Imagine this: You fork over $200 for 60 minutes of pure, uninterrupted skin bliss. You let your esthetician work their magic, treating your skin to a deep cleanse, some extractions, a bit of a sculpting massage, and any other masks or specialty add-ons essential to make the most out of your facial. But then the unthinkable happens, and in the days following the selfie you captioned “heaven in the hands of a skin angel” on Instagram, your face starts to erupt. Gone is crystal clear, smooth, dewy skin with virtually invisible pores, and in its place are red, inflamed pimples.

A post-facial breakout doesn’t discriminate – it can happen to anyone regardless of the treatment you received. However, the reason why you get pimples can vary. That’s why TZR tapped three experts to get to the bottom of why your skin can sometimes look worse after getting a facial. Ahead, they dive headfirst into the causes of the blemishes you experience the days following your seemingly relaxing spa visit. What they reveal may surprise you, and maybe even have you reconsidering the next appointment you booked with your esthetician.

Why Post-Facial Breakouts Happen

Pimples that pop up in the days following a facial may not be what you signed up for, but chances are they were already brewing under the skin. Dr. Brendan Camp, M.D., a board-certified dermatologist in New York City, explains that post-facial breakouts represent a purge in acne. “Massage, steam, extractions, and the use of exfoliating agents like alpha and beta-hydroxy acids, which can increase cell turnover and potentially cause a temporary worsening of acne, may cause congested pores to come to a head after a facial treatment since they encourage the evacuation of the pore’s contents.”

Sometimes, during a facial, the skin is cleansed more than it is used to, and exfoliating agents can be too harsh for it — both of which can bring impurities trapped within the pore up to the surface. Dr. Karan Lal, D.O., a double-board certified dermatologist in Scottsdale, AZ, adds that any changes to the skin barrier that ensue during the treatment can also result in breakouts. “This can happen after regular facials, HydraFacials, laser facials, chemical peels, and even dermaplaning since all of these treatments, to some degree, induce skin barrier damage, which in turn augments the skin’s microbiome and can lead to breakouts.”

Even though facials clean out the pores to eliminate dead skin, bacteria, and oil from them, if they incorporate potentially pore-clogging, too-heavy-for-your-skin ingredients or strong, active ingredients (particularly if your skin is new to them), they too can be pimple-causing culprits. Samantha Susca, an esthetician at Casa Cipriani in New York City, says using too many active ingredients on the skin can disrupt the skin barrier, causing reactivity, breakouts, and sensitivity.

The physical act of massaging the skin can also be to blame. While Lal says that facial massage is great for improving lymphatic drainage, “It can lead to purging from either occlusion or overstimulation of the tissue.”

Aside from ingredients, massage, and extractions, there’s also the technique portion to consider. Performing a facial incorrectly or too aggressively can irritate and inflame the skin, leaving it angry due to overstimulation or micro-tears, which can cause it to react by breaking out due to increased sebum production. Plus, if the skin is not properly cleansed and prepped before and after extractions, there’s a higher risk for post-facial breakouts, according to Susca. Dirty tools, instruments, and hands are all equally liable for potentially irritating the skin, prompting a breakout, or even worsening acne.

Are Breakouts After Facials Normal?

Post-facial pimples and blemishes aren’t uncommon, but they don’t happen to everyone or occur after every treatment. Even if every step is executed properly, the skin can still flare up due to the amount of bacteria and inflammation that’s present before the facial, Susca says. “If extractions are done impeccably but bacteria and inflammation is looming beneath the skin, it will eventually reach the surface,” she explains. “Increased cellular turnover and stimulation of the lymphatic system make them come out faster, which is not necessarily bad, but rather an accelerated purge (and likely less severe) that would have happened regardless.”

Susca stresses the importance of understanding the difference between a breakout after a facial versus how the skin heals post-treatment. “Even with properly done extractions, the skin and lymphatic system must work hard to heal and detox the skin. Sometimes, the skin might become sensitive and appear textured, like it has hives,” she explains. This type of reaction is often mistaken for a breakout, even though it is not one. She adds, “What is happening is that the lymphatic system allows the bad bacteria in the skin to die off properly and for the skin to heal properly.”

Certain facials, especially those heavy on extractions or deep cleaning, can cause post-treatment breakouts, which is par for the course if your skin is not familiar with them. Keep in mind that if skin veers more on the sensitive side or is acne-prone, a facial can instigate inflammation, leading to unwanted breakouts. However, more pronounced, consistent acne breakouts consisting of large, tender bumps and cysts are not as typical post-facial (but that doesn’t mean they can’t transpire), and Camp says to bring these types of pimples to the attention of a board-certified dermatologist for evaluation.

How To Treat Post-Facial Breakouts

When treating post-facial breakouts, a less is more approach is best to help clear up the skin. Often, one large pimple or a small cluster of them appears, but full-blown acne that never existed before rarely occurs after an aesthetic treatment like a facial. For extra protection, Lal recommends spraying the skin with hypochlorous acid after a treatment to fight off any potential infections.

If a pimple or two pops up, Camp suggests using over-the-counter acne washes or spot treatments, such as those that contain salicylic acid or benzoyl peroxide, and adapalene, a retinoid that can address active acne. Even if the idea of popping the pimple sounds tempting, don’t do it. “Always avoiding popping or picking a pimple, which increases the risk of infection, discoloration, and scarring,” he adds.

Can You Prevent Post-Facial Breakouts?

In the days leading up to your facial, Camp recommends avoiding skin care products with strong active ingredients. These can make the skin more sensitive and fragile, so lay off the acids, exfoliants, and even vitamin C. You also don’t want to wax, shave, or dermaplane your face, as they can remove too much skin and compromise the treatment results.

It’s also a good idea to slightly tweak your skin care routine after a facial since Susca says the best way to prevent pimples from arising comes down to what you use on your skin and how you care for it. While it doesn’t require a complete overhaul, she recommends pressing pause on more potent active ingredients for two to three days to allow the skin to heal without aggravating it. A gentle cleanser, basic, non-alcohol-based toner (if it’s already part of your routine), and a light moisturizer is safe, and anything that touches the skin, such as makeup brushes and sheets, should be cleaned so as not to transfer bacteria back onto the skin. And always wear sunscreen “since some products used during a facial can potentially make the skin more sensitive to the sun,” says Camp.