Perioral Dermatitis: Symptoms And Treatments

Perioral dermatitis is a disease of the skin. It shares symptoms with other conditions such as rosacea and can cause confusion. Here we will tell you about its symptoms and the correct treatment.

The name of perioral dermatitis is given to  the dermatological disease which manifests itself intensely around the mouth. It is from this location that its name and its main characteristic derive. It can also be called peribucal dermatitis .

It is a condition that  shares symptoms with other more well-known ones,  such as acne, rosacea, contact dermatitis and even herpes zoster. Hence the importance of a good diagnosis to be able to have recourse to the adequate treatment.

Perioral dermatitis is not contagious. The person who suffers from it cannot pass it by contact to another person. Nor is it a disease that can be categorized as dangerous. Its biggest problem concerns aesthetics and quality of life.

The people most affected are young women and children, with a particular presentation of the disease. We have noticed an increase in cases in recent years, especially in industrialized countries. This is associated with the intensive use of cosmetics.

Causes of perioral dermatitis

The etiology of this disease is unclear. It is thought to be triggered in people with a certain predisposition to skin allergies. The skin would be more sensitive to the action of certain substances that would cause the symptoms. The substances that science has identified as triggers are:

• Creams with corticosteroids:  those that are applied to the face.
• Toothpastes:  those that are marketed with fluoride.
• Various cosmetic creams:  from make-up to sun protection.
• Steroids for nasal or respiratory use:  even those indicated in pathologies such as asthma.
• Contraceptives:  mainly in their oral presentation.

Perioral dermatitis is also associated with poor facial hygiene, either from not washing it properly or from using soaps that are not recommended. In children, of course,  parents play a fundamental role in preventing perioral dermatitis through hygiene.

In the case of some women of childbearing age,  hormonal changes in the menstrual cycle are behind the onset of symptoms. For them, dermatitis is cyclical and reappears every month, with a similar frequency.

A special situation is that of pediatric age. The cause of perioral dermatitis  in children is irritation from saliva around the lips.  Ultimately, it would be a variant of contact eczema.

Symptoms of perioral dermatitis

The clinical sign par excellence of this disease is the appearance of  small red elevations in an area of ​​dry, red skin. These elevations can sometimes contain pus.

The location of the lesions is always around the mouth. The folds of the nose and the folds of the lips are particularly affected. It may also be surprising to see that about two millimeters of skin adjacent to the lips often have no symptoms.

In addition to skin lesions,  patients speak of pain, burning or itching in the affected area. These symptoms are not always present and do not last throughout the period of the attack.

Based on the symptoms and manifestations, doctors make the diagnosis with a physical examination. Unlike acne, perioral dermatitis never gives rise to comedones. In addition, the difference with rosacea is the location because it does not appear around the mouth.

It is rarely necessary to take a biopsy. The diagnosis is often clear with the examination carried out on the spot. However, when it is recommended to perform an anatomical pathology of the lesions,  it is likely that we are facing more aggressive variants of the disease.

Treatment

The mainstay of treatment for perioral dermatitis is to avoid triggers. When the lesions are already present,  the general measures are linked to the removal of the possible responsible factors. Either way, the removal must be gradual to avoid symptoms of relapse.

These measures should be maintained even when the lesions are no longer there because  the one who has suffered from this disease is very likely to have it again.  The main measures would therefore be:

• Only use cosmetics dermatologically tested with ingredients that have already been tried on the skin.
• Make a habit of washing your face every night.
• Dry your skin well, without rubbing, with a non-irritating cloth towel.
• Use moisturizers that do not have corticosteroids in their components.

If the doctor considers it useful,  antibiotics can be used to eliminate the active lesions. The most widely used drugs are tetracyclines and erythromycin, either topically as a cream or as an oral treatment.

One treatment option that is being studied and applied more and more is the use of pimecrolimus cream at a concentration of 1%. Scientific studies have shown rapid improvement in symptoms in patients recommended for this preparation.

While it is true that pimecrolimus is a good option, especially for patients with a history of corticosteroid use, long-term adverse effects of its use should be taken into account. This theme still divides the scientific community and leads to many discussions. It is therefore necessary that the treatment is supervised by a professional.