Perioral Dermatitis

Perioral dermatitis (POD) is a common inflammatory skin condition that affects young to middle-aged women, and occasionally affects men or children. It develops as a rash or irritation affecting the facial lines from the nose to the sides and borders of the lips and chin. While it is not entirely clear what causes this rash, it is usually something that may be irritating your skin, such as a skin care product or toothpaste. It is also possible that you are allergic to something that is touching your skin. It is not contagious. If not treated, POD may last for months to years.

Causes/Risk Factors: The exact cause of perioral dermatitis isn’t fully understood, but several factors are thought to contribute:

• Topical corticosteroids: The overuse of steroid creams on the face is a common trigger.

• Hormonal changes: Fluctuations, such as those related to menstrual cycles, can exacerbate it.

• Skin care products: Heavy creams, moisturizers, or makeup that clog pores can lead to irritation.

• Environmental factors: Heat, wind, and sunlight may worsen symptoms.

• Oral contraceptives: Birth control pills may be a contributing factor.

Clinical Features:

• Red, bumpy rash around the mouth, sometimes spreading to the nose or eyes

• Small pustules or pus-filled bumps that look like acne

• Dryness, scaling, and itching in affected areas

Diagnosis:  

POD is a clinical diagnosis based upon clinical features.

Differential diagnosis: acne, rosacea, seborrheic dermatitis, contact dermatitis, lip licker’s dermatitis, impetigo.

Treatment:

1. Stop using topical corticosteroids (gradually under medical supervision if needed).

2. Avoid heavy creams and products that may irritate the skin.

3. Gentle skin care: Use mild, fragrance-free cleansers.

4. Medications: Antibiotics, either topical (such as metronidazole or clindamycin) or oral (such as doxycycline or tetracycline), are commonly prescribed.

5. Avoid triggers: Try to minimize sun exposure and avoid harsh weather when possible.

Prevention:

• Limit use of topical steroids on the face.

• Use gentle, non-comedogenic skin care products.

• Maintain a regular skin care routine with mild products.

Citation: Shah, N. (2022, July 1). Periorificial dermatitis. DermNet. Retrieved November 10, 2024, from https://dermnetnz.org/topics/periorificial-dermatitis

Written by Lisa McDaniel, APRN

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