Esthetician

Stubborn Acne Around the Chin and Mouth

As an
Esthetician specializing in Adult Acne and Sensitivity, acne in pores where oil
glands are larger due to being located in the “T-Zone” but where pore sizes are
smaller due to facial contours, is the most common problem I see in my clients,
both in the salon and in my
online adult acne coaching service
 across the nation.  Excess oil from all kinds of hormonal changes
rush into pores causing inflammation of pore linings, resulting in swelling,
redness and pain.





These
areas of larger glands and smaller pores are located on the sides of the chin,
around the mouth, the inner cheeks, and between the brows.
  Sometimes, the sides of the chin will also
extend to the inner jawline and lower cheeks.
 
 


These are
typically called “
hormonal areas”, to which I have quite a few responses, but I
feel the most important point to make is that all acne is technically
hormonal.
  The difference between one
breakout and another for adults late 20s on up will depend on the level of oil
production at any given time plus how much a pore is clogged by cosmetics or
pulled tight by dehydration.
 Painful
breakouts in these areas are not necessarily indicative of a hormonal imbalance.
  By the same token, “it’s just hormonal”
sounds dismissive and unhelpful.
Are you sure your chin breakouts are hormonal?Calming
inflammation with ice and either
clay mask 
or salicylic acid as soon as these breakouts are seen or felt is
the best way to get rid of breakouts aggravated by rushes of oil inside
pores.
  There are many things besides
hormonal shifts that can trigger these kinds of breakouts;
too much iodine in the diet,
 friction from hands, phone or pillowpore clogging materials on hands or face from acne-aggravating skincare, makeup, hair care and hand/body lotions getting pushed into pores, to name a few.  When these are removed from one’s kitchen and bathroom and replaced by skin-friendly alternativesacne clearing starts immediately.

And yet
sometimes, it doesn’t.
  Sometimes, it’s
so stubborn, I really have to wonder if something else is going on.
 Sometimes something entirely different, which
doesn’t
always look like acne, can look
exactly like acne
.

What else
could it be??

One fairly common skin condition
that can look exactly like acne is actually an acquired allergy/sensitivity,
called Contact Dermatitis. 

Contact Dermatitis on the hands.On the
hands it looks like dryness gone amok, most often caused by continual exposure
to strong detergents in things like dishwashing liquid and shampoo.  These detergents can dissolve so much of the
skin’s protective components, water can escape from “broken” sections of the
skin in a process called Trans-epidermal Water Loss, or TEWL.  In addition to the extreme dryness this
causes, blood vessels and nerves are now closer to the surface in these areas, leading
to extra sensitivity, redness, and itching or burning. 
Certain
topical drugs are also known to cause Contact Dermatitis, like Neomycin and
Hydrocortisone, and even a few natural substances can, like Lavender and
Jojoba.
  One very popular lip balm has
been found to cause Contact Dermatitis in many people.
 

So what about the chin and around the mouth?  The usual suspect is the foaming agent in
most toothpastes.  Some people can also
acquire a sensitivity to either the mint or cinnamon, or both, that are also in
most toothpastes as well. 

Chin breakouts caused by over-exposure to foaming agents in toothpaste.

If you
brush your teeth after (or without, yeah I’m looking at you) washing your face
and then rinse with a cup, after which you wipe away leftover foam with a
towel, and if you don’t rinse your mouth like crazy and tend to drool even just
a little at night, the residue left over after wiping, or the little foam that
makes it’s way down your skin with your drool at light, can irritate your pores
so horribly over time, you can end up with an ongoing breakout that never seems
to go away no matter what you do.  This
is Contact Dermatitis. 

When I
see breakouts on the sides of the chin that are close to the lower lip,
especially when they’re located more on one side than the other, and if there
is angry redness surrounding these acne-looking blemishes, or if they’re located
directly underneath the lip with the outsides of the breakouts going in a
downturned pattern, I first ask how long the breakouts have been around, and if
they’ve always been in this particular pattern. 
If the answer is long time and yes, then I ask about the client’s
brushing routine.

Sensodyne Pronamel possible solution to stubborn breakouts around the chin and mouth.

