Although the exact cause of perioral dermatitis is unknown, exposure to corticosteroids that are applied to the skin, use of water or toothpaste that has fluoride in it, or both have been proposed as possible causes.
The disorder mainly affects children and women of childbearing age. The rash typically starts in the folds of skin on the sides of the nose (nasolabial folds) and spreads around the mouth (the perioral area). The rash can also spread around the eyes and to the forehead.
Diagnosis of Perioral Dermatitis
A doctor's examination of the skin
Perioral dermatitis is distinguished from acne Symptoms Acne is a common skin condition causing pimples and other abnormalities on the face and upper torso. Acne is caused by a buildup of dead skin cells, bacteria, and dried sebum that blocks the... read more by the lack of blackheads and whiteheads (comedones). Perioral dermatitis can be difficult to distinguish from rosacea Symptoms Rosacea is a persistent skin disorder that causes redness, tiny pimples, and noticeable blood vessels, usually on the central area of the face. The cause is unknown. Typical symptoms include... read more . However, rosacea does not cause a rash to form around the mouth and eyes. Other symptoms of rosacea must be present for that diagnosis to be made instead of perioral dermatitis.
Doctors also rule out other types of dermatitis such as seborrheic dermatitis Seborrheic Dermatitis Seborrheic dermatitis is chronic inflammation that causes yellow, greasy scales and dandruff to form on areas of the skin that have a high number of oil glands such as the scalp and face, along... read more and contact dermatitis Contact Dermatitis Contact dermatitis is skin inflammation caused by direct contact with a particular substance. The rash may be itchy, is confined to a specific area, and often has clearly defined boundaries... read more .
Treatment of Perioral Dermatitis
Avoidance of toothpaste with fluoride and corticosteroids that are applied to the skin
People with perioral dermatitis should stop using toothpaste with fluoride and corticosteroids that are applied to the skin. Some oily cosmetics, especially moisturizers, tend to worsen the disorder and should also be stopped.
Doctors give antibiotic creams or gels or tetracyclines or other antibiotics taken by mouth. Antibiotics can be stopped once the rash goes away. If these antibiotics do not clear up the rash and the disorder is particularly severe, isotretinoin, an acne drug, may help.
Pimecrolimus (a drug that suppresses the immune system) cream can be used for people over 2 years of age.
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