Periorificial Dermatitis: Understanding and Management
What is Periorificial Dermatitis?
Periorificial dermatitis is a common inflammatory skin condition that primarily affects the areas around the mouth, nose, and eyes. It is characterised by red, bumpy, and sometimes slightly scaly lesions that may be itchy or uncomfortable. While the exact cause is not fully understood, factors such as prolonged use of topical steroids, cosmetics, and certain skincare products are believed to contribute to its development.
Symptoms
The symptoms of periorificial dermatitis may include:
- Redness and small, red bumps around the mouth, nose, or eyes
- Mild itching or burning sensation
- Occasionally, slight scaling or peeling of the affected skin
Causes of Periorificial Dermatitis
Periorificial dermatitis can develop due to a variety of factors, although the exact cause is not fully understood. Some common factors that may contribute to the development of periorificial dermatitis include:
- Prolonged Use of Topical Steroids: One of the leading causes of periorificial dermatitis is the prolonged use of topical steroids on the face. While steroids can effectively reduce inflammation and redness, prolonged use can disrupt the natural balance of the skin and lead to the development of periorificial dermatitis. This is known as steroid-induced dermatitis. Topical steroids can include nasal sprays that contain cortisone, eye drops and accidentally transferring the steroid to the face after applying it to other areas on the body.
- Skincare Products: Certain skincare products, including moisturisers, cleansers, and cosmetics, may contain ingredients that can irritate the skin and trigger inflammation. Ingredients such as actives (glycolic acid, lactic acid, retinols etc.), fragrances, dyes, and preservatives may exacerbate periorificial dermatitis in susceptible individuals. It’s important to choose gentle, non-comedogenic skincare products and to avoid products that may contain potential irritants.
- Impaired Skin Barrier: An impaired skin barrier by overuse of actives and physical exfoliating can worsen perioroficial dermatitis. Environmental factors such as humidity, pollution, and exposure to UV radiation can also influence the development of periorificial dermatitis. These factors can disrupt the natural barrier function of the skin and make it more susceptible to inflammation and irritation.
Prevention
To help prevent periorificial dermatitis or reduce the risk of flare-ups, consider the following tips:
- Avoid prolonged use of topical steroids on the face, especially without medical supervision.
- Use nasal sprays correctly and at night to minimise transference to the skin around the nostrils.
- Choose skincare products labeled as non-comedogenic and free of potential irritants such as fragrances and dyes.
- Practice good skincare habits, including gentle cleansing and moisturising, to maintain the health of your skin.
- Protect your skin from environmental factors such as sun exposure and pollution by wearing sunscreen and avoiding excessive exposure to harsh weather conditions.
By understanding the potential causes of periorificial dermatitis and taking proactive steps to prevent flare-ups, you can help keep your skin healthy and minimise the impact of this condition on your daily life
Treatment
Treatment for periorificial dermatitis usually involves a combination of topical and oral medications, as well as lifestyle modifications. Treatment options may include:
- Topical Antibiotics: You may be prescribe topical antibiotics such as metronidazole or erythromycin to help reduce inflammation and control the growth of bacteria on the skin.
- Topical Immunosuppressants: In some cases, topical medications containing tacrolimus or pimecrolimus may be prescribed to help calm inflammation and redness.
- Oral Antibiotics: Oral antibiotics such as doxycycline or erythromycin may be recommended for more severe or persistent cases of periorificial dermatitis. These medications help reduce inflammation and control bacterial growth from within.
- Avoiding Trigger Factors: It’s important to identify and avoid trigger factors that may exacerbate periorificial dermatitis. This may include discontinuing the use of topical steroids or certain skincare products that may be contributing to the condition.
- Gentle Skincare: Using gentle, non-comedogenic skincare products and avoiding harsh cleansers or exfoliants can help prevent further irritation of the skin.
- Moisturising: Keeping the affected skin well-moisturised with a non-comedogenic moisturiser can help soothe dryness and reduce the risk of flare-ups.
Prognosis
With appropriate treatment and management, periorificial dermatitis can usually be effectively controlled. However, it may take several weeks to months for the condition to fully resolve. In some cases, the condition may recur, requiring ongoing management and vigilance.
Dr Anes Yang 