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Perioral Dermatitis: Causes, Symptoms, Diagnosis, Treatment, and Prevention

A common skin condition affecting the mouth, nose, and eyes is perioral dermatitis. It causes red, itchy, scaly, and sometimes itchy bumps that resemble acne. It affects everyone, but it is more prevalent in women between 20 and 45 years old. Here are the possible causes, symptoms, diagnosis, treatment, and prevention of perioral dermatitis.

Causes of Perioral Dermatitis

The exact cause of perioral dermatitis is unknown, but there are several factors that can trigger or worsen the condition. These include:

• The use of topical steroids on the face, such as creams, ointments, nasal sprays, or inhalers. These can suppress the immune system and alter the skin barrier, making it more prone to inflammation and infection.

• The use of heavy or occlusive skin products that contain petroleum jelly, paraffin, or lanolin. These can clog the pores and trap bacteria and fungi on the skin.

• The use of cosmetics, cleansers, sunscreens, or toothpastes that contain sodium lauryl sulfate (SLS), a harsh detergent that can irritate the skin and disrupt its natural pH balance.

• The exposure to environmental factors such as UV rays, heat, cold, wind, or humidity. These can dry out or damage the skin and trigger inflammation.

• The presence of underlying skin conditions such as rosacea, seborrheic dermatitis, or eczema. These can cause redness and sensitivity on the face and increase the risk of perioral dermatitis.

• The hormonal changes that occur during pregnancy, menstruation, or menopause. These can affect the oil production and immune response of the skin.

• The ingestion of certain medications such as oral contraceptives, antidepressants, or antihypertensives. These can alter the hormonal balance and affect the skin health.

Symptoms of Perioral Dermatitis

Small red bumps appear around the mouth and in the folds around the nose as the main symptom of perioral dermatitis. In addition to the rash appearing under the eyes, under the forehead, and on the chin, the bumps may be scaly or flaky and may contain pus or fluid. Itching, burning, and tingling sensations may accompany the rash, as well as dry, red, or swollen skin.

Diagnosis of Perioral Dermatitis

In most cases, perioral dermatitis is diagnosed based on its appearance and location, as well as the patient's medical history. During a thorough examination, a dermatologist or doctor may ask about any topical steroids or other skin products used by the patient. To rule out other possible causes of the rash, such as bacteria or fungal infections, a skin biopsy or culture test may be performed.

Treatment of Perioral Dermatitis

The treatment of perioral dermatitis depends on the severity and duration of the condition. The main goal is to reduce inflammation and prevent recurrence. The treatment options include:

• Stopping the use of any topical steroids or other irritating skin products. This is the most important step in treating perioral dermatitis. It may take several weeks for the rash to improve after discontinuing these products.

• Applying topical antibiotics such as metronidazole or erythromycin to kill or inhibit the growth of bacteria on the skin. These are usually prescribed for mild to moderate cases of perioral dermatitis.

• Taking oral antibiotics such as tetracycline or minocycline to treat severe cases of perioral dermatitis that do not respond to topical antibiotics. These are usually prescribed for 6 to 12 weeks to clear up the infection and prevent relapse.

• Applying topical immunosuppressants such as pimecrolimus or tacrolimus to slow down the symptoms of severe skin conditions that may trigger perioral dermatitis such as rosacea or eczema. These are usually prescribed for short-term use only due to their potential side effects.

• Applying topical acne medications such as adapalene or azelaic acid to unclog the pores and reduce inflammation on the skin. These are usually prescribed for mild cases of perioral dermatitis that resemble acne.

Prevention of Perioral Dermatitis

The prevention of perioral dermatitis involves avoiding or minimizing exposure to potential triggers and maintaining a healthy skin care routine. Some tips include:

• Avoiding or limiting the use of topical steroids on the face unless prescribed by a doctor for a specific condition.

• Choosing gentle and non-comedogenic skin products that do not contain petroleum jelly, paraffin, lanolin, SLS, or fragrances.

• Washing your face twice a day with a mild cleanser and lukewarm water. Do not scrub or rub your skin harshly.

• Moisturizing your skin with a light and oil-free lotion or cream. Avoid applying too much or too often.

• Protecting your skin from sun damage by wearing a hat, sunglasses, and sunscreen with SPF 30 or higher. Avoid tanning beds and excessive sun exposure.

• Drinking plenty of water and eating a balanced diet rich in vitamins A, B6, C, and folic acid. These nutrients can help support the skin health and immunity.

• Managing stress and getting enough sleep. Stress and lack of sleep can affect the hormonal balance and immune response of the skin.

In addition to causing discomfort and embarrassment, perioral dermatitis is treatable. It is possible to prevent or reduce the occurrence of perioral dermatitis and enjoy a healthy complexion by identifying triggers, following doctor's advice, and taking good care of your skin.