Perioral Dermatitis

Synonyms and related keywords: POD, rosacea like dermatitis, periorificial dermatitis, light-sensitive seborrheid, chronic papulopustular facial dermatitis, papulopustular facial dermatitis, granulomatous perioral dermatitis, lupuslike perioral dermatitis

What is Perioral Dermatitis ?

Perioral Dermatitis - Red Bumps Around the Mouth. Perioral dermatitis (POD) is a common skin problem that mostly affects young women usually between 20 to 45 years of age. Occasionally men or children are affected. Perioral refers to the area around the mouth, and dermatitis indicates redness of the skin. In addition to redness, there are usually small red bumps or even pus bumps and mild peeling. The disease can look a lot like acne. The areas most affected are the areas from the nose to the sides of the lips, and the chin.. Sometimes there is mild itching and/or burning. The clinical and histologic features of Perioral Dermatitis resemble those of rosacea.

What causes Perioral Dermatitis ?

POD is limited to the skin and is not life threatening. Topical steroids are a common cause for perioral dermatitis. Other causes of Perioral Dermatitis are -

The uncritical use of topical steroids for minor skin alterations of the face.
Physical factors like UV light, heat, and wind worsen POD.
Use of many cosmetics, perfumed soaps, creams and especially greasy ointments.
Exposure to sunlight, heat, and wind. Sunburn is a sure cause of aggravation.
Fluorinated toothpaste.
Skin care ointments and creams, especially those with a petrolatum or paraffin base.
Overuse of topical cortisone creams, fluoridated toothpaste, or heavy or occlusive skin-care ointments and creams and foundations may be responsible for perioral dermatitis.
Hormonal factors are suspected because of an observed premenstrual deterioration.

The exact cause of the condition known as perioral dermatitis is not known, but it mostly affects women between the ages of 20 and 50. In addition to redness, there are usually small red bumps and mild peeling. Sometimes there is mild itching and/or burning. The areas most affected are within the borders of the lines from the nose to the sides of the lips, and the chin. Occasionally, the areas around the nose, eyes, and cheeks can be affected.

Perioral Dermatitis Treatment

Patients of Perioral Dermatitis require systemic and/or topical treatment, an evaluation of the underlying factors, and reassurance. Treatment should be adapted to the severity and extension of the disease. Here are some methods for treating Perioral Dermatitis that can be followed -

1.Topical steroids needs to be avoided though in the initial stages mild topical steroids may be required to wean off in the initial stages.

2. You should also discontinue the use of topical cortisone creams.

3. You can try brushing with fluoride-free toothpaste.

4. One treatment pearl for perioral dermatitis is qhs use of Sulphacet R lotion.

5. In severe forms of POD, systemic treatment with anti-acne drugs is required. The drugs of choice are doxycycline (or tetracycline) and minocycline. In unresponsive and granulomatous forms, oral isotretinoin or isoniazid may be considered.

6. Since perioral dermatitis makes the skin very dry, any treatment of perioral dermatitis needs to help the skin regain its moisture retention capacity.

7. Alcohol, hot spicy foods, caffeine may be best avoided.

8. Cosmetics are best avoided though it may be difficult as the condition affects women who use excessive cosmetics.

9. Systemic treatment includes anti-acne medications such as doxycycline, tetracycline, minocycline, and isotretinoin. Topical treatment includes antibiotics such as metronidazole and erythromycin.

When to consult a doctor -

POD is indeed the cause of the bumps around your mouth and nose, it is best to see a dermatologist because there are no cosmetics or over-the-counter medications that can treat the condition. A dermatologist can prescribe topical metronidazole (MetroGel, MetroLotion, or MetroCream), alone or in combination with either oral tetracycline or erythromycin. If the condition persists, professional treatment by an expert doctor is recommended. They will be able to give you advice and can offer many treatments for this condition.

Note: The following information on Perioral Dermatitis does not constitute the practice of medicine and is offered as an educational aid.

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