Perioral dermatitis is chronic facial eczema that affects the skin around the lips. The disease may resemble acne and rosacea. Children and young women are most often affected. With the advent of the Covid-19 pandemic and the prolonged wearing of protective masks, the incidence of perioral dermatitis has increased significantly.
Causes of perioral dermatitis
The mechanism of occurrence of this dermatosis is not fully understood, but it is clear that it is a violation of the barrier function of the skin. This can be due to various factors:
- Long-term use with corticosteroids in the form of a cream.
- Using cosmetics with an inappropriate texture, which are most often ointments based on paraffin or petroleum jelly.
- Prolonged exposure to harmful environmental factors such as ultraviolet light and wind.
- Saliva - prolonged exposure to the skin has an irritating effect.
- Prolonged wearing of a protective mask.
All the listed factors weaken the protective function of the skin and make it vulnerable. Subsequently, a secondary bacterial infection may develop at the site.
Perioral dermatitis in a baby
Young children and infants are particularly vulnerable and prone to developing perioral dermatitis. The main provoking factor is saliva. Saliva contains various enzymes that are related to the initial breakdown of food. Once on the skin, however, they have an irritating effect and break the skin barrier. The same applies to people with a malocclusion, in which the upper and lower rows of teeth do not fit perfectly, which causes saliva to flow, most often in the area of the corners of the mouth.
Perioral dermatitis - pictures
The symptoms of perioral dermatitis are very typical. The skin around the mouth, from the nose to the tip of the chin, is most often affected. In more severe cases, it can involve the midface and cheeks. The skin is dry and red, covered with whitish scales. When a bacterial infection is superimposed, a layering of yellowish crusts is observed.
Diagnosis
No additional tests are usually required to make the diagnosis. The presence of a rash around the mouth and chin are indicative enough. History and clinical picture are usually sufficient. Acne, rosacea, angular cheilitis, etc. are also discussed in the differential diagnosis.
Perioral dermatitis - treatment
There are different opinions about the best treatment for perioral dermatitis. In our opinion, the most correct therapy is the sparing one. The first step is to identify the provoking factors and prevent their harmful effects. This includes revision of used cosmetics, protection from sun and wind, cleaning of saliva, correction of bite (if necessary). After that, it is necessary to restore the skin barrier. Epithelializing creams and emollients are most often used. Choosing the right dosage form is key. In the presence of a secondary infection, the inclusion of an antibiotic is appropriate. The most frequently isolated microbe is S. aureus and S. epidermidis.
Cream for perioral dermatitis – all medical epithelizing medications, as well as other zinc-based creams, are suitable. They must be used long enough to fully restore the skin's barrier function.
Examination at a dermatologist in Sofia
If you have a rash around the mouth and chin or other symptoms of perioral eczema, you should consult a dermatologist. In clinic Dr. Stavrov Aesthetics diagnoses and treats various skin and venereal diseases. Our address is the city of Sofia, g.k. Manastirski livadi - west, Prof. Velizar Velkov St. 36 (behind Pulse fitness center). See how to find us on the contact page.
Prognosis and prevention
The prognosis of the disease is excellent, and with proper therapy, improvement occurs within a few days. The key is prevention, which consists of avoiding the provoking factors whenever possible.