This is an odd question, but I wondered if anyone else agrees with me on this...
I've had acne since at least age 11, and I've never used any treatment that made my skin "purge" or get worse before it got better. If my skin became worse (as in having a lot more acne), or didn't improve almost immediately, the treatment never worked in the long run. I was always very fastidious about following the doctor's treatment protocol, so it wasn't as if I didn't "wait long enough" for the medication/treatment to work.
I've been on Accutane twice, and neither time then did I have a "worse" period before my skin improved. The acne that was already existing on my skin became slightly more red and tender, but my skin didn't break out before it improved.
After being off Accutane for a couple months recently, the doctor put me on Acanya gel and Tazorac since I was having a very slight relapse. The Acanya gel didn't work when I used it on my skin prior to my second round of Accutane, but this time it seems to help-- again, though, I didn't have to endure any "skin purging" before my skin cleared up.
I can't think of any other medical problem, aside from treatment for cancer, where a person is expected to deal with worse symptoms before improvement! It's not as if you go to see the doctor for an ear infection, he/she gives you antibiotics, and you're told "Your ear is going to hurt a lot more for a while, and THEN it will get better!" It seems almost like a cop-out, since acne (at least for me) seems to go in cycles. Sometimes it will get better on it's own. If I wait six weeks for my skin to "purge", it will almost always go through a week or two where it's better, and then will get worse.
I think that if it's something to do with correcting an imbalance you can break out more initially simply because of the fluctuations you cause when you change factors contributing to whatever it is. When I went on antifungals to treat candida my acne got worse (and I mildly freaked out) and since then it's only gotten better. Perhaps it depends on the individual. Just from the homeostatic nature of most body functions, especially with hormones etc, it could make sense. 
I guess I'm mainly thinking about those who start acne treatments, and have hellacious acne for weeks on end, wondering if they're going through the "purging stages". Getting acne at a slower rate after starting a treatment for a week or two would seem like improvement to me (it's not that I'd expect instant clear skin after starting something). However, having my skin become worse or remain exactly the same for weeks on end usually ended up giving me no improvement at all after a period of a few months.
It's interesting that you mention Candida-- makes me wonder if your skin went beserk for a little while because bacteria had more room to flourish once the Candida was dying off.
Some people's body acne (and I'll bet facial acne) is caused by yeasts-- and using topicals like steroids and anti-bacterial ointments just make them worse! This is another reason I'm skeptical that useful acne treatments cause a long purging period-- to me, it might be more of a red flag that the "acne" is not from a bacterial infection, but from a fungal infection instead...
Oh yes, I think much more than 2 weeks you're out of any kind of 'purging phase'. It's interesting what you said about the topicals aggravating yeasts, I've never thought of that. I do think a lot of acne is unidentified fungal infections, I mean I didn't have any external symptoms except the acne, my doc just picked it up from a blood test and he was clearly right.
@JenGK, You just went to your regular doctor and asked to get tested for this? Or was this a derm or holistic doctor? I didn't know they could test for that and would be interested if it's something fungal.
Accutane and retinoids are pretty much the only acne medications where purging periods have been clinically identified and studied over many years. Yes, in general I think "purging" periods are a bit of crock. But with Accutane/retinoids there is science behind it. They thin the epidermis (upper layer of the skin) and thicken the dermis (lower layer of the skin) and increase cell turnover. This naturally pushes acne that is still in its beginning stages from the lower layer to the upper layer where you can see it.
As for the fungal thing, if you google "candida and acne" or "fungal and acne" you will be reading for hours
@JenGK, You just went to your regular doctor and asked to get tested for this? Or was this a derm or holistic doctor? I didn't know they could test for that and would be interested if it's something fungal.
He is a holistic doctor and he's absolutely fantastic, I think he just picked it up from the specific combo of hormone imbalances and nutritional deficiencies I have... I can't tell you exactly how, I'm sorry!
My acne became slightly harder and more inflamed after starting Accutane (two separate times), but I didn't immediately develop a huge, new breakout. Any treatment that I've tried which still resulted in new breakouts never worked in the long run.
Speaking of holistic doctors-- I sometimes wish I had been given alternate treatments to antibiotics as a teenager for my acne. I'm fairly convinced that when I do have severe acne, the acne itself is immune to all antibiotics now, since I've been an every antibiotic prescribed for acne at one time or another.
Skin purging is most commonly associated with bha acne topical solutions. Murad was the first to use purging to explain why and how their acne complex works.
It just means the product is getting rid of the impurities in your pores. Some may see an initial breakout do to purging but depends on what kind of acne you have.
My skin does not purge with new products. Before I started using the Clarisonic I had been warned by others that it could cause major breakouts in the beginning month due to "the product purging out all of underneath acne that usually would not come up for a few more weeks." On the package, the Clarisonic is supposed to be used twice a day. I started out using it once a day, every other day for about two months and my skin never breakout. In my opinion, people breakout from any new skin product simply because their skin is not used to the product. But if you ease the product into your regular skin care routine, then your skin will have no negative reaction to the product.
I wouldn't say my skin has ever 'purged', but it have had breakouts when starting a new product that are simply coincidental. Normally my skin starts to improve instantly when trying something new. Once I started the acne.org regimen, I didn't breakout until I stopped using it, I was clear by the end of week one and maintained that throughout.
I think it depends on how sensitive your skin is. I do believe that some people purge when starting a new treatment, but others see instant improvements. I think it's just a risk you have to take when starting something new.
