Perioral dermatitis: diagnosis and treatment
Why does PD arise?
Any skin disease has many causes. Some of them are irritating to the epithelium. The situation is similar with perioral dermatitis. A number of factors that are attributed to the perpetrators of the disease are identified:
- Uncontrolled use of abrasive cleansing cosmetics, tonal creams, masks, scrubs.
- Illiterate selection of decorative and nutritious cosmetics (skin type is not taken into account).
- Prolonged acceptance of hormonal drugs.
- An imbalance of the immune system, as a result of which the skin becomes ultrathin, the protective layer does not work to the full, which makes the development of pathogens on the surface of the body and in the upper layers of the skin possible.
- If the doctor prescribes corticosteroids, the end of the treatment should be smooth, so as not to provoke a skin reaction.
- A tendency to an allergic reaction to external and internal stimuli.
- The moment of exacerbation of autoimmune pathologies.
- Gastrointestinal dysfunction is one of the most common.
- Mechanical damage to the epithelium.
According to the research results, the most fertile period for the development of PD is the childhood age; by gender, women are more prone to this ailment. Although the cases of men disease are not excluded. In the photo, you can see an example of perioral dermatitis on the face of a man who needs serious treatment:
Children’s skin is very thin and tender, and it is in the area of the mouth that the effect occurs most often, because of contact with the mother’s breast, the nipple. At an older age, the cause may be caries, so pediatricians recommend to monitor the oral cavity of the child and consult a dentist in a timely manner.
Frequent cases of women’s PD are due to daily use of cosmetics (creams, lipstick, powder, concealer).
Symptoms and diagnosis of PD
Due to the fact that the symptoms of this type of skin disease are very similar to seborrheic dermatitis, demodicosis, the person will not be able to determine it by himself. Moreover, he should not engage in self-treatment, because even for the doctor it is extremely difficult to prescribe the correct therapeutic course.
An important feature of PD is the long preservation of the main symptoms (skin rashes around the mouth). This period can last for years. This once again demonstrates the urgent need to consult a specialist, take immediate measures and implement his recommendations.
Perioral dermatitis is characterized by the following symptoms:
- Redness in the lower part of the face, mainly around the mouth.
- Lips are bordered with acne, which can also cover the nasolabial fold and chin. In more rare cases, the rash reaches the eyelids.
- There are swelling in the damaged areas.
- The skin is deficient in moisture, there is tension in the skin.
- Due to excessive dryness, peeling may begin, whitish or yellowish scales form.
At the time of studying the symptoms, the doctor turns to a specific detail: a narrow strip of healthy skin between the border of the lips and the pathological zone.
The photo shows obvious symptoms of perioral dermatitis on the face.
The considered type of ailment does not tolerate unauthorized experiments. If the wrong remedy is applied to the pathological areas, additional symptoms immediately appear:
- Hillocks are formed.
- Coarsening occurs, the skin becomes much thicker.
- There are stains that are almost impossible to remove even with subsequent professional treatment.
The initial examination of the patient allows to visually examine the obvious signs. Next, you need to do the seeding in order to make sure that the preliminary diagnosis is correct and to cut off the probability of other diseases.
In the photo you can see what symptoms of perioral dermatitis look like:
Before proceeding to the treatment course, a number of recommendations should be followed, which are the traditional basis for the treatment of skin pathologies:
- At the time of treatment, the use of cosmetics for any purpose is prohibited.
- The use of hormonal creams is prohibited as well.
- Watch the diet, avoid eating spicy, fried, fatty foods, smoked meats. The menu should be dominated by healthy vegetables, fruits, herbs, low-fat dairy products.
- Wash yourself with clean, non-chlorinated water or decoction of medicinal herbs (pharmacy chamomile, marigolds).
Drug therapy involves taking a drug Zyrtec. It is presented in the pharmacy network in drops or tablets. It can be used at any time, regardless of the meal, once a day. Doctors recommend giving preference to the moment before bedtime (about 1-1.5 hours). Drink it with a whole glass of water so that the drug can be better absorbed.
Antihistamine medicine Suprastin fights allergies, it is indicated for both adults and children. Take 4 or 2-3 tablets, relative to the severity of the disease.
When prescribing antihistamines all points are taken into account, like how clearly the symptoms of the disease are expressed, how old the patient is, the presence of chronic illnesses.
When the infection occurs, local antibacterial drugs are prescribed in the affected areas, such as Metronidazole, Erythromycin, Tetracycline ointment. Apply them in the morning and evening, putting a thin layer on the wound. As a result, secondary infection is eliminated and dermatitis is localized, not extending to new places.
If the individual components of Metronidazole are intolerable, the patient is prescribed its analog, Azelac or Skinoren.
Doxycycline and Minocycline perfectly suppress perioral dermatitis and eliminates the associated symptoms.
The use of antibiotics continues until the symptoms disappear.
