Perioral dermatitis, or periorificial dermatitis, is a fairly common skin condition that presents itself as a rash around the mouth. The rash may expand and reach the nose or the eyes. It mostly affects women aged 16 to 45 years. However, it can also affect children. Overall, we can observe it in all sexes, ages, and races.
Below, we will present the possible causes of perioral dermatitis, as well as the symptoms you should look for. Furthermore, you can read about how to treat this type of dermatitis, including the most effective natural cures.
The disorder looks like a scaly or bumpy rash, often accompanied by redness. An itching or burning sensation can also appear. Some experience a fluid discharge. Without proper treatment, perioral dermatitis may go away but it may reappear at a certain point. Time-wise, the episodes can either last for a few weeks or extend up to a few months.
What Does Perioral Dermatitis Look Like?
The rash typically looks like red spots on the skin near the mouth. This means that it will not only affect the skin closer to the lips, but it can also occur on the chin, the nose, or the cheeks.
Although some people might confuse it with acne, it is not. It is usually painless and it does not itch. However, some patients report a mild burning sensation or a bit of itching. Although it looks unpleasant, the skin being red and lumpy, periocular dermatitis is not serious, nor can it be linked to other diseases.
What Causes Perioral Dermatitis?
Researchers are not clear on the perioral dermatitis causes. However, some possible triggers include:
- Steroid creams are believed to be the main trigger.
- Nasal and oral steroids, steroid inhalers.
- Makeup and other cosmetics. Foundation has been found to be a particular risk factor.
- Environmental factors such as UV light or strong winds.
- Improper personal hygiene (not washing the face).
- Hormonal changes.
- Oral contraceptives.
- Bacterial and fungal infections.
- Epidermal barrier dysfunction.
The most obvious link is with topical steroids (in the form of creams, gels, drugs, ointments, etc.). In many cases, patients develop periorificial dermatitis after using a topical steroid to treat other similar conditions, such as mild eczema. And while you would consider steroids to be a good treatment, as creams can clear a part of the affected skin surface, the effect is only temporary. As soon as the rash disappears and the individuals stop using the steroid cream or ointment, the spots reappear. In some cases, it may even get worse than before.
What Are the Symptoms of Perioral Dermatitis?
Specialists often diagnose the condition through visual examination. There are no particular tests used, but the doctor may perform a skin culture to exclude the possibility of an infection.
The symptoms of perioral dermatitis include:
- Red bumps around the mouth (or other surrounding areas).
- Clusters of one to two millimeters of erythematous papules.
- The affected skin surface may be dry and scaly.
- Itching or burning irritation.
While it is usually limited to the face area, this type of dermatitis can also affect the genital area. It occurs in both men and women, appearing on and around the scrotum, anus, or labia majora.
Perioral Dermatitis Treatment Options
This condition responds well to treatment, but the results only come after a few weeks. Without proper treatment, periorificial dermatitis may last from a few months to a couple of years.
If using topical steroid creams or ointments, nasal steroid sprays, or other products containing steroids, you should stop the treatment. However, you must speak with your dermatologist before discontinuing any medication you take for other conditions or diseases.
The dermatologist will determine the treatment based on the severity of the case. Treatments vary from simply discontinuing the use of certain skin products to taking specific medications.
1. Leave your skin bare
One of the first steps is to stop using any product on your face. This means anything from creams to makeup and other cosmetics. Doctors will prohibit topical steroids, in particular. While the rash is noticeable, patients must wash their face with water and nothing else. Cleansers are also a trigger factor for periorificial dermatitis.
While some may be tempted to start using cosmetics and creams after the rash has cleared, it may reappear.
2. Use prescription medications
Medications speed up the healing process, and may include:
- Antibiotic medications. A doctor will prescribe doxycycline or tetracycline antibiotics are typically for mild cases. The treatment period usually lasts for up to twelve weeks. Patients will see an improvement only after a few weeks of treatment, which is why perseverance is key. Antibiotics reduce the inflammation and kill the bacteria, clearing the skin.
- Immunosuppressive creams. Pimecrolimus cream, for example, is an effective medicine. It is a steroid-free medication that has anti-inflammatory properties.
- Topical acne treatments, such as azelaic acid or adapalene.
- Benzoyl peroxide. It comes in various forms (liquid, bar, cream, lotion, or gel) and can clear up infections.
- Sodium sulfacetamide with sulfur. It is used with great success in treating various inflammatory facial dermatoses. It shows limited adverse effects: dryness, discomfort, erythema, and pruritus.
- Tacrolimus, an immunosuppressive drug that dermatologists also use to cure T cell-mediated diseases.
Patients who suffer from severe cases of perioral dermatitis are given Isotretinoin. This is an oral pharmaceutical drug that dermatologists use mainly to cure acne or other skin conditions. The drug slows down the production of certain substances that cause the red or pink spots to form. This medicine should not, by all means, be taken during pregnancy, nor by women who plan on having a child. Isotretinoin harms fetal development and can cause miscarriages or premature births.
3. Try natural cures
Natural treatment for perioral dermatitis include:
- Essential oils. Oregano, evening primerose, and coconut oils are particularly beneficial for perioral dermatitis sufferers. These natural remedies possess anti-inflammatory, antioxidant, antifungal, and antiseptic properties.
- Vitamins (A, E, B12). Vitamin A promotes new skin cells “birth”, while Vitamin E soothes the inflammation, and Vitamin B12 has the ability to straighten the skin barrier with Calcium.
- Zinc supplements. Zinc deficiencies can lead to a series of health problems, including skin conditions. This type of nutrient deficiency is also linked to periorificial dermatitis. Therefore, we must get our daily intake of zinc if not from our diet, then from supplements.
- Diluted apple cider vinegar and green tea, both applied topically. Some might say it is wrong to apply vinegar on your inflamed,painful skin. However, this is an excellent natural remedy for periorificial dermatitis. It is known to kill the “bad” bacteria that aggravates the condition, and it also has anti-inflammatory properties. However, use it wisely. Moisturize your skin properly after applying it. Use natural emollients, such as coconut oil.
These alternative remedies are not as effective as antibiotics or other medications, but they offer some relief. Please consult your doctor before trying any of these remedies.
Perioral Dermatitis Prevention
The causes of periorificial dermatitis are not exactly understood and vary depending on multiple factors. Consequently, we cannot say for sure there is a way to fully avoid developing the condition. However, there are certain actions that can help either prevent or alleviate it:
- Do not use topical steroid creams or ointments. If your doctor prescribes such a treatment for another disease, do let them know that you also have this type of dermatitis.
- Do not use heavy cosmetics. Remember that makeup foundation is a particularly triggering factor. If you have already dealt with perioral dermatitis, switch brands as a way to avoid having it reappear.
- Do not spend much time outside on extremely sunny days. Beware of UV rays and heat, and look for shade.
Always consult your doctor or physician before trying any of these treatments. Let us know how it went for you.