well hey guys welcome back to the Friday
QA so today I am gonna be addressing
your questions about a condition called
peri oral oral dermatitis I think that
this is a long time coming you all have
been asking me for it for a long time
and um I I'm I think I'm a little bit
overdue so if you're new here welcome my
name is Andrea I'm a dermatologist I
post fun vlogs recipe videos and a lot
of my content on my youtube channel is
on skincare skincare reviews and
different skincare products
and I also have this Q&A on Fridays
wherein I address a topic and the most
frequently asked questions regarding the
topic that come through in the comment
section of my channel so if this type of
content is of interest to you I
encourage you to stick around for more
all right so perioral dermatitis is a
condition that affects approximately one
percent of the u.s. population only so
I'm not exactly sure internationally
what percentage and it seems to affect
predominantly women
it's a condition characterized by small
red bumps that can be painful and and/or
itchy
most frequently located around the mouth
hence it's called perioral dermatitis
additionally it can also occur around
the nose as these little red tender or
itchy bumps or around the eyes in which
case it falls under a broader umbrella
term of peri or official dermatitis and
as I said it's a condition that
predominantly affects women usually
between the ages of 15 and 45 men
however can be affected and people who
develop this condition frequently report
a prior history of using topical
steroids to the face by topical steroids
I mean things like hydrocortisone cream
cortisone cream triamcinolone can our
catalog Club ADA's all steroid creams
that may be available over-the-counter
that you may have gotten from a pharmacy
online or that may have been prescribed
to you and it is
into a history of using steroid
containing creams on the face it's also
commonly reported in people who use
inhaled steroids for say asthma or our
seasonal allergies in the nose like a
nasal spray that contains steroids in it
okay but not everybody gives that
history so you know not having used any
topical steroids or inhaled steroids
does not mean that that perioral
dermatitis is out of the question for
you if you're wondering if that's
perhaps something that you're dealing
with but other causative factors that
play a role and are reported in
association with development of this are
things like kind of hormonal changes
it's probably why it's more prevalent in
women and potentially can you know wax
and wane and flare cyclically also with
oral contraceptives this has been
reported to come out the other things
that have been reported in association
and are thought to be causative
causative or use of fluorinated
toothpastes as well as cosmetic use and
makeup use and heavy heavy foundation
use in particular certain sunscreens can
exacerbate this problem but as far as
sunscreens the study that observed that
noted that it occurred with physical
sunscreens - those containing zinc are
titanium dioxide very high SPF and for
whatever reason that was reported that
particular report was in children
children yes can develop this as well I
don't think I mentioned that but it is
most while it's most common and women
children can also develop it and another
associated factor is neglecting to wash
off your makeup can definitely
contribute to this and or exacerbate it
women who go to bed with their
foundation on and tend to have more
stubborn cases of this because the
makeup makes this problem much much
which is why I always tell you guys who
try and abandon makeup if you can
embrace that trend of the natural face
because it certainly can make this
problem much much worse in addition to
many other skin conditions foundation in
particular and you know everybody will
want to know well what's a good
foundation right that's always the
question there's not a good foundation
okay I just you know I can't recommend
one they all have the potential to cause
problems there's not a magic ingredient
list that would be predictive
unfortunately so the best thing is to
just skip makeup particularly if you're
suffering from this condition because it
can worsen it specifically heavy
foundations as I said the other kind of
the other the other thing that can make
perioral dermatitis worse or flared or
potentially be causative is the use of
occlusive moisturizers on the face and
by occlusive I mean moisturizers that
are in that form okay so things like
Vaseline like aquaphor for example these
should not be on the face particularly
in people with with this condition
because they're very occlusive okay see
this is what it looks like right it
comes out kind of thick and white like
this and it's making its making a skin
skin shield here right this kind of a
vehicle and is great for dry skin on the
body but if you're dealing with perioral
dermatitis this is kind of gonna trap
everything there and just kind of make
it Angry underneath so these type of
moisturizers occlusive moisturizers on
