Perioral dermatitis: causes, symptoms, diagnosis, treatment, diet

Skin diseases cause not only an aesthetic problem, but also seriously affect the patient's quality of life. Among such ailments, perioral dermatitis can be noted. The disease is not so common, but requires a special approach to treatment.

What is a pathology?

This disease has many names: near-mouth dermatitis, rosacea-like, stewardess disease. Perioral dermatitis on the face is an inflammatory process that constantly recurs, which most often captures the area around the mouth.

A distinctive feature of the disease is the presence of an unaffected strip of skin adjacent to the lips. The disease was first diagnosed in the 50s of the twentieth century, now about 1% of the population is affected by this disease.

Types of Dermatitis

Based on the symptoms, doctors distinguish several forms of the disease:

1. The first variety manifests itself in the form of diffuse erythema around the oral opening and small reddened areas of the skin.
2. The second form is characterized not only by the formation of papules, but also by bubbles filled with liquid.
3. The third form is accompanied by the formation of purulent vesicles.

Causes of the disease

Doctors still can not name the exact causes of perioralgo dermatitis. But there are some factors that can serve as provocative for the development of the disease. Among them, the following should be noted:

• Use of poor-quality or unsuitable cosmetics for the skin type. This leads initially to irritation, and gradually to the formation of dermatitis.

• Infectious skin diseases of a bacterial nature. Various bacteria constantly live on the face, for unknown reasons, they can begin to multiply uncontrollably.
• Some varieties of perioral dermatitis develop due to the presence of parasites on the skin, for example, Demodex folliculorum. They cause inflammation and irritation of the skin.
• Indirectly provoke the development of the disease can stressful situations. They negatively affect the whole body and the immune system, including one that is not able to withstand bacteria.
• The constant exposure of the skin to cold temperatures, especially in combination with the wind, drains the skin and makes them more vulnerable to attack by pathogens.
• If there are problems with the immune system, some fungi, for example, from the genus Candida albicans, can cause disease.
• Perioral dermatitis in an adult can be allergic in nature and occur after contact with an allergen.
• Increased predisposition to the formation of pathology in people with problems in the digestive tract, suffering from gastritis.
• Periodic dermatitis in a baby can develop against the background of frequent and prolonged sucking of a dummy.
• Exposure to the ultraviolet rays of the sun can provoke skin irritation or enhance the manifestations of dermatitis.
• Permanent use of fluoride toothpastes for the care of teeth. This element irritates the skin.
• The use of creams, ointments based on cortisone in the first stages of therapy weakens the symptoms, and then causes a relapse of the disease.
• Among the causes of perioral dermatitis can be called hormonal disruptions, for example, during pregnancy, menopause.
• Deficiency of vitamins and minerals, especially A and E.
• Neurological disorders.
• Eating some foods may increase the likelihood of dermatitis, such as cinnamon.

The disease can occur with periodic exacerbations and remissions. Pathology can support the activity of:

• Frequent visits to the solarium or prolonged exposure to the sun.

• Taking oral contraceptives.
• Chronic foci of infection in the body: caries, sinusitis.
• The period of bearing a baby.
• Tuberculosis.
• Hormonal disorders.

With a combination of several provoking factors, the likelihood of developing perioral dermatitis increases. At the slightest suspicion, you should consult a doctor.

Signs of the disease

Symptoms of perioral dermatitis are very similar to the manifestations of other diseases, for example, eczema or rosacea, so the doctor should make a diagnosis and prescribe effective therapy.

But the most striking manifestations of the disease can be noted:

• In the area of ​​the lips there is redness, a burning sensation.
• Small erythema appears on the skin of the face, which can pass into vesicles and pustules.
• Itching of the affected areas.
• On pathological areas of the face, peeling and redness are observed.
• Single formations gradually increase and merge with each other, forming continuous spots.
• Rashes, as a rule, are localized symmetrically on both sides.

• Skin soreness is felt.
• A swelling appears.
• Gradually affected areas of the skin are covered with scales, crusts that disappear over time. If you peel them off yourself, then there are pigment spots that are difficult to remove.

The disease often leads to neurological disorders, especially in women because of their appearance. They become closed, some even quit their jobs, and conflicts arise in the family.

Is perioral dermatitis contagious?

Pathogenic microorganisms that cause the development of the disease can be transmitted from a sick person to a healthy one. But with a strong immune system and the absence of other provoking factors, pathology is unlikely to manifest itself.

But we must remember that with the development of the disease under the influence of fungi and bacteria, infection is still possible.

Features of the disease in childhood

Manifestations of the disease in children have their own characteristics. Until puberty, rashes most often differ little in color from the skin. They are usually bodily, but may be slightly pink. There are almost no other symptoms, sometimes a child may complain of a burning sensation in the affected areas of the skin.

The rash can be single or form clusters in the form of spots. Not only the area near the mouth can be affected, but also near the ears, eyes, skin on the head, on the hands, in the genital area.

With the onset of puberty, the manifestations of the disease practically do not differ from those in an adult.

Diagnosis of the disease

Only an expert can make an accurate diagnosis, it is important to differentiate the disease from other similar pathologies. To recognize dermatitis, it is prescribed:

• Examination of a patient by a dermatologist.
• Examination of the skin using dermatoscopy. The doctor examines the pathological areas using a device that gives a 10-fold increase.
• Microflora is sown from the affected areas of the skin.
• A blood test may show a slight increase in ESR, due to the presence of a focus of inflammation or infection in the body.

