TibotSkin ProblemAcne & RosaceaPerioral Dermatitis

Perioral Dermatitis

Perioral dermatitis is possibly a variant of seborrhoeic dermatitis, with some features of acne. It is a chronic papulopustular facial dermatitis. It mostly occurs in women and children. It is an inflammatory rash involving the skin around the mouth. The rash may spread up to the nose, genitals or even the eyes. In that case, it’s referred to as periorificial dermatitis.

It usually appears as a scaly or red bumpy rash around the mouth. There may be a clear fluid discharge. Redness and slight itching and burning can also occur.

Perioral dermatitis occurs almost exclusively in women age 20-35, but can be seen in all ages, races, and ethnicities. It also occurs in children of any age.

Without the right treatment, cases of perioral dermatitis go away, but may reappear later. Episodes of perioral dermatitis can last weeks and even months.

Patients require systemic and/or topical treatment and an evaluation of the underlying factors.

Perioral dermatitis is a rash that most often affects the skin around the mouth.

Perioral dermatitis is a rash that develops around the mouth and tends to be bumpy or scaly.

The bumps generally do not affect the skin right next to the mouth but appear a short distance away from the lips. They may form a ring around the mouth.

Sometimes the rash can appear around the nose or eyes. It can occasionally appear around the genitals too, but this is rare.

The cause of perioral dermatitis is unknown; however, long-term use of topical steroids for minor skin alterations of the face often precedes the manifestation of the disease. Some causes are as follows:

Drugs: Many patients abuse topical steroids. No clear correlation exists between the risk of perioral dermatitis and strength of the steroid or the duration of the abuse. Perioral dermatitis has also observed after the use of nasal steroids and steroid inhalers.

Cosmetics: Fluorinated toothpaste; skin care ointments and creams, especially those with a petrolatum or paraffin base, and the vehicle isopropyl myristate are suggested to be causative factors.

Physical factors: UV light, heat, and wind worsen perioral dermatitis.

Microbiologic factors: Fusiform spirilla bacteria, Candida species, and other fungi have been cultured from lesions.

Miscellaneous factors: Hormonal factors are suspected because of an observed premenstrual deterioration. Oral contraceptives may be a factor.

Treatment should be adapted to the severity and extension of the disease. Stopping the use of topical steroid creams or nasal sprays, containing steroids, if possible. Doctor will determine treatment based on the severity of condition. In some cases, using mild soaps and discontinuing the use of heavy skin creams and fluorinated toothpaste may ease symptoms. Medications may also speed healing.

Medications include:

  • topical antibiotic medications, such as metronidazole and erythromycin
  • immunosuppressive creams, such as pimecrolimus or tacrolimus cream
  • topical acne medications, such as adapalene or azelaic acid
  • oral antibiotics, such as doxycycline, tetracycline, minocycline, or isotretinoin, for more severe cases

Diet and lifestyle

Lifestyle changes are a part of treating perioral dermatitis that can help prevent it. Consider the following:

  • Get rid of harsh face scrubs or perfumed cleansers. Instead, use only warm water during flare-ups. Once healed, only use mild soap and don’t scrub skin.
  • Avoid steroid creams.
  • Stop using or reduce use of makeup, cosmetics, and sunscreen.
  • Frequently wash pillow cases and towels in hot water.
  • Limit overly salty or spicy foods. They can irritate skin around the mouth.

Consult a dermatologist to evaluate provoking factors and to determine the individualized treatment.

It’s important to speak with doctor before discontinuing any medications.

  • Oxford hand Book of medical Dermatology
  • ABC Of Dermatology
  • Roxburgh’s common skin diseases
  • Andrew’s Diseases of the skin
TibotSkin ProblemAcne & RosaceaPerioral Dermatitis

Perioral Dermatitis

TUI - Tibot Urgency Index

Perioral dermatitis is possibly a variant of seborrhoeic dermatitis, with some features of acne. It is a chronic papulopustular facial dermatitis. It mostly occurs in women and children. It is an inflammatory rash involving the skin around the mouth. The rash may spread up to the nose, genitals or even the eyes. In that case, it’s referred to as periorificial dermatitis.

It usually appears as a scaly or red bumpy rash around the mouth. There may be a clear fluid discharge. Redness and slight itching and burning can also occur.

Perioral dermatitis occurs almost exclusively in women age 20-35, but can be seen in all ages, races, and ethnicities. It also occurs in children of any age.

Without the right treatment, cases of perioral dermatitis go away, but may reappear later. Episodes of perioral dermatitis can last weeks and even months.

Patients require systemic and/or topical treatment and an evaluation of the underlying factors.

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Dr. Lora Smith

MBBS (Dhaka), DGO (DU) Ex SR. Gynaecologist & Obstetrician

09 606 111 222

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