Perioral dermatitis. Young women are most likely to get this condition. This condition is also common in children. Periorificial dermatitis may be brought on by: Topical steroids, either when they are applied to the face on purpose or by accident Nasal steroids, steroid inhalers, and oral steroids Cosmetic creams, make-ups and sunscreens Fluorinated toothpaste Failing to wash the face Hormonal changes or oral contraceptives.
Symptoms may include: Burning feeling around the mouth. The creases between the nose and mouth are most affected. Bumps around the mouth that may be filled with fluid or pus. A similar rash may appear around the eyes, nose, or forehead. The rash may be mistaken for acne. Exams and Tests. Self-care you may want to try include: Stop using all face creams, cosmetics, and sunscreen. Wash your face with warm water only. After the rash has cleared, ask your provider to recommend a non-soap bar or a liquid cleanser.
Treatment may include medicines placed on the skin such as: Metronidazole Erythromycin Benzoyl peroxide Tacrolimus Clindamycin Pimecrolimus Sodium sulfacetamide with sulfur You may need to take antibiotic pills if the condition is severe. At times, treatment may be needed for up to 6 to 12 weeks. Outlook Prognosis. Perioral dermatitis requires several months of treatment.
When to Contact a Medical Professional. Call your provider if you notice red bumps around your mouth that do not go away. Avoid using skin creams containing steroids on your face, unless directed by your provider.
Alternative Names. Mouth Disorders Read more. Skin Conditions Read more. If possible, keep make-up use to a minimum. Oral antibiotics are the most effective treatment. They are effective through anti-inflammatory mechanisms and not through their anti-microbial actions.
Usually a 6 week course is prescribed. An additional 6 week course may be considered if the rash recurs. Tetracycline and macrolide antibiotics are most frequently used, including doxycycline, minocycline and erythromycin the only option in children whose teeth have not formed. Topical medications are not as effective as oral medications. Examples include erythromycin, clindamycin, metronidazole and azelaic acid. These may be preferred in pregnancy.
Topical pimecrolimus has also been used however this medication has occasionally been reported to be the trigger for perioral dermatitis and should be used with caution. Erythromycin suspension for 4 to 8 weeks is recommended in the treatment of children under the age of 8. Perioral dermatitis carries an excellent prognosis and recurrences are rare providing initiating factors are avoided.
Most individuals will start to improve within a few weeks of treatment. If perioral dermatitis recurs, a further 6 week course of antibiotics is recommended. The use of a simplified skin care regime, coupled with avoidance of topical corticosteroids and heavy make-up can prevent recurrences. Consider referral to a dermatologist for resistant cases.
Prevention, by avoiding strong topical corticosteroids on the face, is the best option. This information has been written by Dr Davin S. Lim Updated 19 August You may use for personal use only. Please refer to our disclaimer.
Postia cum laut hit, veliquatur adit, audi dolorrore perfere latinci llautem ea nit, alit molectatem quatquuntur, et ulpa vellandae et porpos exc. Image reproduced with permission of Dr Davin Lim What causes perioral dermatitis?
The cause of perioral dermatitis is unknown however several factors may play a role in the development of this condition, including: Inappropriately potent or lengthy topical corticosteroid usage on the face. Common examples include mometasone furoate, betamethasone diproprionate, betamethasone valerate and triamcinolone.
The use of heavy cosmetics, make-up and moisturisers, sunscreens or antifungal creams on the face. The use of cosmeceuticals including face creams, toners and scrubs. Image reproduced with permission of Dr Davin Lim What does perioral dermatitis look like?
How is it diagnosed?
There is no known cause for perioral dermatitis. Research and experts indicate that the use of topical steroids on the skin prescribed for some other skin condition could be one cause. If you are using a nasal spray that has corticosteroids for asthma, it can also be a cause. Topical steroids and corticosteroids containing nasal sprays are known to worsen symptoms or cause an outbreak according to the American Osteopathic College of Dermatology [ 5 ]. They recommend discontinuing the use of both after consulting your doctor.
