Understanding and Treating Perioral Dermatitis

The possible symptoms that can lead to the PD are as follows:

1. Redness: The affected areas can appear red and inflamed.

2. Bumps or Papules: Small, red, and raised bumps or papules may develop. These can sometimes be filled with pus.

3. Burning or Itching Sensation: You may experience a burning or itching sensation in the affected areas.

4. Flaky or Peeling Skin: The skin around your mouth may become flaky or start to peel.

5. Pimple-like Lesions: The rash may resemble acne with pimple-like lesions.

6. Papulopustular Rash: The rash often has a characteristic appearance with clusters of small, red bumps that may have a central pustule.

7. Distribution around the Mouth and Eyes: PD typically spares the skin around the eyes but affects the areas around the mouth, sometimes extending to the cheeks and nose.

It’s important to note that PD can be mistaken for other skin conditions such as acne or rosacea. If you suspect you have PD or are experiencing persistent skin issues, it is advisable to consult a dermatologist for a proper diagnosis and appropriate treatment. 

How do Dermatologists Diagnose Perioral Dermatitis?

Diagnosing PD typically involves a combination of a thorough medical history, clinical examination, and sometimes additional tests. Here are the diagnostic methods commonly used by dermatologists for perioral dermatitis:

1. Your Clinical Examination: Dermatologists will examine the affected areas of your skin, particularly around the mouth, nose, and eyes. Periorificial dermatitis often has a distinctive appearance with red papules and pustules.

2. Asking Medical History: There are other relevant factors that are crucial for the diagnosis. They will ask you for information about the onset of symptoms, any recent use of topical steroid creams, or changes in skincare products.

3. Doing Biopsy: In some cases, a dermatologist may recommend you a skin biopsy. A small sample of your skin is taken and examined under a microscope to confirm the diagnosis and rule out other skin issues.

4. Elimination of Triggers: If topical steroid creams are suspected as a cause, the dermatologist may advise discontinuing their use. Improvement in symptoms after discontinuation can support the diagnosis of perioral dermatitis.

5. Doing A Patch Test: If there is suspicion of contact dermatitis or an allergic reaction to a specific substance, patch testing may be conducted to identify potential allergens.

6. Taking A Blood Test: In some cases, blood tests may be performed to rule out other potential causes or to assess overall health. But these are not typically specific to PD.

What Treatments You Should Try For PD?

The medical treatment of perioral dermatitis typically involves a combination of lifestyle changes, discontinuation of potential triggers, and, in some cases, medications prescribed by a dermatologist. Here are some general approaches for the effective treatment of PD:

1. Discontinuation of Topical Steroids: If the use of steroid creams is identified as a trigger, the first step is to discontinue their use. However, this should be done under the guidance of a healthcare professional. Abruptly stopping steroids can sometimes lead to a flare-up.

2. Using Topical Antibiotics: Dermatologists often prescribe topical or oral antibiotics to reduce inflammation and control bacterial overgrowth. Common topical medications include metronidazole, clindamycin, and tetracycline. 

3. Topical Calcineurin Inhibitors: In some cases, dermatologists may recommend topical calcineurin inhibitors, such as tacrolimus or pimecrolimus, as an alternative to steroids.

4. Incorporating A Gentle Skincare Routine: Use a mild, fragrance-free cleanser and moisturizer. Avoid using harsh products or excessive cleansing, as this can exacerbate your symptoms.

5. Implying Sun Protection: Protect the affected areas from the sun using a broad-spectrum sunscreen with at least SPF 30. Sun exposure can worsen your PD.

6. Avoiding Triggers: Identify and avoid potential triggers such as spicy foods, toothpaste with fluoride, and certain cosmetics.

7. Oral Contraceptives: For some women, hormonal factors may play a role. In such cases, oral contraceptives may be considered under the guidance of a healthcare provider.

8. Probiotics: Some studies suggest that probiotics may be beneficial in managing perioral dermatitis by promoting a healthy balance of bacteria on the skin and in the gut.

What Natural Remedies You Can Use for PD?

You should cautiously approach home remedies for PD.  Also, consulting with a healthcare professional before trying alternative treatments is crucial. Some of the  natural remedies you can use for PD are:

• • Azelaic Acid
  • Apple Cider Vinegar
  • Calendula Cream
  • Healthy Diet
  • Probiotics
  • Aloe Vera Gel
  • Stay Hydrated
  • Coconut Oil
  • Manuka Honey
  • Tea Tree Oil

What Steps You Can Take to Prevent Perioral Dermatitis?

While the exact cause of PD is not well understood, and individual responses to preventive measures may vary. There are some general recommendations that may help you reduce the risk of PD or prevent flare-ups. 

 Avoid Steroids:

Limit the use of steroids on the face, especially around the mouth, nose, and eyes. If prescribed, use them strictly according to your dermatologist.

