Perioral dermatitis is a facial rash that causes bumps to develop around the mouth. In some cases, a similar rash may appear around the eyes, nose, or forehead. Perioral dermatitis (POD) is a chronic papulopustular and eczematous facial dermatitis. Simply put, the skin looks red, raised, angry and sore. It mostly occurs in young women and children, but it may affect men as well.

The exact cause of perioral dermatitis is not known. However, it may appear after topical steroid creams are applied to the face to treat other conditions.

Treatments for POD:

  • Photodynamic therapy (PDT) has been reported to be helpful for perioral dermatitis (POD) although large studies have not yet been performed.
  • Certain supplements that improve skin conditions may be recommended such as Vitamin D3 and pycnogenol.
  • Carboxytherapy
  • IV Infusions with Ozone have shown to be helpful
  • Biopuncture treatments for inflammation
  • Various barrier repairing treatments and products have been helpful in treating the sensitivity experienced with POD. Visit out Online Store for incredible product options.

Please note: When starting a treatment plan, patients have to be aware that initial deterioration may occur, especially if they previously used a topical steroid. The use of all topical preparations, including cosmetics, should be avoided except the prescribed medication. The patient should be advised that remission might not occur for weeks, despite correct treatment.

What causes this condition?

An underlying cause of the perioral dermatitis (POD) cannot always be detected in all patients.

Note the following:

  • Drugs: Many patients abuse topical steroid preparations. No clear correlation exists between the risk of perioral dermatitis and strength of the steroid or the duration of the abuse. Perioral dermatitis has also been reported after the use of nasal steroids and steroid inhalers.
  • Cosmetics: Fluorinated toothpaste; skin care ointments and creams, especially those with a petrolatum or paraffin base, and the vehicle isopropyl myristate are suggested to be causative factors. In an Australian study, applying foundation in addition to moisturiser and night cream resulted in a 13-fold increased risk for perioral dermatitis. The combination of moisturiser and foundation was associated with a lesser but significantly increased risk for perioral dermatitis, whereas moisturiser alone was not associated with an increased risk. Recently, physical sunscreens have been identified as a cause of perioral dermatitis in children. Physical factors: UV light, heat, and wind worsen perioral dermatitis.
  • Microbiologic factors: Fusiform spirilla bacteria, Candida species, and other fungi have been cultured from lesions. Their presence has no clear clinical relevance. In addition, candidiasis is suggested to provoke perioral dermatitis.
  • Miscellaneous factors: Hormonal factors are suspected because of an observed premenstrual deterioration. Oral contraceptives may be a factor. Gastrointestinal disturbances, such as malabsorption, have been considered as well.

Frequently Asked Questions

When you feel good, you look good, but when you're under stress, your skin is usually the first place to show it.

The interplay between stress and multiple biologic systems in our bodies can trigger the onset of psoriasis and other inflammatory skin diseases, including acne, atopic dermatitis, psoriasis, seborrheic eczema, chronic urticaria, alopecia areata, and pruritus (skin itching). Researchers use the term, "psychodermatologic disorder" to refer to skin conditions such as psoriasis that can be triggered or exacerbated by emotional stress. Scientists are seeking to learn more about the "brain–skin connection" in psoriasis and other inflammatory skin diseases. They have discovered that stress management can benefit individuals with psoriasis. Patients who listened to a meditation tape while undergoing phototherapy (light therapy) for psoriasis improved four times faster than those who received phototherapy only, as judged by two independent dermatologists. Psychotherapy has been shown to be an important treatment adjunct for individuals with persistent unresolved psychosocial stress-related psoriasis.

Perioral dermatitis results in bumps around the skin of the mouth, and a rash may appear around the eyes, nose, and forehead. The condition usually is characterized by an uncomfortable burning sensation around the mouth. Subjective symptoms of perioral dermatitis (POD) consist of a sensation of burning and tension. Itching is rare. Often, an uncritical use of topical steroids for minor or even undiagnosed skin alterations precedes the development of perioral dermatitis. Perioral dermatitis tends to be chronic. Patients may have marked lifestyle restrictions due to the disfiguring facial lesions

A doctor is likely to diagnose perioral dermatitis based on the skin's appearance. No tests are usually done. In some cases, a culture for bacteria may be needed to eliminate the possibility of infection.

Clinical criteria, prick tests, and specific IgE testing against a mixture of aeroallergens has been used to test for skin barrier dysfunction. In a German study, Perioral Dermatitis patients experienced significantly increased trans-epidermal water loss compared with rosacea patients and a control group, which indicated a skin barrier function disorder. This type of testing is not routinely used.

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

To treat perioral dermatitis, discontinue the use of all topical steroid medications and facial creams. In every case, an initial worsening of the symptoms may occur with treatment, especially if topical steroids are withdrawn. The patient should be made aware of this complication. In cases of preceding long-term use of topical steroids, steroid weaning with low-dose 0.1-0.5% hydrocortisone cream can be tried initially.

Zero-therapy is based on the idea that by ceasing use of all topical medications and cosmetics, the underlying causative factor for perioral dermatitis is eliminated. This form of therapy is appropriate in very compliant patients. It may be effective predominantly in cases associated with steroid abuse or when intolerance to cosmetics is suspected.

Sharon Izak Elaine Chat staff ) WhatsApp