The real cause behind the spots on your chin may surprise you.
The typical response to a breakout is swift and Pavlovian: See a bump, blast it with benzoyl peroxide or salicylic acid. But this time it wasn’t getting better. In fact, the inflamed blemishes around my mouth and chin seemed to get worse.
To make matters worse, my panic resulted in self-manipulation aka attempted extraction, which then led to utter chaos on my chin. Once desperation drove me to seek professional advice, I learned some surprising news.
Is it even acne?
“Hormonal blemishes usually involve the entire jawline,” says Dr Low Chai Ling founder of SW1 Clinic. “Perioral dermatitis, however is totally different. It’s usually found around the upper and lower lip area, the angles of the mouth, and maybe the nose and caused by a yeast bacteria. And it’s often presented as a reddish, orangey, waxy, lumpy, bumpy, inflamed pustule rash that comes in varying severity.”
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What you should not do
Extract: Do not extract, pop, prod or even touch your face, advise doctors. Any form of manipulation will only make your skin worse. These lesions are not due to dirt and will only become more inflamed with pressure.
Exfoliants: That explained why the traditional acne treatments weren’t working. In fact, inflammatory exfoliants can exacerbate perioral dermatitis.
Corticosteroids: What did help was a prescription corticosteroid cream — at least for a while. But the results were short-lived. “If you treat it purely with hydrocortisone, when it recurs, it gets progressively more difficult to control,” says Dr Low. “It hides the symptoms, but it’s not treating the problem.”
What you should do:
Perioral dermatitis is triggered by an overgrowth of bacterial yeast, which can come from stress and humidity. But it can also come from two things that make me unreasonably happy: carbs and alcohol. Dr Low says sugar from bread, pasta, potatoes, rice, booze, and even fruit can all contribute. So lifestyle modification is the best way to prevent those bumps from re-sprouting.
“I advise patients on the proper diet — going to zero caffeine intake, zero dairy intake, and very low carb intake,” says Dr Low. Cutting back on toast, penne, rice-with-everything, and cocktails has been the painful part. But I have seen a huge difference between the weeks I survive on Stromboli and the ones padded with veggies. Smooth skin is a pretty damn effective motivator.
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What I always thought was acne was actually a lifestyle-triggered inflammation. By dialing back the constant smears of salicylic acid and benzoyl peroxide which only added to the irritated appearance, my skin has also gotten softer and healthier. I still get the occasional, tiny whitehead because I don’t want to give up any food entirely. And that’s a tradeoff I’m 100 percent cool with.
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