Perioral dermatitis is a common facial skin problem in adult women. It rarely occurs in men. It may occasionally affect children. Groups of itchy or tender small red papules (bumps) appear most often around the mouth. They spare the skin bordering the lips (which then appears pale) but develop on the sides of the chin, then spreading to include upper lip and cheeks. The rash looks like a cross between acne and eczema. PD does tend to affect people differently. Perioral dermatitis is usually characterized by an uncomfortable burning sensation around the mouth. Most often, patients are primarily concerned with the cosmetic appearance of skin lesions. In most cases, discrete papules (bumps) and vesicopustules (fluid- or pus-filled bumps) are seen around the mouth.

Causes

Perioral dermatitis most commonly affects young women. However, it may sporadically affect men. While its exact cause is unknown, it may appear after topical steroids are applied to the face to treat other conditions.

Symptoms

Perioral dermatitis is usually characterized by an uncomfortable burning sensation around the mouth. Itching is not a common symptom.

Dermatitis may be a brief reaction to a substance. In such cases it may produce symptoms, such as itching and redness, for just a few hours or for only a day or two. Chronic dermatitis persists over a period of time. The hands and feet are particularly vulnerable to chronic dermatitis, because the hands are in frequent contact with many foreign substances and the feet are in the warm, moist conditions created by socks and shoes that favor fungal growth.

Perioral Dermatitis Treatment

Anti-inflammatory systemic and/or topical therapy is required. Recently, photodynamic therapy (PDT) has been reported to be helpful,2 although large studies have not yet been performed.

Treatment should be adapted to the severity and extension of the disease.

A mild soap or soap substitute, such as Dove or Cetaphil should be used for washing. Scrubbing should be avoided. Try stopping fluorinated toothpaste for stubborn cases. Non-fluorinated toothpaste is available at a health food store. The most reliably effective treatment is oral antibiotics. These are taken in decreasing doses for three to twelve weeks. Topical antibacterial creams and lotions may also be used for faster relief. These can be continued for several months in order to prevent recurrences.

Oral therapy (pills and capsules):

If you get adequate treatment, your chances of having it recur are low. Most perioral dermatitis sufferers will see improvement after 4-6 weeks, but some need to take it for longer periods. Oral therapy includes oral antibiotics such as:

* Minocycline 50-100 mg twice a day until clear, which is usually 1-2 months, though some will continue at a lower dose for an additional month