Synonyms
Perioral dermatitis is also known as oral erythema, stewardess disease or rosacea-like dermatitis. If the affected areas are only around the eyes, it is called periocular dermatitis.
Definition
The term perioral dermatitis describes an inflammation of the skin that typically extends around the mouth and eyes. However, symptoms can also occur on the nose. The inflammation occurs in the form of raised blisters, which may also be filled with pus.
The skin underneath is reddened and shows a slight scaling. Usually there is a light-colored border between the lips and the skin appearance, without redness and blisters. Most frequently, younger and middle-aged women are affected, but increasingly men are also affected.
Causes
It is caused by the frequent use and changing of moisturizers. These creams destroy the barrier and thus protective function of our skin. The skin loses more water and a feeling of tightness develops, which usually leads to the use of more creams, which only worsens the disease. Another cause can be the use of glucocorticoids such as cortisone (for example, due to another skin disease), which are applied directly to the skin.
Duration
Typical of perioral dermatitis is a slow onset and alternation of the various skin symptoms. The disease can last for several months in its various stages. It is important to remember that even under optimal treatment (“zero therapy”), a worsening of the symptoms must first be expected before the skin inflammation can heal as well as possible. It is possible that a spontaneous regression of the symptoms will occur in the course of the treatment. Unfortunately, relapses are also possible in principle.
Treatment
In order to treat perioral dermatitis, it is important that those affected can understand the cause of the skin changes. Frequent use of moisturizers and greasing skin care products damages the skin and should be avoided if possible. This is why the therapy here is also called “zero therapy”, which means that patients should consistently avoid using skin care products and cosmetics in any way.
It should be pointed out that this can initially worsen the skin condition. Very cautiously, base creams can be recommended for local application which may contain 1-2% metronidazole. In extreme cases, antibiotics such as tetracycline may be used.
Rarely a systemic antibiotic administration is used, for example with the antibiotic doxycycline. Black tea can be used to take action by natural means. In this case, however, the tea is not drunk but applied directly to the skin.
After a infusion time of three to five minutes, let the tea bag cool down. Afterwards it is simply placed on the affected skin areas. The cooling and the black tea itself have an anti-inflammatory effect and cause faster healing.
Zinc is a trace element that can neither be produced nor stored by the body. It indirectly influences the build-up and breakdown of connective tissue (as it occurs in the skin). Only dry skin has been associated with zinc deficiency so far.
For perioral dermatitis there is no clear recommendation for treatment with zinc. The use of zinc ointments on open wounds can lead to wound healing disorders. Zinc should only be used in the context of deficiency symptoms of the body, otherwise side effects such as nausea, vomiting and diarrhoea may occur.
Who prefers the use of Schüssler salts can choose for example the No. 3 (Ferrum Phosphoricum). It is generally used in the context of inflammatory processes and can therefore also be used in cases of inflammation of the skin.
No. 1 (Calcium Fluoratum) and No. 11 (Silicea) are recommended especially for the skin.
Depending on the selection, application as an ointment or direct intake is possible. A recommendation for the use of antibiotics for the treatment of perioral dermatitis is given very cautiously. Normally it is sufficient to discontinue all creams used so far. In severe and long-lasting cases, however, base creams containing antibiotics or antibiotics for ingestion can be administered.Antibiotic therapy can be particularly helpful in patients who develop symptoms while withdrawing corticosteroids.
