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What is Periorificial dermatitis? What causes it, how long does it last and how is it best treated?

If you woke up to find a red rash around your mouth and you don’t know why it could be that you have a type of dermatitis called periorificial (or perioral) dermatitis. If your skin is flaking and you have inflamed bumps that itch and burn, and it seems as though it may be spreading to the nose and eyes, then this is the article for you. We will give you all of the information you need to determine whether you do have periorificial dermatitis and how it can be treated.

Try not to panic, simply gather as much information as you can and visit a skin specialist (dermatologist) for a professional diagnosis. In the meantime, here’s everything you need to know.

 

What is Periorificial dermatitis?

Periorificial dermatitis is a red rash that tends to circle around the mouth. The skin will become scaly, dry, and flaky and may exhibit swollen or inflamed bumps, also known as papules.

Perioral is one of the many types of dermatitis and it can be a cause of serious anxiety. It is also most often mistaken for acne as it is a skin condition that closely resembles it.

Some people find that their periorificial dermatitis itches and burns. Often it can spread beyond the mouth up to the nose and eyes and in some very rare cases, to the genitals.

What does periorificial dermatitis mean?

The world periorificial can be broken down into several parts:

  • Peri: The word ‘peri’ means ‘around’.
  • Oral: The word ‘oral’ means ‘mouth’.
  • Orificial: The word ‘orificial’ means ‘orifice’ or ‘an opening’.

As such, the word literally means, ‘around an opening’, which refers to the skin condition.

 

What are the symptoms of Periorificial dermatitis?

So, what are the symptoms of periorificial dermatitis? The main symptom is a red rash that forms around the mouth. Again, this rash may appear to be scale, dry, and/or flaky.

Often, there are inflamed bumps that accompany the rash, called papules.

In addition to the flaking skin and inflamed bumps, you may develop vesicles (clear fluid-filled bumps), or pustules (white-fluid-filled bumps), which is why the condition is often mistaken for acne.

Though this condition is typically found around the mouth, it is not uncommon for it to spread to your eyelids, around your eyes, and the nose. In some very extreme cases, it can appear on your genitals, scalp, ears, and neck.

Other symptoms of periorificial dermatitis include an itching or burning sensation.

Some people report experiencing conjunctivitis (aka pink eye). If you suspect that you have pink eye and think that it may be related, then your health care provider may refer you to an ophthalmologist as well.

Summary of symptoms

  • Red rash around the mouth, eyes, nose, and/or genitals
  • Dry, scaling, and/or flaking skin
  • Inflamed bumps
  • Clear fluid-filled bumps
  • White fluid-filled bumps
  • Burning or itching sensation
  • Pink eye

 

 

What causes Periorificial dermatitis?

And what are the main causes of periorificial dermatitis? Unfortunately, the exact cause of this condition has yet to have been determined, however, experts have noted a number of possible causes:

  • Topical steroid creams
  • Inhaled prescription steroid sprays
  • Certain moisturisers
  • Heavy face creams
  • Chewing gum
  • Dental fillings
  • Hormonal changes
  • Epidermal dysfunction
  • Immune system issues
  • Altered cutaneous microflora
  • Bacteria such as follicular fusiform
  • Candida albicans
  • Demodex mites

As you can see there are quite a few potential causes of this condition so it is worth consulting with your healthcare provider in order to try and determine the root cause with an expert. In that case, it will be much easier to determine how best to combat the issue and prevent the rashes from spreading further or the condition from worsening.

 

How long does Periorificial dermatitis last?

If you are worried that you may be stuck with it forever, don’t panic! It is possible to resolve periorificial dermatitis – however, this can take weeks and even years depending on the situation. As such, you must seek treatment immediately. Those who do not seek treatment may end up with periorificial dermatitis indefinitely. If, however, you do seek help, your symptoms are far more likely to go away much sooner. It’s a matter of catching it as early as possible, figuring out what might be causing it, and then making the necessary lifestyle changes to combat it.

 

What is the best treatment for perioral dermatitis?

What is the best way to treat perioral dermatitis? Unfortunately, there isn’t a single “cure-all” for this skin condition as of yet. However, there are steps that you can take to treat it.

First, you need to stop using any of the products that are likely causing your periorificial dermatitis, such as the following:

  • Topical and inhaled steroids (including over-the-counter and prescribed steroids). If you have been prescribed a particular steroid for another ailment, ask if there are any alternative medications that you can switch to.
  • Face creams, including moisturisers.
  • Cosmetic products such as makeup. Understandably, this skin condition can cause anxiety and you will likely be tempted to try and mask it, however, wearing makeup may only make the condition worse.
  • Sunscreen – there are other organic methods of protecting your skin from the sun. Otherwise, it may be worth avoiding direct sunlight for a while.
  • Fluorinated toothpaste (un-fluorinated toothpaste can be found in health food stores and online).
  • Chewing gum.

Please note that your periorificial dermatitis may flare up again after stopping using a topical steroid. In this case, experts recommend that you go back on a topical steroid as long as it is not quite as strong as the one that you were using. This is something that you must discuss with your healthcare provider. It is also worth bearing in mind that the condition may worse first before it gets better.

Additionally, there are certain other medications that can help with your periorificial dermatitis. While these may take weeks or months to work, they may be worth trying:

 

Topical mediations (applied to the skin)

  • Erythromycin gels
  • Clindamycin lotions or gels
  • Metronidazole creams or gels
  • Pimecrolimus
  • Azelaic acid
  • Sulfur preparations
  • Tacrolimus ointments
  • Pimecrolimus
  • Adapalene
  • Photodrynamic therapies.

 

Oral antibiotics medications (consumed by mouth)

Your healthcare provider may prescribe oral antibiotics which can help with inflammation. What you will likely find is that you are advised to try both a topical treatment alongside antibiotics. Here are some of the recommended antibiotics:

  • Tetracycline
  • Doxycycline
  • Minocycline
  • Oral erythromycin
  • Low-dose isotretinoin.

 

Is there a known cure for periorificial dermatitis?

Unfortunately, there is no cure for periorificial dermatitis, however, long-term remissions are indeed possible. This is a condition that could be with you for months and even years. Sometimes the rash will disappear on its own and then reappear later. The best thing to do is seek medical assistance and go from there.

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