Use Gentle Skincare Practices:

• Use mild, fragrance-free cleansers, moisturizers, and facial creams on your face.
• Avoid abrasive scrubs and harsh skincare products that may irritate the skin.
• Choose your foundations wisely.

Choose Toothpaste Wisely:

• Use fluoride-free toothpaste or consider switching to toothpaste without sodium lauryl sulfate (SLS), as SLS has been associated with perioral dermatitis in some cases.

Get Sun Protection:

Protect your face from the sun by using a broad-spectrum sunscreen with at least SPF 30. Sun exposure can trigger or worsen PD.

Identify and Avoid Triggers:

• Pay attention to factors that may trigger or worsen your symptoms. This may include certain foods, cosmetics, or environmental factors. They may cause you skin irritation.

Stay Hydrated:

• Maintain good skin hydration by drinking an adequate amount of water.

Consider Hormonal Factors:

• For some individuals, hormonal factors may play a role. If relevant, discuss hormonal options with your healthcare provider.

Add Probiotics In Your Diet:

• Consider incorporating probiotics into your diet to promote a healthy balance of bacteria on the skin and in the gut.

Regular Dermatological Check-ups:

• Schedule regular check-ups with a dermatologist to monitor your skin health and discuss any concerns.

It’s important to note that these preventive measures are general recommendations, and their effectiveness may vary from person to person.

What’s The Relationship Between Skin Conditions and Mental Health?

Skin issues, including PD, can have a significant psychological impact on mental health. Visible skin issues can affect self-esteem, body image, and overall emotional well-being.

Coping with the psychological aspects of skin problems involves a combination of self-care, support from others, and professional assistance. Here are some ways to cope with the psychological impact of perioral dermatitis:

Seek Professional Support:

• Consult with a dermatologist to address the physical symptoms of PD. They can provide effective treatment options to manage the condition.
• If the psychological impact is substantial, consider consulting with a mental health professional, such as a psychologist or counselor, to discuss your feelings and develop coping strategies.

Educate Yourself:

• Learn about PD to understand the condition better. Knowing the causes, triggers, and available treatments can empower you to manage the situation more effectively.

Open Communication:

• Share your feelings and concerns with friends, family, or a support group. Talking about your experiences can provide emotional relief and foster understanding among those close to you.

Focus on Self-Compassion:

• Practice self-compassion by acknowledging that having a skin issue does not define your worth or identity. Treat yourself with kindness and understanding.

Develop a Skincare Routine:

• Establish a gentle skincare routine that supports the management of perioral dermatitis. This can contribute to a sense of control over the condition.

Explore Makeup Techniques:

• If appropriate, explore makeup techniques to conceal or minimize the appearance of the rash. However, be cautious with makeup products to avoid exacerbating the condition. 

Set Realistic Expectations:

• Understand that managing PD may take time. Set realistic expectations and be patient with the healing process.

Engage in Stress-Reduction Activities:

• Practice stress-reduction techniques such as meditation, deep breathing, yoga, or other activities that promote relaxation. Stress can exacerbate skin conditions, so managing it is crucial.

Real Stories: Dealing With Perioral Dermatitis

In our journey to understand and conquer PD, real stories from individuals who’ve faced this skin condition head-on can be powerful sources of inspiration and guidance. Their experiences shed light on the challenges and triumphs that come with managing perioral dermatitis.

We are sharing the experience of Bachelor alum Kristina Schulman with you so that you can get inspiration for dealing with your skin issues. Here is what she says on the captions of her photos on Instagram,

“This morning I woke up feeling down, overwhelmed, sad, and defeated. For the past few days, I stayed quiet and off social media in hopes that I’ll reach [a] mental state where I can share my skin’s journey + progress—that progress hasn’t come… just yet.”⁣

Schulman modified her skincare approach by adjusting her makeup routine to eliminate potentially irritating products. She opted for an ultra-minimalist skincare routine and transitioned to hypoallergenic laundry detergent as part of her treatment process. She says,

“But here we are, still struggling with random flare-ups that hurt, itch, burn, feel very dry and tight⁣.”

This time I hope to be better prepared and offer some knowledge in return⁣,” she said.

“While I know I am not alone in this or with this condition (which is very tricky to treat since triggers are different for each individual),” Schulman wrote, “I hope we can create a community where we can openly share our journey and success stories.”

Some Frequently Asked Questions:

Now that we have understood the condition well, let’s delve into some FAQs that are mostly asked by the people to a dermatologist.

How long does it typically take to see improvements with treatment for perioral dermatitis?

The timeline for improvement in PD varies, but some individuals may notice improvement within a few weeks, while complete resolution may take several weeks to months. Consistency in following the prescribed treatment plan is crucial for optimal results.