So you made it through your adolescence and 20’s without suffering the indignity of becoming a pimple face only to wake up one morning with… an eruption of papules and pustules, which propel you, back to your teen years like some sick episode of the Twilight Zone. ACNE?
ACNE? Ugh! But, wait a cotton-picking, zit-squeezing minute! You’re over 30! Who ever heard of such a thing?
Actually, it’s not REALLY acne, per se. Oh, I know. It LOOKS like acne and FEELS like acne and it causes your teenager to snicker, but dermatologists have christened it with a different moniker–PERIORAL DERMATITIS. There, don’t you feel better? Doesn’t that have a poetic ring to it?
Perioral dermatitis is an eruption that occurs . . . go figure–periorally! (literally, around the mouth.) Although, sometimes it can occur around the eyes and on the eyelids. It generally is located on the chin, lower cheeks and surrounding the mouth. It tends to spare the naso-labial folds (the crease between your nostril and the corner of your mouth).
The cause is idiopathic (i.e. we haven’t the foggiest!), however, it IS known that using topical steroid creams can precipitate the condition.
If you figure that you have perioral dermatitis (and making the diagnosis isn’t rocket science), the first order of business is to stop all steroid creams and moisturizers. Then get to your family doctor (you really don’t need to bother a dermatologist for this one), and she can prescribe either tetracycline or minocin, two antibiotics that have been shown to be effective for this condition. The former has to be taken 4 times a day and can cause a lot of stomach upset; the latter is more expensive, but well-tolerated and only taken once a day.
People are often confused as to why they were prescribed an antibacterial agent when bacteria are unlikely to be the cause of the problem. These antibiotics are actually employed for their anti-inflammatory properties in this condition.
Once you get the condition under control use a simple face-cleaning regimen.
Start with a very basic, nondrying, non-irritating cleanser, such as Dove or Alpha Keri. Soaps are alkaline (pH 9-10) and skin is acidic (pH 6). Thus, soaps are often a source of contact irritation, which can aggravate dry skin. Cetaphil, and Spectrogel are two cleansers that are soap substitutes. They are non-irritating and won’t dry your skin excessively.
If you feel the need to use a moisturizer, make sure it is an OIL-FREE product (not just water-based). Look on the label for the words “non-acneogenic” or “non-comedonic” (a term that refers to blackheads and whiteheads).
Of course, it goes without saying (but I’m gonna say it anyway!), that you always use a sunscreen when exposed to the sun’s harmful rays (we’re talking SPF 30 or higher); that you stay out of the sun between 10am and 2pm when the rays are harshest, and that you wear a wide-brimmed hat while on the beach.
Yes, sun exposure can aggravate most skin conditions but, more importantly, nothing ages a woman like the sun. We can easily get your perioral dermatitis under control–but if you come to me in 10 years complaining of crow’s feet and fine lines around your mouth–there may not be a lot I can do about it!
An ounce of prevention . . .
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