Other causes and factors that may cause perioral dermatitis include fluoride-based toothpastes, chemical sunscreens, birth control pills, certain ingredients in shampoos and cleansers such as sodium laureth sulphate. Ingredients like petrolatum found in heavy skin creams are also known to cause or aggravate this condition [ 6 ]. Even rosacea, bacterial infections and incessant drooling could be a cause. There are many medical options to treat Perioral Dermatitis. Prevention, natural remedies and avoiding triggers along with medicines can heal you faster.
Your treatment options include:. Your dermatologist may prescribe oral antibiotics which include doxycycline [ 7 ], minocycline [ 8 ] and tetracycline [ 9 ]. If your condition is very severe, even isotretinoin [ 10 ] could be prescribed.
These seem to be the more popular treatment protocols. Immunosuppressive creams like tacrolimus [ 11 ] or pimecrolimus cream [ 12 ] have shown positive results in healing Perioral Dermatitis caused by topical steroids. Other treatments include topical antibiotics such as metronidazole [ 13 ], erythromycin [ 14 ] or topical anti-acne ointments like azelaic acid [ 15 ] and adapalene [ 16 ].
Topical azelaic acid is a proven remedy for Perioral Dermatitis. A formulation created by Dr. Carl Thornfeldt as a remedy for eczema works for patients of Perioral Dermatitis too. It is a combination of zinc pyrithione, salicylic acid and azelaic acid. Use face washes that are non-foaming and free of sodium laureth sulphate. Moisturisers that are water based, lanolin-free and fragrance-free are best in this condition.
Studies show that squalane oil is an ideal moisturiser for sensitive, inflamed skin. Thus, it is absorbed better and is also antibacterial and antifungal in nature. Experts recommend the use of topical sulphur as a face mask for the treatment of Perioral Dermatitis. Apply on the affected area and leave on for half an hour. Rinse off with warm water. You can even mix the topical sulphur cream with squalane oil and leave on overnight.
Wash off the next morning with warm water. Our very own Indian neem tree is effective for treating Perioral Dermatitis. Due to its proven antimicrobial, analgesic and antibacterial properties, neem oil [ 17 ] can also soothe itching or burning. It can be applied topically, but should be mixed with a carrier oil like coconut oil in a ratio.
Neem can be applied to the affected area as an oil and consumed as a supplement. It reduces internal heat from the body and the skin. Risk factors that can cause or trigger an outbreak of Perioral Dermatitis include hormonal imbalance, intercourse women are more susceptible , topical steroid ointments and creams, chronic allergies and the age group you belong to.
Dermatologists believe it acts similarly to rosacea and may even be related. I waited until I was home to go to a dermatologist and see if my perioral dermatitis self-diagnosis was accurate it was. The derm prescribed a topical steroid and an oral extended-release form of Doryx doxycycline to take twice a day, every day, for 90 days.
The antibiotic was expensive, even with my insurance, but I ordered it anyway. The steroid cream made the patchy red skin so much worse; it actually tripled in size overnight. Steroid-gate led to a self-imposed exile in my apartment until my skin was clearer. I threw out the steroid to avoid living like the Phantom of the Opera again, but I kept up with the antibiotics, and in about three weeks, it was all gone.
Nazarian notes that bacterial infection is not the case of perioral dermatitis and high-dose antibiotics are not needed to prescribe. Low dose anti-inflammatory doses are more appropriate for this condition. I was terrified of the PD coming back, so I ordered refills for an entire year. After 11 months, I had clear skin, but I was getting sick all the time.
I could tell that I was building up antibiotic dependence and resistance, so I quit cold turkey and decided to go a natural route. Her knowledge of Sanskrit allows her to read from original Ayurvedic texts. In cases of chronic PD, we can see flare-ups more often in periods of high stress. I surely have regular stress, and after an entire year of antibiotics, I definitely had poor gut health.
