What is Periorificial Dermatitis?
Periorificial Dermatitis is a common pathological skin condition which affects usually the face, nostrils, eyes, and at times the genital area in the form of itchy erythematous and tender blisters or papules which may or may not be painful. When the eruptions of the papules are confined to the lower half of the face then the conditions is termed Perioral Dermatitis.
Periorificial Dermatitis affects usually females in the age range of 20 and 50. It tends to also occur in children irrespective of their age. Excessive use of oral or topical corticosteroids is the main reason behind majority of the cases of Periorificial Dermatitis.
What Causes Periorificial Dermatitis?
What exactly causes Periorificial Dermatitis is not yet known but it has been related at times to autoimmune disorders, bacterial infections, excessive use of steroids which are found in may facial creams and lotions, nasal steroids which may be prescribed for certain conditions related to the nose, excessive use of make-up and sunscreens which contain steroids in abundance.
Fluorinated toothpaste is also at times related although rarely to development of Periorificial Dermatitis. People who are hesitant to wash their faces also tend to get Periorificial Dermatitis. Use of certain oral contraceptives has also been linked to development of Periorificial Dermatitis. Hormonal changes in some females have also a connection with the development of Periorificial Dermatitis.
What are the Symptoms of Periorificial Dermatitis?
The main symptoms of Periorificial Dermatitis are:
- Eruptions of papules or blisters on the skin surface either one side of the face or bilaterally in the area of the chin, nostrils, or near the eyes which are usually red in color and may or may not be painful
- Dry skin surface around the eruptions
- The eruptions are usually in clusters and not random
- Burning and irritation at the site of the eruptions can also be a symptom of Periorificial Dermatitis.
- In cases of the genital regions being involved then the eruptions may be in the area of the labia in females and scrotum in males.
How is Periorificial Dermatitis Diagnosed?
The diagnosis of Periorificial Dermatitis is quite easy as just by the look of the papules a physician will be able to tell that the patient has Periorificial Dermatitis. There are no specific lab tests or other investigations required for diagnosing Periorificial Dermatitis.
How is Periorificial Dermatitis Treated?
Periorificial Dermatitis can be definitively treated but it usually takes about four to six weeks before the actual improvement is seen and there is thinning of the papules and ultimately the papules disappear. Some of the general measures of treating Periorificial Dermatitis as prescribed by the physician are to stop applying any lotions or creams to the face, including topical steroids, make-up and other cosmetics, and sunscreens.
In an event where there is a flare up after stopping steroid use then gradual weaning of steroids are recommended. Washing the face with warm water as long as the rashes are present is recommended. Application of a gel or a liquid sunscreen is recommended as long as the rash developed due to Periorificial Dermatitis is present.
In some cases of Periorificial Dermatitis, topical medications in the form of erythromycin or clindamycin may be given for reducing the inflammation and getting rid of the rash caused due to Periorificial Dermatitis.
For some forms where the physician identifies an infection associated with Periorificial Dermatitis, then a course of oral antibiotics may be prescribed for a period of about one month until the infection clears and the rashes disappear which are caused due to Periorificial Dermatitis. The most preferred antibiotic for treatment of Periorificial Dermatitis is doxycycline. Oral form of erythromycin is used for pregnant females who suffer from Periorificial Dermatitis.
How Long does it Take to Get Rid of Periorificial Dermatitis?
Without treatment, periorificial dermatitis may last for a couple of months or more if the person continues to apply corticosteroid creams on the face. With proper treatment, periorificial dermatitis rash usually clears within 1-2 months. There is every possibility of periorificial dermatitis to recur but it usually responds well to re-treatment.
Can Periorificial Dermatitis be Prevented?
The answer to this question is yes. Periorificial Dermatitis can definitely be prevented provided individuals especially females avoid excessive use of topical steroids and facial creams which contain steroids as an ingredient. In cases where use of topical steroids cannot be avoided such as in cases of a facial rash then using it at a minimal amount where the effect of the steroid is not much on the skin and to stop the use as soon as the condition is treated is recommended to prevent Periorificial Dermatitis.
What is the Long Term Outlook for Periorificial Dermatitis?
Cases of recurrence of Periorificial Dermatitis have been reported even after a full course of antibiotics. In such instances, the same form of treatment as mentioned above need to be given so as to treat Periorificial Dermatitis.