What is perioral dermatitis ?
The primary symptom of perioral dermatitis is a red rash around the mouth. The rash may be scaly or dry and flaky and can be accompanied with inflamed bumps. Although it is usually found around the mouth, the eruption can also move to your eyelids and nose. Sometimes it itches, sometimes it burns, sometimes the skin feels tight or sore. It commonly affects women between 20 and 50 years old.
What are causes, triggers or factors contributing to perioral dermatitis?
Classic perioral dermatitis is usually triggered by the use of steroid creams on the face but it can also be triggered by steroid tablets or inhalers taken for another medical condition.
Perioral dermatitis is seem in patients with a compromised skin barrier. This can be triggered by using the wrong skin care for your skin type, the right skin care in the wrong combination, switching too much between products or using too many products in general.
Sometimes other conditions are mislabelled perioral dermatitis because the eruption affects the area around the mouth. For example eczema, seborrheic dermatitis and contact dermatitis can affect the perioral area and can be confused with perioral dermatitis
How is perioral dermatitis diagnosed?
Perioral dermatitis is usually a clinical diagnosis. Work up may include a full body skin examination. Sometimes patch testing will be recommended to look for an underlying contact allergy (eg to lipsticks, toothpaste ingredients) but usually a clinical examination is enough. Occasionally a skin biopsy will be considered if the diagnosis is not clear. In recurring long standing perioral dermatitis, patients may need analysis of the gut health.
How can I treat perioral dermatitis?
The standard approach to treatment of perioral dermatitis involves taking oral antibiotics but milder cases may settle with antiseptic or antibiotic creams. Steroid creams should not be used. Topical calcineurin inhibitors can be added to help. The skin care routine will be optimised, and this means minimising products used and discontinuing all skin products potentially compromising the skin barrier. Products helping to restore the skin barrier will be recommended.
At The Clinic, Dr. Amelie Seghers offers a skin consultation to discuss any concerns you have.
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