Perioral Dermatitis - Western SummaryWestern Medicine Summary

Western Medicine

Western Summary

Perioral dermatitis is a chronic condition that has features of both acne and rosacea. The condition predominantly affects girls and women typically between the ages of 16 to 45.[1] In rare cases children and infants can be affected. 

Symptoms

Perioral dermatitis is a rash made up of small red bumps on the face.  Perioral dermatitis typically occurs around the mouth and can occur around the nose and eyes as well. 

Causes

The exact cause for perioral dermatitis is not known but it has many features that overlap with both acne and rosacea. There have been many associations  made that include a combination of genetic and environmental causes.[1] These include:

  • Medications: topical steroids (especially steroids that contain fluorines), inhaled steroids, oral steroids
  • Products: Toothpaste that contains fluoride, Sunscreens, Dental fillings
  • Food items: Cinnamon, Chewing gum
  • Microorganisms: Demodex mites, Bacteria, and Candida
  • Hormonal variations including premenstrual flares
  • Poor skin barrier function

Treatments

The treatment for perioral dermatitis includes stopping items that could be worsening the condition as well as starting medications to treat it.[2] 

A qualified healthcare provider may prescribe any one of the following medications.

  • Metronidazole cream: This is an antibiotic that has anti-inflammatory properties
  • Sulfacetamide: This is a sulfur based wash that has anti-inflammatory properties
  • Clindamycin or erythromycin: These are both antibiotics that also have anti-inflammatory properties
  • Azelaic acid: This cream has an anti-inflammatory effect
  • Oral antibiotics such as doxycycline or minocycline
  • In children that are 8 years of age or younger, doxycycline and minocycline are avoided since they can permanently stain teeth.  Instead other antibiotics with anti-inflammatory effects are used, such as erythromycin and azithromycin.[2]
  • Photodynamic therapy:[3] In this treatment, the skin is incubated with a chemical known as 5-aminolevulinic acid and is converted into a chemical known as protoporphyrin IX. This chemical is sensitive when exposed to red and blue light.

​1.    Tempark T, Shwayder TA. Perioral dermatitis: a review of the condition with special attention to treatment options. Am J Clin Dermatol.2014;15(2):101-113; PMID: 24623018.

2.    Goel NS, Burkhart CN, Morrell DS. Pediatric periorificial dermatitis: clinical course and treatment outcomes in 222 patients. Pediatr Dermatol.2015;32(3):333-336; PMID: 25847356.

3.    Richey DF, Hopson B. Photodynamic therapy for perioral dermatitis. J Drugs Dermatol.2006;5(2 Suppl):12-16; PMID: 16485876.