Perioral dermatitis, also known as erysipelas, is a non-contagious and harmless condition of the facial skin that is manifested by redness and pimples. In most cases, it is caused by excessive use of skin care products on the face. If these care products are consistently avoided, perioral dermatitis usually heals without problems.
What is perioral dermatitis?
‘Perioral dermatitis, also colloquially known as erysipelas, is a harmless disease of the facial skin. Primarily, perioral dermatitis affects women between the ages of about 20 and 40. However, there are also known cases in which men or children suffer from erysipelas. The harmless skin disease manifests itself as red pustules, spots, irritations and pimples in the area of the nose, forehead and mouth. Perioral dermatitis is often psychologically very stressful for affected patients, even though it is one of the harmless diseases. Erysipelas is neither contagious nor transmissible and usually heals without major difficulties.
Causes
How perioral dermatitis develops is not really known. However, medical experts suspect that erysipelas is related to excessive care of the facial skin and the cosmetic and cleansing products used in the process. This is why the condition is also known as stewardess disease, as this professional group attaches particular importance to their appearance and also used products containing cortisone to improve the facial skin without medical supervision a few years ago. It is now known that cortisone promotes the development of perioral dermatitis. In addition, there are certain risk factors that may account for the development of erysipelas. These include, for example, easily irritated or very sensitive skin or the presence of certain allergies, such as to fragrances or ingredients of cosmetics. Excessive use of cosmetics or cleansing products disturbs the skin’s natural protective barrier, drying it out and making it more susceptible to infection. Affected patients often feel that they have particularly dry facial skin and apply more skin care products. This additionally promotes the development of oral erysipelas.
Symptoms, complaints and signs
It is typical for perioral dermatitis that the symptoms only occur on the face, and mainly around the mouth (perioral). It does not affect the lips, leaving a small narrow strip that is symptomless and where no rash appears. The skin becomes dry, it tightens and burns. In addition, the face may be swollen and red. Itching and scaling are also possible. Furthermore, red nodules or even pus-filled blisters of a few millimeters in diameter may form. Although the characteristic site for perioral dermatitis is the mouth region, it can also occur on the chin, nose, especially the nostrils, and cheeks. More rarely, the skin manifestations are found on the forehead, around the eyes or on the eyelids. Only in exceptional cases do they spread over the entire face and onto the neck. The rash is intensified by UV light, but also by mechanical irritation when the patient scratches the affected areas because of the itching. Hormonal fluctuations can also aggravate the symptoms. In women, this sometimes happens before the onset of menstruation. Because the rash is clearly visible on the face and cannot be hidden, affected individuals often feel disfigured and suffer greatly.
Diagnosis and course
Perioral dermatitis can be diagnosed relatively quickly by a dermatologist based on the typical redness and pimples on the face. However, he or she will use certain tests of the skin as well as blood tests to rule out more serious conditions, such as acne or atopic dermatitis. In addition to examining the facial skin, the dermatologist will inquire about the skin care products used and how they are applied so that a treatment plan for erysipelas can be established. If the patient adheres to the doctor’s recommendation and temporarily refrains from using the skin care products, the perioral dermatitis usually improves very quickly. Within a few weeks, the erysipelas can be expected to heal.
Complications
Serious physical complications are not to be feared in perioral dermatitis. Thus, erysipelas appears exclusively on the face and is limited to superficial impairments. Destruction of the skin does not occur. In addition, the disease can be treated without any problems. Only in severe cases antibiotics can be used. Perioral dermatitis usually heals within four to six weeks without any consequences. However, in some patients it recurs later. It is important that erysipelas is treated consistently, which includes weaning the skin off creams. This requires plenty of self-discipline. Thus, during the initial period of treatment, those affected often experience a greater feeling of tightness in the skin as a result of the withdrawal of cosmetics. Negative consequences of perioral dermatitis are imminent if it is not treated. There is a risk of relapsing and chronic course of the disease. It can then take several months or even years for the erysipelas to heal. Sometimes, however, it heals without leaving any scars. If there is pronounced damage to the face due to perioral dermatitis, this increases the risk of bacterial infections that require medical treatment. A common complication of erysipelas is psychological impairment. In such cases, those affected are so ashamed of their appearance that they isolate themselves socially. In cases of severe psychological distress, psychotherapy may prove useful.
When should one go to the doctor?
