Perioral dermatitis is a very common skin condition. Perioral means “around the mouth” and dermatitis means “inflammation of the skin”.
So in basic terms, perioral dermatitis means inflammation of the skin around the mouth. This type of dermatitis is characterized by multiple small papules, vesicles and pustules in the facial area localized around the mouth, nostrils and eyes. It is most commonly seen in women of menstruating age rather than men. However, it can also affect the elderly and children as well and as the number of men using cosmetic products increase, do does the number of them being affected by perioral dermatitis. Perioral dermatitis is believed to affect 1 in 100 women at some point in their life.
Diagnosis of perioral dermatitis is made based on the characteristics of the rash. It can be misdiagnosed as it resembles acne and eczema (allergic contact dermatitis and irritant contact dermatitis). It also resembles rosacea and seborrheic dermatitis. It is not the sign of any underlying disease so there’s no need to worry however, the rash can be unsightly especially since it is located at the face making it completely visible.
The symptoms vary with severity – in mild cases, there’s bumpy, red or irritated skin with mild flaking around the mouth, chin, nose and even eyes as well but it is less common while in severe cases, there’s inflammation with flakes or scabs that bleed or become infected. Small red or pink lumpy spots can be typically seen around the outside of the mouth and it can also be seen around the nose, chin and cheeks as well. The severity of the skin condition also dictates the variation of the rash from minor spots to definite lumpy rash around the mouth almost forming a ring around it. Although, not painful or itchy, the rash can have a burning sensation. Even yeast and bacteria that live on the skin and hair follicles are suggested to be one of the causes. It is common in women than on men and hormone plays a significant role hence, the rash is found to be worse just before a period.
There are a number of known causes of perioral dermatitis. Steroid cream on the face is only common cause of perioral dermatitis. Other causes includes strong winds, UV rays, oral contraceptive pills, fluorinated toothpaste, beauty products such as makeup, cleansers and other cosmetic products that are applied to the face can trigger perioral dermatitis.
One of the perioral dermatitis treatment is to completely stop the use of all creams and ointments to the face and this includes topical steroids which itself can trigger the skin condition as well as cosmetic and health products. The treatment will not only help heal the redness and the rash but it also helps with the inflammation and the burning sensation. Without proper or any treatment, the condition lasts for months to years. When the rash is present, the best approach would be to wash the face with water only and it is also best advised to avoid using toothpaste that contains fluoride.
If you consult a doctor, then you’ll most likely be prescribed an antibiotic tablet that contains tetracycline. Doxycycline is also used in case of mild perioral dermatitis. The treatment will last for six to twelve weeks without any signs of improvement in the first few weeks but it is important to follow the prescription until the end.
There’s a strong link between topical steroids and perioral dermatitis. It is considered to be the primary cause therefore, should be avoided at all cost. Skin medications such as metronidazole, benzoyl peroxide, erythromycin, clindamycin, pimecrolimus, tarcolimus and sodium sulfacetamide with sulphur are used to treat perioral dermatitis.
Pimecrolimus cream is also used to treat perioral dermatitis. The cream helps reduce skin inflammation and it is quite effective in curing the skin condition that has been caused by topical steroids. In severe cases, isotretinoin is also used. It is a prescription drug that consists of tablets and are to be taken orally. It works by slowing down the production of certain substances that causes spots to form on the skin. It is also used to treat acne and other skin conditions. Pregnant women or women who intent to become pregnant are to stay away from this drug as it may harm developing baby and can also lead to miscarriage or premature birth of the child.
Perioral dermatitis is a skin condition that once occurs, it has the tendency to recurring so even when the rash disappears, avoid using any cosmetics or creams on the face. Instead, use a bland liquid face cleaner over bar soap. If you are using topical steroids, you need to accept that the condition will get worse for a few days before it actually gets better. Since, it is a recurring skin condition, it is best to consult a doctor and find the cause and avoid it. Also, as it can result in infection, a proper diagnosis can help determine if a bacteria is causing an infection or not.
Remember, the route to success to avoid perioral dermatitis from recurring is to do less instead of doing more. Go for water based facial products instead of the oil based serums. Avoid using cosmetics on your face. Another easy lifestyle change would be to avoid toothpaste with fluoride and go for one that is free from fluoride. Apple cider vinegar is also thought to help with perioral dermatitis. It contains antioxidants that balance pH level and reduces yeast in the body.