Tetracycline is effective in severe forms and to prevent relapse. The course of treatment lasts up to 2 months, the dosage is gradually reduced.
Protopic agents can be used for adult patients, except for pregnant and lactating women.
When prescribing potent drugs, the doctor takes into account the likelihood of a side effect, like the inhibition of the activity of the digestive system. At the same time, he can prescribe probiotics and drugs that stabilize the functions of the gastrointestinal tract.
Elidel or Pimecrolimus cream will help in cases when the therapeutic effect of taking other medicines can’t be obtained. However, this drug has not been studied enough to predict its negative effects. The decision of its appointment is preceded by a thorough study of the individual characteristics of the patient, in order to eliminate the likelihood of intolerance to its components. There are serious concerns associated with the provocation of oncological tumors.
In order to speed up the healing process of the affected areas, Desitin Cream can be used, which contains zinc oxide. A thin layer is applied to the wounds from 1 to 3 times per day, relative to the stage of the disease. Duration of treatment is 14 days, in some cases, this period is extended.
Retinoic and Bepanthen creams are also useful to speed up skin regeneration.
You can learn a lot of useful information about the effectiveness of the drugs from the forums. Their participants share their own experiences, provide tips, leave feedback on the use of various agents in the treatment of perioral dermatitis.
The treatment course is fixed by the passage of physiotherapy procedures, in particular, cryomassage with liquid nitrogen.
Another method is vitamin therapy, which is used to treat young patients.
When prescribing drugs or food with the necessary micronutrients, you need to be extremely careful that they do not have the opposite effect. Such substances are called reactogenic, these include iron and copper.
Patients with chronic perioral dermatitis are recommended sanatorium treatment. There they will be able to undergo a wellness procedure using therapeutic mud, bathing in a hot water.
Traditional medicine against PD
Nature gives people hundreds of opportunities to maintain or restore health. There are lots of wise folk advice for those with perioral dermatitis.
Linseed oil, onion juice, and honey are sent for 15 minutes to the water bath. After that, the problem areas are treated.
Pumpkin pulp is crushed to a mashed state, this can be achieved with a blender. Apply the mass on painful areas for 10-15 minutes.
Cut the green succulent leaves of the plant and mash, pour them with a glass of purified water, put on a slow fire, bring to a boil and leave on the stove to cool. Strain and drink 100 ml after each meal.
A good effect is given by lotions from decoctions of oak bark, plantain, birch buds, walnut, calendula, and chamomile flowers. Aloe and Kalanchoe juices are good for treating this ailment as well.
External means of sulfur and tar will help to get rid of the acute form of PD.
Do not forget about the preliminary conversation with a doctor about the choice of popular recipes.
Diet and PD
Foods with calcium and protein content should prevail in the patient’s menu. During the day, you should take as many drinks as possible (fresh juices, dairy, weak tea) and pure water.
Different soups are the most desirable among hot dishes.
Cereals, vegetables, herbs, fruits are prescribed as second dishes.
For breakfast: buckwheat porridge and a piece of steamed lean fish, unsweetened green tea.
For lunch: soup with corn grits, pumpkin, and zucchini, vegetable salad without tomato, millet porridge, compote of dried prunes and fresh apples.
In the afternoon: sour milk, toast with a slice of cheese.
At dinner: curd mass without sugar with low-fat sour cream, weak tea.
The main condition is the exception of spicy, salty, fried food, a minimum of sugar. Also, you have to avoid alcohol.
Prevention and prognosis
Try to keep to a diet that is not as strict as possible. Forget about the fact that fried foods are tastier, and replace them with baked ones. They are no less tasty, but much healthier. Do not eat smoked meat, hot peppers, limit citrus and chocolate consume.
You should not risk using cosmetics from a dubious manufacturer.
Do not self-medicate using medication at random. Especially you should avoid using corticosteroid ointments.
At the first suspicion of PD, consult a doctor.
Personal hygiene products have to be hypoallergenic only.
Do not get involved in excessive sun exposure. The decision to visit the solarium has to be taken only after consulting with the doctor.
Fluoride kinds of toothpaste are undesirable for susceptibility to perioral dermatitis.
Make sure to maintain the oral cavity in good shape, keep the teeth in check, visit the dentist regularly.
Perioral dermatitis is fraught with complications:
- The appearance of ulcers.
- The occurrence of oozing wounds.
- Transition to severe form, secondary infection.
We can assume that in milder forms the disease may well succumb to therapy and pass without a trace. This can not be said about the forms that have become chronic. Unfortunately, it is not always possible to completely get rid of this unpleasant disease. Its signs can haunt a person for a number of years. The chronic form does not affect the general condition of a person, in particular, his physical tone, he can live and work fully. Only one “but” remains — an unpleasant external sign that distorts aesthetic appeal. In this regard, a person has a psychological problem.