• Suzi Sailer

Acne? Maybe Not....

Acne? Or is it something completely different?

I see a very wide range of clients at my office (14-mid 80’s). Many patients suffer from a skin condition that they think is acne, but it is actually something very different. This specific condition is often misdiagnosed, and treated incorrectly, which can lead to exacerbation as well as frustration for the patient.

Perioral Dermatitis is a condition that causes small clusters of red bumps around the nostrils, nasolabial folds, and chin/mouth area. Most patients assume that is is an acne breakout, and apply a topical ointment or cream such as a steroid or benzylperoxide, which can aggravate the symptoms. This condition is most commonly seen in girls and women between the ages of 15-45. The symptoms usually include either red or pink colored bumps that surround the nose, nasolabial folds, mouth, and chin area. The way the condition is diagnosed is usually by the pattern, as well as symptoms such as itchiness and the fact that it most often appears “all of the sudden”.

There is no clear cause for the condition, however there are many things that studies have shown may trigger perioral dermatitis. Some patients have developed the condition after use of steroids(both topical and nasal steroids). Other triggers may include oral hygiene products, food sensitivities/allergies, and stress. It is very important to think about recent changes in diet, products, or lifestyle issues that may have stimulated or triggered the condition.

The treatment for perioral dermatitis is not so “cut and dry”. First off, as a practitioner, it is very important to have an in-depth consultation in regards to any changes a patient has made in regards to diet, skin care, environment etc... Asking about possibilities of/or current intolerances or allergies to foods etc... After thoroughly investigating the health history, the next step is to evaluate the current skin care routine. A “gentle” routine is important in individuals with perioral dermatits, to eliminating the “harsh products while treating the condition is important. These products may include exfoliating agents, products with retinol, tretinoin, hydroquinone, or products with additional “fillers”(perfumes etc...), all of which can dry out the skin and exacerbate the condition.

The optimal treatment will begin with a very gentle face wash, and often a sulfar mask. Depending on the patient, a topical and or oral medication is used to treat the condition. Topicals prescribed may be an immunomodulator such as pimecrolimus, or Soolantra, (used to treat eczema), or a topical antibiotic like erythromycin. In addition, a prescription of oral doxycycline may be added.

The most important thing to remember is that while this condition can be difficult to treat, and may take months to “clear-up”, it is definitely treatable with the right regime.

If you are suffering from a dermatologic condition and would like to schedule a free consult, please call and make an appointment. We would be happy to help!

~Refresh Med Spa

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