Perioral dermatitis: DermaClub’s treatment plan

Perioral dermatitis

Perioral dermatitis is an inflammatory reaction with folliculitis that occurs around the mouth. It usually follows the folds from the nose down to and around the chin. The arrangement of the erythema and folliculitis, therefore, forms a ring with the mouth at its center and the nose at its upper apex. The redness and folliculitis is often associated with seborrheic dermatitis-like scaling, and may be accompanied by itching and burning. While perioral dermatitis can affect people of any ethnicity from across the world, it mainly only affects young women and rarely affects adolescents or men.

Causes of perioral dermatitis

No specific cause of perioral dermatitis has been identified. Therefore, various factors are considered as triggers of perioral dermatitis, whether alone or in combination with others. These include:

• creams with cortisone, or cortisone buccal nasal inhaler
• non-breathable, film-forming cosmetics (vaseline, silicone)
• serums or balms with essential oils
• sunscreens
• toothpastes containing fluoride
• excess salivation
• contraceptive pill

Treatment

The first step in treating perioral dermatitis is to eliminate any products, medications or behaviors that could trigger the condition.

Within dermatologic literature, perioral dermatitis is often treated with topical or systemic medications. These may include antibiotics (tetracyclines), antiparasitics (metronidazole), creams with immunosuppressive action (tacrolimus, pimecrolimus), or topical creams used for acne such as retinoids, adapalene and azelaic acid.

Outside dermatologic literature, there are also suggestions of restrictive diets or the use of supplements to cure perioral dermatitis. However, there is no proven benefit in these proposals and they can often aggravate the condition.

The multiplicity and disparity of treatments discussed here reflects just how vague treatment of perioral dermatitis can be, which often results in disappointing results.

DermaClub recommends…

Following the elimination of any triggers, DermaClub dermatologists have found perioral dermatitis responds well to the evening application of 2S Cream. Apply a small amount to the affected area and massage well. In addition, responsible sun exposure is recommended to strengthen the skin and its defenses. In cases of previous cortisone use, withdrawal and rebound must take place before treatment with 2S Cream can begin. During rebound, or general treatment for perioral dermatitis, lesions can be masked with Sun Clay and Argillina Skin Color that do not penetrate the skin and, so, do not aggravate the condition further.