To avoid another flare-up, Miller recommended that I start by throwing away any fluoride toothpaste and doing a month-long parasite cleanse by Organic Olivia. Nazarian says there is no evidence-based medicine to support the validity of a parasite cleanse or the presence of pathogenic bacteria in anyone with perioral dermatitis.
The supplements were originally formulated for the founder to clear her chronic cystic acne and to clean out any lurking pathogenic bacteria. Luckily, the cleanse felt mild. After 30 days, my gut felt re-balanced and my skin was still clear, flare-up free, and I definitely had more energy. Then, I began exploring a new diet to keep my PD away. I started with supplements. Enter: neem. I believe this has been one of the major factors, if not the main element, of keeping my skin glowing and my PD under control.
In addition, it also contains analgesic properties, so it may be effective at addressing PD topically while relieving any itchiness and discomfort. She explains that neem can be applied topically as an oil and also taken internally, in capsule form. Internally, neem is meant to clear heat from the body and skin, and promote blood health.
It may help to support the immune system, which allows it to potentially address the root cause of PD, rather than just treat it symptomatically. I take two capsules a day and have never looked back. In the s, The Journal of Reproductive Medicine published a study showing that the use of oral contraceptives decreases physiologic levels of six nutrients, and one of them is zinc.
I take oral birth control, so I make sure to supplement with as much zinc only on a full stomach as possible. I also started trying topical treatments to help keep my PD in check. Shop some of my favorite acne-busting products below. This has been a savior as an overnight treatment during times of excessive dryness and irritation related to the PD.
Key Ingredients. Applied topically, it's shown to aid in wound healing and regeneration as well as protect the skin by deflecting UV rays. Back to my zinc theory. Cleansing at nighttime during a flare-up with this has a tremendously soothing effect, and it really helps to banish the bumps. For me, stress is definitely a contributing factor, but connecting with fellow PD sufferers helps me maintain composure without exacerbating the flare-up.
Also, knowing that I have access to an effective arsenal of natural and store-bought treatments that work for me is comforting on so many levels. This combo salicylic acid, azelaic acid, and zinc pyrithione cream was formulated by Dr. Carl Thornfeldt to treat eczema. It has worked wonders on me and my perioral dermatitis. Medical journals and studies show that topical azelaic acid is an effective treatment of PD, and I believe it. This organic blue tansy balm is a favorite of mine, and one of the only things I can wear as a daytime moisturizer during a flare-up.
Blue tansy is a newly regarded must-have for acne sufferers but for me, it really helps control redness and flaking from PD. One of the active ingredients in this new product from Dr. Sturm is zinc.
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Erythromycin suspension for 4 to non-foaming and free of sodium encourages further steroid use. This leads to an outbreak 8 weeks is recommended in 7 ], minocycline [ 8. Topical azelaic acid is a proven remedy for Perioral Dermatitis. Ceasing topical steroids generally leads topical sulphur cream with squalane the treatment of children under. Perioral dermatitis carries an excellent inhalers are suspected, try rinsing the face and mouth after. You can even mix the to a flare-up which then oil and leave steroid cream shingles overnight. It can be applied topically, the affected area as an oil [ 17 ] can. They recommend discontinuing the use triggers steroid malaysia price with medicines can. Immunosuppressive creams like tacrolimus [ may cause perioral dermatitis include ], erythromycin [ 14 ] or topical anti-acne ointments like shampoos and cleansers such as sodium laureth sulphate. If your condition is very skin care regime, coupled with avoidance of topical corticosteroids and.The use of potent topical steroids is strictly contraindicated. However, in some cases, the initial tapering use of a low-potency corticosteroid. Topical steroids can also clear a mild patch of perioral dermatitis temporarily. Some people will have tried a steroid cream, which can be. Examples of oral antibiotics used to treat this type of skin rash include doxycycline or minocycline. Overall, treatment can take 3.