Information On Perioral Dermatitis

Perioral dermatitis is a common disorder of the skin but little is known about the cause.

This type of dermatitis differs from other types because it directly affects the face. Typically there are concentrations of small red papules around the mouth but not the lips. It can also spread to the folds of the nose and around the eyes known as periocular dermatitis. It looks like a bumpy rash that is very difficult to camouflage with makeup.

The symptoms of this dermatitis present as small papules that flake and spread. It usually occurs on those with oilier skin types and also those who have rosacea with oily skin. More often women will get it but men and children have also been diagnosed with it.

While the cause of eruption is unknown it is theorized that emotional or physical stress may exacerbate the condition. There is also a link to the use of topical steroids on the affected area. When steroids are used the skin builds up a resistance. When the steroids are stopped the dermatitis will come back with a vengeance. Physical factors like UV light, heat, cold and wind can worsen the dermatitis. Some cosmetics and skin care products can cause the problem especially those with petrolatum or paraffin, and the vehicle isopropyl myristate. There have also been connections to microbiologic factors like fusiform spirilla bacteria a candida species a.k.a yeast. Products with sodium lauryl sulfate have also been linked to this condition but there is no scientific evidence. Hormones may also play a part. That all said you and you’re your dermatologist will have to customize your treatment to the cause.

There are many treatments that can be used to treat this condition. One of the treatments may work or you may have to try a few to find the right fit.

One of the most common treatments is the use of oral and topical antibiotics either alone or together. These are commonly used for other inflammatory skin conditions and have had great success. Tetracycline type antibiotics are commonly used. If the condition is resistant than isotrenin may be used. In steroid-induced perioral dermatitis pimecrolims cream is very effective. Children and women who are pregnant or nursing need to use caution and find a topical that will work effectively. Some topicals that work are metronidazole (Metro-gel), erythromyacin, and possibly azelaic acid. Please remember to talk to your dermatologist to get the right topical or oral treatment for you.

My personal experience with rosacea and perioral dermatitis has been long. When I developed the perioral dermatitis rash while pregnant I had no idea what it was or how to treat it. After my daughter was born it worsened. For me I think the physical and emotional stress of pregnancy and childbirth exacerbated the condition. Since I am predisposed to rosacea it makes sense that my skin cannot handle loads of fluctuating hormones that cause skin inflammation. I used Metrogel to control the rash and now all that is left is some scarring that is fading little by little.

If you are suffering from perioral dermatitis please go see a dermatologist right away. Try to figure out what is causing it. Maybe it’s cosmetics or skin products. Maybe it is products containing SLS or possibly steroid cream use. Whatever the cause, it will go away with treatment. It will usually take anywhere from 2-6 weeks to see results but you will be freed from this condition.

Good Luck.

SOURCE: Hans J Kammler, MD, PhD, German Federal Institute for Drugs and Medical Devices.