What is Perioral Dermatitis?

Perioral dermatitis is a condition that occurs around your mouth, nose, eyes and many times only on the chin.  The condition is very common and it tends to come and go over time. It is caused from a combination of eczema and an infection. Both components must be treated at the same time.  With appropriate treatment, it can be cured.

The eczema component is a localized allergic reaction that occurs when irritating products are used on the facial skin.  This process leads to poor barrier function and allows infection by organisms that reside on your skin.  Many people treat the condition for two weeks and it comes right back because it takes at least a month to allow the skin to normalize.

What causes perioral dermatitis?

It is, many times, aggravated by stress, tension, changes in the weather, sun, the wrong make-up, toothpaste, and many other factors of which we are not aware.  The wrong types of medications, soaps, colognes, perfumes, and touching the area will aggravate the skin.  Many expensive makeup brands are bad for this condition and should not be used.  Microdermabrasion, chemical peels and other harsh beauty treatments may set the skin up for this problem.

How can I protect myself?  

Try to keep your hands away from the area except when you wash your face, which should be done at least two or three times a day with water and a mild cleanser, such as Aquanil Cleanser or Pure Blend Cleanser.  Topical Vitamin C serum can speed healing.  For the first month, a mild moisturizer may be needed such as Oil-Less Moisturizer whenever the skin feels dry or tight.  Do not use any other medications or soaps, cleansing agents or astringents, abrasives, glycolic acids, sunscreens, topical antibiotic creams or moisturizers on this area.  Avoid products that contain propylene glycol or parabens. You may use a powdered mineral make-up. 

How is perioral dermatitis treated?

The infection component of perioral dermatitis usually responds very well to Doxycycline (prescription required) but if caused by a yeast organism or a mite, may require Diflucan or Metronidazole (prescriptions required).  Some people have to take these pills for many months in order to keep the condition from recurring.  There is no harm in taking this medication long term as long as you are not pregnant or breastfeeding. 

Topical fluorinated cortisone creams are very bad for this condition.  You must not use strong cortisone creams on your face for long periods of time, as they will tend to perpetuate perioral dermatitis or aggravate it.  If you have been using any type of cortisone cream on your skin, your skin has become addicted to it and will go through a temporary withdrawal when it is stopped.  You must stop the cream. You will likely experience a flare-up in the first week to 60 days.  This will gradually resolve with medication prescribed by your doctor and the regimen detailed earlier.