the face can can exacerbate perioral
dermatitis okay there was one small
small study that also showed them that
moisturizers contain the vehicle
isopropyl myristate I'll list that down
below
we're potentially problematic
you know I bring this to your attention
because I get a lot of questions like is
paraffin bad
you know petrol autumn bad no these are
not bad ingredients these are not
ingredients to be demonized but when
they're present in high concentrations
to make something occlusive as an
ointment it's too too much often times
for the poor dense areas of the face you
know the oil bearing lens of our face
it's too much it's too much occlusion at
that high level and it can contribute to
worsening ACK rashes and you know many
people think that it's clogging their
pores but it's really not you know
because perioral dermatitis is almost an
acne like a peering rash but it's not
acne it's not you know zits its not
clogged pores it's really an
inflammatory skin condition that's quite
quite different okay and that occlusion
you know while the moisturizer isn't you
know necessarily deadly it just it can't
breathe okay with that on there so do
you know that heavy moisturizers ponds
cold cream cold creams left on the face
have been reported to be problematic in
this condition okay just because they're
too occlusive and the skin needs a
little breathing room okay so they're
not bad moisturizers they're not demon
they're not ingredients to like be
terrified about but if you have this
condition you want to avoid leaving
things like that on your face and many
people ask me how do I know if I have
perioral dermatitis well my my
recommendation to you would definitely
be to go see a dermatologist for
evaluation and subsequent management
because there are many skin conditions
that look like acne look like perioral
dermatitis look like these things with
very very subtle differences and they
each have different treatments so it's
really important to get an accurate
diagnosis rather than try and self treat
something that you could be totally
wrong about okay but classically
perioral dermatitis were just talking
about around the mouth here you know it
can be for the most part it occurs on
both sides however it can occur on just
one side but it tends to really a spare
the skin just
around the borders of the lips okay so
there's like a little halo between your
actual mouth and then the skin around it
where the skin around it is affected
okay so there's like there's an area of
sparing around the border of the lips
almost like a halo okay in perioral
dermatitis and it tends to be comprised
of little clusters of 1 to 2 millimeter
red papule so red bombs okay that look
like acne but aren't it aren't the same
as acne okay their biology is different
and the overlying skin can become dry
can become flaky this can etch quite a
bit and it can have a burning sensation
to it as well okay while we don't know
entirely what causes the skin condition
one of the things that is speculated is
that it may be somewhat similar to a
condition called rosacea they have some
similar features on biopsy some similar
you know clinical features if you will
the burning stinging sensation in
rosacea the cheeks are often involved in
perioral dermatitis there there tends to
be sparing of the cheeks it tends to
just it you know involving around the
mouth so that's another difference
between those two and one of the other
kind of classic features of it I
mentioned there's oftentimes a history
of using topical steroids or inhaled
steroids so one of the other things that
people can get into a bad habit of is
self treating this condition with
steroids because that steroids actually
will make it go away transiently but
they put you at quite a significant risk
because once the steroid cream is
stopped then the perioral dermatitis
rebounds with a vengeance okay and so
definitely avoid that those steroid
containing creams because they're a bad
bad bad idea on the face and on the face
of somebody with perioral dermatitis in
particular steroid creams on the face
and once prescribed by a your treating
healthcare provider with specific you
know instructions they can have
risks associated with them like thinning
the skin stretch marks discoloration so
I caution you against self treating
things particularly on the face with
over-the-counter or you know somebody
else's prescription steroids it can have
very very adverse effects on you okay
regardless of if you have perioral
dermatitis or what I always caution you
guys against self treating things on
your face you particularly if you don't
know what they are with topical steroids
this this this can be a dangerous dance
okay so don't do it but this condition
but perioral dermatitis is typically
treated with topical antibiotics not so
much because it's thought to be an
infection it's it's not but topical and
prescription antibiotics while they you
know target bacteria they also have
profound anti-inflammatory effects and
so we you know take advantage of that in
