What is Perioral Dermatitis?
Perioral Dermatitis is an inflammatory skin condition that occurs particularly around the nose, nasolabial folds and mouth which can manifest drastically if left untreated or treated inappropriately. It is often misdiagnosed as acne.

What can cause Perioral Dermatitis?
The answer to this question is highly complex as the skin is multifaceted; meaning there is often not just one cause, but many. Perioral Dermatitis can occur if one’s Acid Mantle (first line of skin barrier defense and home to an ecosystem of bacteria) has been compromised due to incorrect skincare products or topical medications such as steroids; which unfortunately do not treat the cause of the condition and breakdown the entire set of epidermal barrier defense systems; leading to skin atrophy (thinning/tearing) and the destruction of bacteria (microbiome) that live on and within our skin.

The Acid Mantle is a protective hydrolipidic film and is composed of a mixture of water, sweat, sebum and epidermal lipids that work to defend it’s integument against the invasion of pathogenic bacteria while also maintaining internal hydration of the lower layers. It also helps to buffer the action of acidic and alkaline chemicals; meaning this defense mechanism slows the absorption of applied topicals without generating an onset immune system response while maintaining a healthy pH balance.

As a Corneotherapist who preserves the integrity of the epidermis at all times, I often wonder how these consumers’ microbiome will be affected by the personal care industry if they continue to expose their skin to toxic skincare/makeup and topical/internal medications such as antibiotics. Will the microbiome survive? That is the question because once our ecosystem of micro-flora starts to breakdown, skin barrier disorders come along for the ride and Perioral Dermatitis is just one of many.

Stress is also very much related with this condition as it’s a blocking factor for essential nutrients such as Omega 3 + 6 (Essential Fatty Acids), Zinc, Magnesium and a multitude of B Complex Vitamins. Psychological stress alters the pH of the Acid Mantle while also releasing cortisol; rendering the epidermis under attack by free radicals (damaging molecules) and inflammatory cytokines (cellular signalling molecules), and this process causes discrepancy to other barrier defense systems such as the Keratinocyte (cells made of keratin), Multi-Lamellar Lipid Structure (Phospholipids) and Stratum Corneum (top layer of skin).

Impaired Enzyme Activity is a leading cause for skin barrier disruption while also being a very common skin condition. Textured skin disorders, incomplete corneocyte compaction (cell formation of one’s Stratum Corneum), high trans epidermal water loss and rough, dry, flaky and scaly skin conditions are all leading symptoms and will trigger inflammatory cytokine production.

Perioral Dermatitis is very much linked to the world of our inner gut health, so it’s very important during this time to seek out a Naturopath who specializes in this field of internal inflammation.

Do you have a potential Filaggrin Gene Deficiency?
Filaggrin is a calcium-binding protein found within our skin and is highly responsible for the formation of NMF (Natural Moisturizing Factor) which relies heavily on a well structured and compacted Stratum Corneum. Those who have a family background originating further away from the equator (Northern European) for example, are more susceptible to having this genetic gene mutation due to intrinsically obtaining the MCIR gene variant (red hair colour). To keep this fairly simple and on track, those with the MCIR gene are much higher risk candidates for this particular barrier disorder and will ultimately make ‘rice bubbles’ for skin cells instead of juicy, plump ‘grains of rice’ for as long as they’re on this earth.

If you suffer from any forms of eczema/dermatitis, peanut allergies and asthma for example, then this renders you highly allergen susceptible for cutaneous disruption that contributes and exacerbates the cause of your external inflammation. Changes in climate can also be a contributing factor for this condition as the higher the humidity, the more heat is produced along with sweat from your sudoriferous glands. If your Acid Mantle is not intact to begin with, then you’ll most likely experience a very hot, itchy and burning skin.

Overfeeding the skin with too many lipids can in turn over nourish the skin and cause an inflammatory response from our cutaneous bacteria. If you have a history of Perioral Dermatitis and you’re beginning to show signs and symptoms of a flare up, discontinue using the Dermaviduals Lotion N (if you have been prescribed this) and come and speak to Mary and I so we can write up a new treatment plan for you. Less is best when it comes to this skin condition.

To summarize, Perioral Dermatitis cannot be cured as you intrinsically own this condition, however, with the right topical products, stress management and internal support, you’re already on your way back to the journey of skin health. Genetic factors aside, you may own them, but it’s our physiological, psychological and lifestyle choices that ultimately pulls the trigger. Prevention, prevention, prevention… ALWAYS.

Written by Kai Atkinson

References:
Dermaviduals.com
Pastiche-training.com
Dermanetnz.org