After the doctor has no doubts about the presence of perioral dermatitis, treatment is prescribed.

The main directions of treatment

Any skin pathology requires an integrated approach, it will not be possible to get rid of the disease using only external agents. The treatment regimen for perioral dermatitis may look like this:

• Taking medications. Only a doctor prescribes them. The main remedy for perioral dermatitis is Metronidazole. If the pathology proceeds without complications, then the patient is prescribed 500 mg per day for 3-6 weeks. In severe cases, treatment begins with taking 1 gram of the drug for at least 3 weeks, and then when the therapeutic effect is obtained, the dosage is reduced to 500 mg and the dose is taken for another 1-1.5 months.

• If there is an allergy to Metronidazole, the drug can be replaced with Ornidazole. It can be taken in shorter courses.
• Severe forms of dermatitis have to be treated with drugs from the tetracycline group: Unidox, Solutab. If a woman is in a position, then Tetracycline is forbidden to use. It can be replaced with Erythromycin.
• A long antibacterial course of treatment adversely affects the intestinal microflora, so it is advisable to take probiotics at the same time.

In addition to preparations for internal use, external agents are always prescribed, among them the following ointments for perioral dermatitis are effective:

• Ointment "Doxycycline." Destroys many pathogens. Apply to affected areas 2 times a day.
• 1% cream "Metronidazole". Apply to the affected skin twice a day with a thin layer for 2 months.
• "Metrogil gel." The drug is based on metronidazole. It is well tolerated, quickly absorbed, a good therapeutic effect is observed. But it is not recommended for women in position, as well as for renal failure.
• Ointment "Pimecrolimus" refers to immunosuppressants and is often prescribed if the disease was provoked by corticosteroids. The tool removes inflammation well.

If the patient has intolerance to metronidazole, then use a cream or ointment with azelaic acid. Preparations must be applied to the skin twice a day. Among the external products containing this acid, one can name: Skinoren, Azix Derm, Azogel.

If in the process of treating a patient’s disease, dry skin and irritation began to bother, the doctor prescribes Skin-cap cream. It softens the skin well, relieves inflammation, has an antibacterial and antifungal effect. In the presence of purulent rashes, retinoic ointment will help, its components contribute to the rapid restoration of the skin. You can use Bepanten.

The answer to the question of how long perioral dermatitis is treated depends on the severity of the pathology. But usually it takes at least 3-6 weeks.

Other treatments

Doctors often prescribe laser therapy or pulsed light to the patient, but there is no evidence of 100% effectiveness of the procedures. The prescription is based on the therapeutic effect of such treatments for rosacea.

Alternative treatment of dermatitis

Therapy of skin diseases can be supplemented with the use of folk remedies. To reduce the symptoms on the skin, traditional healers recommend the use of the following means:

• Compresses with linseed oil. To do this, mix flax oil and honey in equal proportions and heat in a water bath. Then add onion juice. In the resulting composition, moisten a napkin and apply to the affected area of ​​the skin. Repeat 2-3 times a day.

• Prepare mashed potatoes from raw pumpkin pulp and apply it on the skin.
• Prepare a decoction from a series: pour a tablespoon of raw materials with a glass of boiling water and insist for half an hour. Wet cloth and wipe affected areas.
• It is useful to wash with decoctions of birch buds, oak bark or diluted aloe juice, and then leave the skin to dry naturally.
• Beekeeping products will help cope with the manifestations of the ailment. They have bactericidal properties. You can prepare propolis ointment: combine 1 part of the product with 4 parts of any oil and heat until dissolved in a water bath. Use to lubricate diseased areas. But it must be borne in mind that there is a likelihood of developing an allergy, so initially try the product on a small area of ​​the skin.

Before using folk remedies, it is better to consult a doctor.

Diet during the treatment of the disease

An important diet for perioral dermatitis. It is important to remove from the diet all foods that can become potential provocateurs of the disease. Will have to exclude:

• Milk.
• Sweets.
• Limit fried and fatty foods.
• Do not eat exotic fruits.
• Reduce salt intake.
• Reduce the amount of fish in the diet.
• Limit the intake of caviar and mushrooms.
• Maintain water balance and consume enough fluids.

No need to starve yourself, nutrition should be balanced in terms of vitamins and minerals. Dishes are better to prefer homemade with a high fiber content.

Disease prevention

If there is a predisposition to skin diseases, then special attention should be paid to preventive measures. Among them, the following can be noted:

• Timely engage in the treatment of any infectious diseases in the body, to prevent their transition to a chronic form.
• Do not use ointments and creams for skin care containing corticosteroids without a doctor’s prescription.
• Use only proven and safe products for skin care.
• Buy quality cosmetics.
• Do not use fluoride toothpaste constantly.
• To adjust the diet and adhere to the principle of a healthy diet.
• Observe personal hygiene.

Periodic dermatitis does not belong to dangerous pathologies for health, but it causes a lot of trouble for patients. Do not overdo it in skin care, do not expose it to excessive exposure to cold and wind, then you will not have to look for means to combat the disease. If the diagnosis has already been made, then follow all the recommendations of a specialist. Self-medication using dubious means will only aggravate the situation.