dermatology and use these drugs to treat
a variety of skin conditions perioral
dermatitis being one of them so some
common creams that are prescribed or
things like you know
clindamycin cream might be prescribed
natural night is all or metro gel cream
may be prescribed by just some general
measures that you can employ to kind of
help your cause first and foremost would
be to discontinue use of all cosmetics
for at least the short term you know a
few weeks months till things get better
no makeup not even joking no I can't
recommend one they're all problematic
certainly Foundation is a real problem
in this condition
definitely definitely skip it and if you
are somebody who is using a topical
steroid surreptitiously do you know that
abruptly stopping in can make this
really really badly so talk to your
treating healthcare provider say hey
I've been using this everyday rather
than stopping it abruptly it may be a
better situation for you to kind of wean
yourself off of it
with the help of them you know instead
of just stopping it cold turkey try and
just wash your face with honestly just
water alone for a few days no soap the
last thing you want to do is dry out the
skin mirror I think people perceive this
as acne and that they have to
decontaminate the skin or scrub the skin
or exfoliate it and that actually makes
this condition so much worse if anything
just just remove you know residual from
the day with just plain water honestly
no oils no nothing just plain water okay
just let it breathe and then once it has
cleared up then you know use a gentle
I'm kind of soap-free cleanser and I can
list some down below but you certainly
want to wait until the skin has cleared
up and it's not actively inflamed to
start using using any kind of facial
cleanser again because that can
certainly and make this worse and then
once you put sunscreen back into your
arsenal try and pick one that's in a
liquid form or a gel form as those tend
to allow the skin to breathe a little
bit more readily here in the u.s.
sunscreens that are in more liquid and
gel forms are our chemical sunscreens
and they frequently have aim of Ben's
own and so do know that you know there
are sunscreens that blend into the skin
really well but there's sunscreens that
people sometimes can find irritating or
sting around the eyes I will list some
down below that I happen to like and be
a fan of so what is the outlook for
perioral dermatitis well it can you know
it certainly can get better and go away
that being said it can also recur so you
know some people will battle this off
and on and on a continual basis for many
many years but I think with these you
know kind of proactive skincare measures
that I've talked about in conjunction
with the treating physician who can you
know manage prescription antibiotic if
needed or some other prescription cream
if need be or medication that the
outlook is quite good okay it takes
patience and unfortunately the burden is
on you the individual dealing with this
because you know I've just told you
abandon all of you
make up and at the end of the day nobody
wants to have a rash like this around
their face it can be incredibly
alienating and really get you feeling
down about yourself and that's the last
thing that I want for you guys is to
feel badly about yourselves and to have
poor self-esteem and it certainly
certainly cannot go without being said
that having a skin condition like this
or you know any inflammatory skin
condition particularly when it's on your
face it can oftentimes it coincides with
social isolation feelings of poor
self-esteem and depression so if that
sounds like you there is an optimistic
outlook but don't struggle alone feeling
badly about yourself I encourage you to
you know talk to a counselor develop a
plan and some strategies for coping with
this unfortunately the burden is on you
the individual to be proactive about not
only your skin health but your mental
health as well so that is a piece of
this that I don't want you to neglect I
happen to be a fan of the app better
help because it offers you know easily
accessible counseling at an affordable
price
if you're interested in that check the
description box I made a video on it but
I think that can be helpful if you're
battling a skin condition like this and
you know just it really can affect your
your life and I guess you feeling pretty
down about yourself and having having
somebody on your team and not only you
know somebody treating your skin disease
but having somebody helping you you know
be proactive about your your mental
health while you're coping with this it
really really really can be incredibly
beneficial so I would encourage you to
check that out as well but yeah that's
gonna conclude the Q&A this week guys I
hope you enjoyed it I hope that answered
all of your questions about perioral
dermatitis and if you liked this video
give it a thumbs up share it with your
friends and as always don't forget
sunscreen and subscribe thank you guys
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