No acne
medicine or skincare treatment is going to touch this.  The offender has to be taken away, plain and
simple.  The treatment is to always brush
your teeth before washing your face, rinse extremely well inside your mouth and
outside, and cut out all peppermint and cinnamon from your diet until the problem
clears.  More importantly, you must
switch your toothpaste to one that has none of the foaming agents that cause
this problem.  A good choice is Sensodyne
Pronamel.  What to look for and avoid
:  Sodium Lauryl Sulfate and Sodium
Laureth Sulfate.

~~~~~~~~~~~~~~~~~~~~~~~~

“I’ve got this breakout around my
mouth and my nostrils.  It never seems to
go away, nothing ever works, it’s really irritated, dry and flakey, and it
sometimes itches.  I’ve used drugstore
acne meds, coconut oil, all kinds of cleansers and nothing.  A while back I even tried Cortaid, cleared it
up a little bit, but then a week later it was the worst it’s ever been.  I tried extracting the little pimples there,
some are little white heads, some are just hard red bumps, but most of them
don’t come out at all.  They just keep
persisting.  Help!”  -Meghan P.

After reviewing all of her
products, allergies and photos sent with her Eval by Email® form, I was sure
this was something called 

“Perioral Dermatitis”.

Perioral
Dermatitis in actuality looks more like a rash than acne.
  But when the wrong remedies are used
(especially coconut oil, which is highly
comedogenic), it can flare up in such
a way that it can look more like a collection of small acne blemishes.
  Hence the mistaken identity.  Aside from its rash-like appearance, stopping
about a ¼ inch away from the entire lip line is another telltale sign (although this does not always happen).
  Within the rash are tiny pimples with and
without white heads, occurring mostly in clusters.

It can affect men, but most often it occurs in women.  

Peri-Oral Dermatitis could be the answer you've been searching for.

 It can be caused by several different assaults, such as the skin’s
barrier being compromised by harsh products resulting in a change in the skin’s
natural flora, overuse of steroidal medications such as nasal sprays and eczema
creams, surface bacterial infections, and immune system issues.
  Interestingly, it has not been found to be
connected to yeast.
 

The most
frustrating thing about Perioral Dermatitis is that can be quite difficult to
get rid of.  Using Mandelic Acid in my
facials and low dose every-other-day application of Benzoyl Peroxide has worked
in some cases, but aside from making sure skincare is hydrating, calming and
100% non-comedogenic, 
topical prescription antibiotic together with a strong topical anti-inflammatory is really the best way to go.  Two that make the most sense to me are Clindamycin and Azelaic Acid (Finacea).  In super severe cases, 6-12 weeks of oral Doxycycline is recommended.   Metronidazole works in some cases, as well.
Your
doctor may tell you to not wash your face with anything but water and stop
using all sunscreens, but too many of us have seen negative consequences from
doing that.
  I suspect the reason for
telling patients this, is an assumption that all cleansers are harsh and all
sunscreens are made with film-forming mineral oil, both of which can very much
worsen the problem.
  On the other hand,
sometimes it’s a matter of eliminating possibilities when it comes to looking
for causal factors.
  Usually, though, a gentle gel cleanser,
 hydrating, non-clogging sunscreens and repairing, hydrating moisturizer, all as **non-natural** as possible in order to
give the skin as little as possible to react to, seems to work best with
topical Rx medications for this skin disorder.
 
In this case, as well, a switch in toothpastes and avoidance of mint and
cinnamon is helpful.
   As with Contact
Dermatitis and hormonal breakouts, stopping all lip balms containing petrolatum
and petroleum jelly, and avoiding all pore-clogging skincare and cosmetics will
help the skin heal much faster.

It’s very
important to note that in cases where a Perioral Dermatitis is caused by
steroidal meds like hydrocortisone or other topicals for eczema, the condition
will get worse before it gets better, as the skin gets used to the cessation of
these steroidal meds.

Hopefully
this clears things up for you (ha!), and that you’ve gained some insight into
the chin and mouth breakouts that plague you. 
If you have any specific questions about your breakouts, please contact
me!

Your acne problem has a source, and clearing your skin requires finding that source and either eliminating it or healing it.  You can start that right now by filling out my Eval by Email® Online Skincare Consultation Form created specially for ages Gen-X to Baby Boom!

Eval by Email, Virtual Skincare Coaching specially designed for acne sufferers ages 24 and up.

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