Yes, that is correct. The damp-heat and fire toxin of the lung and stomach described in Donguibogam aligns strikingly with several mechanisms of perioral dermatitis explained in modern medicine. This dermatitis mainly shows symptoms of red papules or pustules rising bumpily around the mouth, chin, and nose, accompanied by itching or stinging, and many people suffer as it often worsens with routine mask-wearing.
Modern medicine largely views the main causes of perioral dermatitis through three factors. The first is damage to the skin barrier. The humid and sealed environment inside a mask softens and weakens the skin. When physical friction with the mask is added to this, the protective layer of the skin is damaged, leaving it more vulnerable to external irritants. Similar to how Donguibogam stated that dampness worsens inflammation, this humid environment breaks down the skin barrier, allowing microorganisms such as bacteria or fungi to penetrate easily.
The second is dysbiosis of the skin microbial ecosystem. Various microorganisms live in balance on our skin, but the humid and warm environment inside a mask can promote the proliferation of certain anaerobic bacteria or demodex. Excessive proliferation of these microorganisms stimulates the skin's immune response to induce inflammation, worsening redness and papules. This can be seen as consistent with how Donguibogam referred to inflammation and toxic substances using the expression fire toxin. In particular, when steroid ointments are misused or overused, there may be temporary soothing effects, but over the long term, caution is necessary as it can further weaken the skin barrier and worsen dysbiosis, causing chronic recurrence.
The third is the connection with internal factors. Just as Donguibogam emphasized stomach heat or lung and stomach damp-heat, modern medicine also pays attention to the influence of the gut-skin axis, immune system, and stress on skin disorders. Gut dysbiosis can induce a systemic inflammatory response, which can also manifest on the skin. Frequent intake of instant foods, excessive sugar, and stress are all factors that can impair gut health and fuel inflammatory embers inside the body. Stress can promote the secretion of hormones like cortisol, disrupting the immune system and weakening skin barrier function. In particular, perioral dermatitis is sometimes reported to be related to hormones or chemicals such as oral contraceptives and fluorine ingredients in toothpaste, requiring an even more comprehensive approach.
In conclusion, perioral dermatitis is not simply caused by external irritation alone. The external environmental factor of a mask merely acts as a trigger; it can be understood as a chronic inflammatory response that occurs through the combined interaction of internal factors: a weakened skin barrier, microbiome dysbiosis, and gut health and immune status. Just like the wisdom of Donguibogam, modern science reminds us once again of the necessity to restore the balance of the entire body beyond the skin.
