Perioral dermatitis (PD) is a rash that typically occurs around the mouth. It primarily affects young women between the ages of 25 to 45 but children can also be affected. At first, it may be difficult to diagnose PD because it can look like rosacea, eczema or acne. The actual cause of PD is unknown, however there are suspected triggers that you should be aware of.
What the rash looks like?
The rash usually appears around the mouth but can extend to the nose and sometimes the eye area. The skin is reddened with small itchy, tender bumps. The bumps may be scaly or small pustules can develop. It is possible to have PD on only one side of the face.
Suspected triggers:
Use of topical steroid cream is the most frequent cause of PD. If strong steroids are used on the face, the skin can become overly accustomed or “addicted” to them. When someone tries to stop using them, their skin breaks out so they typically restart applying the steroids. This creates further skin damage and sets the skin up for PD.
The combined use of cosmetics, moisturizers and foundation has been found to increase the development of PD. A study in Australia found that there was a 13-fold increase in subjects who had applied both a moisturizer and nighttime cream. There also was an increase in the incidence of PD in those who applied both moisturizer and foundation but to a lesser extent while the use of just a moisturizer alone did not increase PD outbreaks.
Fluorinated toothpaste or other additives such as sodium lauryl sulfate (SLS), red dye and cinnamon flavoring may cause PD. It is thought that saliva containing these substances can irritate the skin that surrounds the mouth.
How to treat PD:
• Wash your face daily with warm water alone until the PD has improved, then use a mild cleanser to keep the area clean.
• Discontinue use of strong steroid creams, suspected moisturizers and cosmetics until the rash has greatly improved. The rash may become worse at first when the steroid cream is stopped but it will improve afterwards. Sometimes a much weaker type of steroid cream or a non-steroid creams called immune modulators can be prescribed.
• Change your brand of toothpaste to one that does not contain fluoride or other additives.
• Use sunscreen every day as it is thought that UV light, wind and heat may aggravate PD. You may have to select a brand that is specific for sensitive skin.
Your dermatologist may want you to take oral antibiotics, such as tetracycline, for several weeks. Topical antibiotics can be tried but they may also be drying and irritating. If your doctor suspects that yeast instead of bacteria is aggravating your PD, an anti-yeast shampoo may be used on your skin.
Don’t ignore a rash around your mouth hoping it will just go away. PD can last for months if not treated and the cause may be as simple as irritation from an ingredient in your toothpaste.
sources:
http://emedicine.medscape.com/article/1071128-overview
www.dermadoctor.com/article_Perioral-Dermatitis_77.html
http://dermnetnz.org/acne/perioral-dermatitis.html
http://knol.google.com/k/will-johnson/perioral-dermatitis periorificial/4hmquk6fx4gu/230#
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles