few hours.

A tingle or a burn?PAIR 3
EXPECTED

A tingle that fades

A light tingle or sting on application that settles within a few minutes.

STOP

A tingle that fades

A light tingle or sting on application that settles within a few minutes.

Tight or swollen?PAIR 4
EXPECTED

Tight and dry

Skin feels taut, especially after cleansing. A moisturiser relieves it.

STOP

Tight and dry

Skin feels taut, especially after cleansing. A moisturiser relieves it.

Purging or a new breakout?PAIR 5
EXPECTED

Purging

Small spots where you usually break out, clearing faster than usual. Settles within four to six weeks.

STOP

Purging

Small spots where you usually break out, clearing faster than usual. Settles within four to six weeks.

A dry itch or an allergic itch?PAIR 6
EXPECTED

A mild, passing itch

An occasional itch as dry skin sheds, relieved by moisturiser. Some actives also itch briefly on application.

STOP

A mild, passing itch

An occasional itch as dry skin sheds, relieved by moisturiser. Some actives also itch briefly on application.

Read these eight situations.

Choose the reading you would give each one. You'll see the reasoning after every answer.

Situation 1 of 8

Week two of Retinol Serum. The skin around your nose and chin is flaking, and feels tight after cleansing.

Step 1 of 3 · What you notice

What are you noticing?

Select everything that applies.
How it looks
How it feels
The science

Why active ingredients make your skin feel things.

Every sensation in the first weeks has a mechanism behind it. Understanding it makes the adjustment much easier to sit through.

Your outer layer is a wall

The surface of your skin, the stratum corneum, is built like a brick wall. Flattened, dead cells (corneocytes) are the bricks. Fats such as ceramides are the mortar. Protein rivets (corneodesmosomes) hold each brick to the next. Healthy skin sheds its oldest bricks continuously and invisibly.

Acids loosen the rivets

Glycolic and mandelic acid (AHAs) work at the surface. Salicylic acid (a BHA) is oil-soluble, so it also works inside the pore. Both loosen the bonds between dead cells so they shed. If your skin has never been exfoliated, there is more built-up layer to clear, so the first weeks can look flakier.

Retinoids speed up renewal

Retinoids signal living skin cells to renew faster. Until your barrier adapts, more water escapes from the skin, which is why dryness, tightness and peeling come first, and the results follow.

Stinging is nerve endings, not damage

Acids work at a low pH. Nerve endings register that acidity as a tingle, more so while the barrier is temporarily thinner. A tingle that settles is expected. A burn that lingers is a signal to dial down.

Purging brings forward what was forming

Congestion builds under the surface for weeks before you see it. Faster renewal brings those forming spots up sooner, in the places you usually break out. Then they stop coming.

Fresh skin is more sun-sensitive

Exfoliating acids and retinoids leave the surface more vulnerable to UV. Daily SPF 50 protects the new skin and the results, and with AHAs it should continue for at least a week after you stop.

Five things people believe and what is actually true.

MythRedness means toxins are leaving your skin.

FactSkin doesn't detox through redness. Mild, short-lived pinkness reflects faster renewal and a temporarily sensitive barrier.

MythIf it burns, it's working.

FactResults come from consistent use over weeks, not from discomfort. Lingering burning means the dose is too high for your skin right now.

MythMore peeling means better results.

FactPeeling is a side effect of adjusting, not the goal. Many people get excellent results with very little visible peeling.

MythA breakout in the first weeks means the product isn't for me.

FactSpots in your usual areas during the first four to six weeks are typically purging. New areas or a different kind of bump are a different story.

MythOnce my skin calms down, I should stop to be safe.

FactStopping resets the adjustment and you start again. Dial down instead: lower the frequency, then build back up.

Turn it down, not off

You control the strength.

Most reactions don't mean stopping. They mean adjusting the dose. These are the levers your practitioner works with, and you can use them too. Change a lever to see how the intensity moves.

How often
Cleanser contact time
Leave-on serums and gels
Where you apply
Relative intensity

A comfortable middle. Hold here for two weeks before you step anything up.

Illustrative. Change one lever at a time, and only once your skin is comfortable at the current setting.

The reset protocol

When you've read dial down, follow these four stages.

  1. Tonight
    1.Pause
    • Stop all actives: treatment cleansers, gels, Chemical Peel Spray, Excelerate, retinoid and treatment serums.
    • Keep a gentle cleanse, your moisturiser and SPF 50.
    • A cool, damp cloth for 5 to 10 minutes eases heat.
  2. Days 1 to 7
    2.Repair
    • Cleanse in the evening only, with Dermavue or lukewarm water. Rinse with water in the morning.
    • Moisturise two to three times a day with DermNourish, DermRepair or Enriched.
    • Avoid scrubs, face brushes and devices, hot water, saunas, waxing and anything new.
  3. Usually day 3 to 7
    3.Ready check
    • Your moisturiser no longer stings.
    • Redness has settled.
    • Skin has felt comfortable for two to three days in a row.
  4. Then
    4.Restart lower
    • Bring back one active at a time, one step below your previous frequency.
    • Hold each level for two weeks before stepping up.
    • Treatment cleansers: wet your face first and rinse within 30 to 60 seconds.