If peculiarities and changes in the appearance of the skin occur when using cosmetic products or skin care preparations, the first step should be to stop using the products. If there is an improvement in health and there is a complete healing of the irregularities, the creams used should be checked for the ingredients and avoided in the future. In addition, it is recommended that an allergy test be performed by a dermatologist so that the affected person can obtain an overview of the existing intolerances. If the complaints arise after the use of prescribed medicines, consultation with the attending physician is necessary. Dry skin, a development of scales on the mouth, as well as a blistering should be presented to a doctor. In case of sporadic changes in skin appearance, which occur in sexually mature girls and women in connection with menstruation, a doctor should be consulted. The hormonal fluctuations can be treated and therapized in a medical care. Itching, open sores, as well as spreading of the affected region over other areas of the face, should be discussed with a doctor. Caution should be exercised if pus is formed. It can lead to sepsis in severe cases, resulting in a life-threatening condition. If the affected person suffers from mental as well as emotional irregularities due to the skin changes, a visit to the doctor should also take place.
Treatment and therapy
In most cases of perioral dermatitis, the attending physician advises to stop using cosmetics and skin care products so that the skin can recover and rest. However, many patients find this difficult, especially because after discontinuation there may be a temporary aggravation of erysipelas. Usually, in this case, the doctor recommends to the patient medically useful and harmless products to be used as a substitute for the usual cosmetics. In more severe forms of perioral dermatitis, there may be inflammation of the facial skin, which must be treated by the doctor with antibiotic creams or medications. Under no circumstances should affected patients experiment themselves with creams or ointments containing cortisone. This agent further aggravates the problem of erysipelas. Effective treatment of perioral dermatitis is possible only in consultation with a dermatologist.
Outlook and prognosis
In most cases, erysipelas can be cured relatively well. The disease itself is relatively harmless and can thereby also not be transmitted to other people by infection. However, in the case of erysipelas, a doctor should nevertheless be consulted relatively early and furthermore also a treatment should be initiated, so that it does not come to complications or to other complaints in the further course.Self-healing rarely occurs, so that as a rule medical and care products should always be used to counteract the symptoms of erysipelas. If the erysipelas is not treated at all, it can continue to spread and considerably restrict the aesthetics of the affected person. In the process, many of those affected suffer from a reduced quality of life and also reduced self-confidence. Treatment of erysipelas can permanently limit the symptoms, although re-infection is still possible. A complete protection against the disease cannot be built up with it. In many cases, visits to a beautician are also very important to prevent a new episode of the disease. Stress should also be avoided, while a healthy lifestyle with a healthy diet can have an equally positive effect on the further course of this disease.
Prevention
In principle, anyone can develop perioral dermatitis. To avoid the onset of the skin disease, it is recommended to use as few facial care products as possible. If a patient has already had erysipelas once, he or she should be careful not to over-care for the skin again in the future. Otherwise, there is a great risk for the recurrence of perioral dermatitis.
Aftercare
Aftercare consists mainly of preventing recurrence of perioral dermatitis. Patients can help with special applications from trained professional cosmetologists, in the regeneration of the affected skin. During the therapy of an acute outbreak, if possible, no additional care products or cosmetics should be applied. Nevertheless, those affected can gradually use products without irritating ingredients such as fragrances or preservatives as well as emulsifiers sparingly during aftercare. Special plant substances and vitamins, such as those contained in skin care packs, help the sensitive skin to regenerate. One particularly important active ingredient is linoleic acid. The doubly unsaturated fatty acid soothes skin inflammation and improves the resistance of stressed skin. It is also recommended to use aloe vera, which has anti-inflammatory properties and soothes the skin. Sun vitamin D is also important for aftercare, as it helps heal inflammation. To reduce the visible veins, the vascular walls of the skin should be strengthened with the help of vitamin K. Amino acids are also recommended. These protein building blocks regenerate the skin that has just healed. Hyaluronic acid, on the other hand, promotes the skin’s natural ability to store water and thus prevents it from drying out. Those affected are advised to consult a trained specialist cosmetician for aftercare, who is in contact with the treating dermatologist if possible.
What you can do yourself
In the case of perioral dermatitis, patients can do a few things themselves to alleviate the condition. Above all, it is important not to end the therapy prematurely, otherwise a recurrence of the symptoms is very likely. The objective of the therapy is to eliminate the factors that cause the skin to become diseased. For this purpose, it is essential to refrain from using cosmetic care products and make-up. The face should only be cleaned with clear water. Patients should also only apply a lipid-replenishing cream if they feel tight, based on the effects of erysipelas, after consulting the attending physician. A zinc cream, on the other hand, supports the healing of perioral dermatitis and should be applied thinly to the affected skin area. Black or green tea compresses also help to heal erysipelas. To do this, the tea must be cooled and applied to a piece of cloth and then placed on the inflamed area of the face for about 15 minutes. During the 15-minute treatment, the overlay should be soaked several times to additionally benefit from the accompanying cooling effect. The tannins in the tea lead to a drying out of the diseased skin area and thus to healing.
