08/12/2025
Now for Michelle's Top Five from Ep 171! We also wanted to include Dr. Theriot's top points.
1️⃣Alarmins are released in response to tissue damage. Scratching activates alarmin receptors on mast cells, triggering degranulation & histamine release.
2️⃣Cryotherapy can often scare children, leading to emotional distress and periprocedural pain. Using a cotton wick can reduce discomfort & make the procedure more tolerable.
3️⃣The wick technique uses a large rayon swab twisted into a firm point, submerged in liquid nitrogen, and applied horizontally. Tilting the stem vertically increases flow.
4️⃣CARP is a skin condition characterized by distinctive patterns of coalescent papules, usually on the central trunk & neck. 1st line tx is typically minocycline or doxycycline.
5️⃣CARP is associated with Dietzia papillomatosis, a gram-positive, anaerobic bacterium that forms biofilms that act as a “biologic glue,” allowing bacteria to adhere to surfaces and contribute to the disease pathology.
Dr. Theriot:
1️⃣In the EU, over 1300 cosmetic ingredients are banned, whereas the FDA in the US has banned only 11. Increased exposure to these possible toxins can inflame the ocular surface, impair meibomian glands, & contribute to dry eye disease.
2️⃣Hyaluronic acid supports the eyelid/undereye skin barrier & can be applied via moisturizers, makeup removers, or artificial tears to improve hydration, plumpness, & collagen support.
3️⃣Dark circles worsen with age as the skin thins and underlying blood vessels become more prominent.
4️⃣Residual makeup on the eyelids and lashes can harbor bacteria, leading to blepharitis or styes. Micellar water is gentle for routine removal, whereas oil-based removers are better for heavy makeup.
5️⃣For dry eyes, preservative-free artificial tears reduce toxin exposure. Patients on isotretinoin may lose tear film oils, so artificial tears containing oils, such as Refresh Mega or Systane Pro, can be more effective.
6️⃣Hordeola are whitehead-like bumps at the eyelid margin that can respond to warm compresses. Chalazia form on the palpebral conjunctiva and may improve with doxycycline 50 mg BID for 7-10 days--or require excision if persistent.
