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Perioral Dermatitis - Symptoms and Treatment

Perioral dermatitis is a skin disorder characterized by tiny red papules (bumps) around the mouth. It is a facial rash, which is slightly scaly and bumpy. Any itching or burning is mild. It may spread up around the nose, and occasionally the eyes while avoiding the skin adjacent to the lips. Perioral Dermatitis is an Often triggered by higher potency topical steroids. There are no blackheads or black topped pimples on the surface of skin. The lesions can be asymptomatic or symptomatic. It is a disease that occurs mostly in young and middle-aged women. It may also be localized or extend to involve the eyelids and adjacent glabella area of the forehead. Diagnosis is by appearance; perioral dermatitis is distinguished from acne by the absence of comedones and from rosacea by the latter's lack of lesions around the mouth and eyes. Seborrheic dermatitis and contact dermatitis must be excluded. Biopsy, which is generally not clinically necessary, shows spongiosis and a lymphohistiocytic infiltrate affecting vellus hair follicles. In the lupoid variant, granulomas may be present. Treatment is tetracycline 250 to 500 mg po bid (between meals) for 4 wk, tapered to the lowest effective dose. Alternatives include doxycycline 50 to 100 mg bid and minocycline 50 to 100 mg bid. In contrast to acne, antibiotics can usually be stopped. Reasons for efficacy of antibiotics are unclear given the absence of evidence for infection. Topical antibiotics (eg, metronidazole 0.75% gel or cream bid) may be helpful. Isotretinoin has been successfully used to treat granulomatous perioral dermatitis.

Perioral Dermatitis is a common facial skin problem. It rarely occurs in men. 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 pus bumps, and mild peeling. Sometimes the bumps are the most obvious feature, and the disease can look a lot like acne. The areas most affected are within the borders of the lines from the nose, to the sides of the lips, and the chin. There is frequent sparing of a small band of skin that borders the lips. Sometimes there is mild itching or burning. There are different types of dermatitis, and the disorder can have many causes and occur in many forms. Generally, dermatitis describes swollen, reddened and itchy skin. Dermatitis is a common condition that isn't life-threatening or contagious. But, it can make you feel uncomfortable and self-conscious. A combination of self-care steps and medications can help you treat dermatitis.

Causes of Perioral Dermatitis

Common Causes of Perioral Dermatitis :

  • The emotional stress is also a cause of perioral dermatitis.
  • Allergic reactions (for example, to poison oak or ivy).
  • These includes UV light, heat, and wind.
  • The use of contraceptive pill , cosmetic usage can worsen perioral dermatitis.
  • Low humidity or soaps and detergents.
  • Prolonged therapy with topical corticosteroids is main cause of this disease.
  • Certain microbiologic factors such as fusiform spirilla bacteria, candida species, and other fungi may provoke perioral dermatitis.
  • Genetic make up.
  • Chemicals, such as nickel and cobalt.

Symptoms of Perioral Dermatitis

Some common Symptoms of Perioral Dermatitis :

  • Itching.
  • Pain.
  • Stinging.
  • Burning.
  • Blisters, thick or scaly skin, red skin, sores from scratching.
  • Perioral dermatitis.
  • Neurodermatitis.

Treatment of Perioral Dermatitis

  • Topical creams and lotions i.e. Metronidazole cream, gel or lotion, should be applied twice a day.
  • Steroid creams should be avoided in all cases of this disease.
  • Oral antibiotics , like tetracycline, doxycycline and microcycline are the most common treatment for perioral dermatitis.
  • Avoid irritating and drying substances such as perfumes or harsh detergents.
  • Minimize the use of moisturizers .
  • Do not apply face creams in the affected areas in the future, as the rash is very likely to reappear. Choose a liquid, gel or light milk sunscreen.
  • Treat other rashes, especially fungal infections, even though they may not seem related.
  • Reduce itching and scratching with topical medications or antihistamines.








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