Also known as perioral dermatitis, periorificial dermatitis is an inflammatory condition characterized by the presence of small pink bumps and pustules around the mouth, nose, and eyelids. While the exact cause of periorificial dermatitis is unknown, stress and alcohol consumption are possible culprits. It is a highly prevalent condition among men and women in their 20’s and 30’s and can recur.
The exact cause of periorificial dermatitis is unknown. Proposed culprits include the use of topical steroids, fluoridated toothpaste, dental resins, cosmetic products, and wearing of masks. However, clinical experience has shown stress patterns and alcohol consumption are other possible causes. Periorificial dermatitis can often be worsened with the use of chemical peels and topical creams containing retinoids.
Periorificial dermatitis are small, grouped pink bumps and pustules around the mouth, nose, and eyelids. These bumps are often scaly and have a burning sensation. The condition can often relapse and can take months before it resolves. It also is unresponsive to over the counter topicals and can be worsened by the use of harsh products such as benzoyl peroxide and salicylic acid.
Possible risk factors for periorificial dermatitis include dry, sensitive skin with an impaired barrier, use of topical steroids and retinoids, consumption of alcohol, and stress patterns.
Periorificial dermatitis is a clinical diagnosis, based on the appearance of small, grouped pink bumps and pustules associated with burning.
Treatment options for periorificial dermatitis include topical medications with anti-inflammatory properties, such as pimecrolimus cream, metronidazole gel, and sodium sulfacetamide sulfur cream and cleanser. Pimecrolimus may help regenerate an impaired skin barrier. Oral antibiotics, such as doxycycline, taken over four to eight weeks can help reduce inflammation. Patients with chronic periorificial dermatitis can consider low dose doxycycline to help reduce the appearance of bumps.
Patients are encouraged to discontinue topical steroid use, as patients often experience a rebound effect after stopping the medication. They are also recommended to avoid harsh products such as topical retinoids and alcohol consumption. Addressing stress patterns reduces periorificial dermatitis, as stressors can worsen inflammation of the skin.
Untreated periorificial dermatitis can spread and be more resistant to treatment over time and may require prolonged oral antibiotic treatment.
Periorificial dermatitis can often overlap with acne vulgaris, rosacea, and eczema. However, some treatments for the other conditions can worsen periorificial dermatitis, such as topical steroids and retinoids.
Individuals are recommended to see a board-certified dermatologist for the correct diagnosis and proper treatment.
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