The rinse-off rule

If a gel or Chemical Peel Spray burns past the point of comfort, building instead of easing, rinse it off with cool water and apply your barrier moisturiser. You haven't wasted it: rinsing early simply lowers that night's dose. Try again in two to three days.

Caring for flaking skin

After your evening cleanse, press the microfibre sponge from your pack, or a soft lukewarm face cloth, over the skin and lift it away. Don't rub. Never pull or pick at peeling skin; let it shed when it is ready.

Your introduction calendar

Low and slow, planned for you.

Starting one new active on its own, or restarting after a reset? Choose what you are introducing and your start date, and this builds your first eight weeks. If you have a Dermal Diagnosis plan, its tolerance ramp comes first.

What are you introducing?
Pace

Choose what you are introducing to build your eight weeks.

Apply that eveningRest night: gentle cleanse, moisturiser

Step back if you need to. If your skin becomes uncomfortable, return to the previous level for two weeks before trying again.

One new active at a time. If your plan starts several products together, follow its own schedule rather than this one.

SPF 50 every morning, on application nights and rest nights alike.

Your products

What to expect from each active.

Find the products in your plan. Each family of actives has its own typical sensations, and its own rules.

Retinoids

Vitamin A derivatives that speed up renewal

Retinol SerumInflacin SerumTime Freeze Eye Serum
You may notice
Dryness, tightness and flaking, mostly in weeks one to four, and possible purging.
The rules
Evenings only. A pea-sized amount for the whole face. Start on two nights a week and build up. Retinoids are not used during pregnancy.

Professional-strength salicylic

A high-strength salicylic acid treatment

Excelerate
You may notice
Clear stinging when applied, then peeling over the following days.
The rules
Once or twice a month only, on affected areas, as directed. Never on irritated skin. Rinse off if the burning goes beyond tolerable.

Azelaic acid

Pigment-correcting and calming

Litaderm Serum
You may notice
A brief tingle, warmth or itch after applying, common in the first weeks, fading within minutes.
The rules
If your plan also includes a retinoid, follow its ramp: Litaderm usually starts a week later.

Vitamin C

Antioxidant and brightening

Collagen Serum
You may notice
A light tingle on application.
The rules
Mornings, under SPF 50. Pause it during a reset if it stings.

Zinc pyrithione

Medicated, antimicrobial cleansing

Medi-Zinc CleanserFollicure
You may notice
It can feel drying, especially in the first weeks.
The rules
Apply to dry skin with lightly wet fingers and leave on for 5 to 10 minutes, as directed. Keep it out of your eyes.
Your support team

These carry your skin through adjustment and any reset.

Use the ones in your plan. None of them speed up renewal; they protect and rebuild the barrier while your actives work.

DermNourishBarrier-replenishing moisturiserDermRepairVitamin K moisturiser for rednessEnrichedCeramide barrier-repair creamDermavueGentle micellar cleanseDermdefence SPF 50Daily broad-spectrum protectionDermatintTinted SPF 50
Questions

Common questions, answered.

Can't find yours? Ask your practitioner or our team.

How long will the peeling last?

Usually two to six weeks for the first round, while your skin adapts. It can return briefly each time you step up frequency. If you are still peeling heavily after three months, your routine is probably too strong for your skin; talk to your practitioner.

Should I scrub the flakes off?

No. Scrubbing tears flakes away before they are ready and adds irritation. After your evening cleanse, press a soft, lukewarm face cloth or your microfibre sponge over the skin and lift it away. Let the rest shed on its own.

Can I wear make-up while my skin is peeling?

Yes. Apply moisturiser first so make-up sits smoothly, and remove it gently in the evening, with Dermavue for example, rather than rubbing.

Is it purging, or is the product breaking me out?

Purging happens where you usually break out, starts in the first weeks, and clears faster than your normal breakouts. Spots in new areas, an unfamiliar kind of bump, or breakouts still increasing after eight weeks need your practitioner's eyes.

My skin calmed down after I stopped. Is the product not for me?

Usually it means the dose was ahead of your skin. Restart lower and build up more slowly; most people tolerate active ingredients well once the frequency suits them. The exception is anything from the Stop reading. Don't restart those without advice.

Can I use my actives around my eyes?

Keep exfoliating acids and face serums off your eyelids and away from the corners of your eyes, nose and lips, where skin is thinner and product collects. Use eye-area products only as directed.

Do I really need sunscreen every day?

Yes. Exfoliating acids and retinoids make skin more sensitive to the sun, and UV undoes the work they do. Use SPF 50 every morning, reapply when you are outdoors, and keep using it for at least a week after stopping an AHA.

Can I have waxing, a peel or laser while using actives?

Tell your therapist what you use. Waxing skin that is on retinoids or acids can lift the surface, so pause actives on that area for about a week beforehand. Don't book a professional peel or resurfacing treatment while your skin is irritated.

I'm pregnant, planning a pregnancy or breastfeeding.

Tell your practitioner before you start. Retinoids are not used during pregnancy, and there is a separate DermExcel pregnancy range. If you are breastfeeding, ask your practitioner which products suit you.

How soon will I see results?

Skin can feel smoother within days. Clearer pores and fewer breakouts usually show from about six to eight weeks, and changes in tone and fine lines over twelve weeks and beyond. Consistency matters more than strength.