Red, inflamed skin around the mouth could indicate perioral dermatitis (POD). Because the chronic inflammatory skin disease appears in the area around the mouth, it is also called "mouth rose". It is a common dermatological disease that can preferentially affect women. The small red poplars, pustules or blisters are often very distressing for those affected.
What are the symptoms of perioral dermatitis?
As the name perioral dermatitis expresses, it is a skin inflammation around the mouth. The disease is typically manifested by the following symptoms:
- Pimples: In the initial stage of perioral dermatitis, small pimples and a feeling of tightness around the mouth usually appear.
- Red and inflamed skin: The affected skin around the mouth may look red, irritated and inflamed. This can range from mild redness to intense inflammation.
- Poplars and blisters: Small red poplars or blisters may form around the mouth. These may occur singly or in groups and may or may not be filled with fluid.
- Dry and flaky skin: The skin may appear dry and flaky. This is usually accompanied by an uncomfortable feeling of tightness and flaking.
- Burning: The affected skin may itch or cause a burning sensation.
A characteristic feature of perioral dermatitis is a narrow hollow around the mouth. No skin changes occur in this area.
How severe is the itching in perioral dermatitis?
Perioral dermatitis may be accompanied by itching. The skin may itch slightly or intensely. The itching may lead to a strong desire to scratch or rub the affected skin. However, scratching or rubbing can make the symptoms worse.
Can perioral dermatitis also occur in the eye?
In some cases, the inflammation can spread from the mouth and nose area to the surrounding skin, including the eyelids and the area around the eyes. This is called periorbital or periocular dermatitis. The symptoms of perioral dermatitis around the eyes are similar to those around the mouth and nose. Some sufferers also report burning or a foreign body sensation in the eyes.
What is the cause of perioral dermatitis?
The exact cause of perioral dermatitis around the mouth is not fully understood. It is thought that several factors may contribute to the development of the condition:
What factors can trigger perioral dermatitis?
Doctors have so far been able to identify some factors that favour perioral dermatitis. These include:
- Impaired skin barrier
- Excessive use of creams and cosmetics
- Intense sunbathing
- Use of topical steroids
- Hormonal factors such as the contraceptive pill
- Bacterial infection or fungal infection
- Wearing face masks
- Fluoride-containing products such as toothpaste
Which risk groups are more likely to get perioral dermatitis?
Perioral dermatitis is also called "stewardess disease" because especially well-groomed women between 20 and 40 years of age fall ill with it. But even among children, it is mostly girls who suffer from the skin inflammation. However, this does not exclude the fact that more and more men also suffer from perioral dermatitis.
What is the treatment for perioral dermatitis?
Treatment of perioral dermatitis usually involves different approaches. It should be individualised based on the severity of symptoms, potential triggers and individual needs. The goal is to reduce inflammation and soothe the skin.
What therapy helps with perioral dermatitis?
A "zero diet" for the skin is advised for perioral dermatitis. For six to twelve weeks, those affected should avoid skin care products. Harsh cleansing foams or lotions, irritating moisturisers, masks or make-up should not be used during this time. Instead, mild cleansing with warm water is recommended. Afterwards, the skin is not treated any further. During zero therapy, fluoride toothpastes, perfume, fabric softener for towels and creams containing corticosteroids should also not be used.
What medicines help against perioral dermatitis?
Severe perioral dermatitis must be treated medically. The following externally applied preparations are suitable for this:
- Zinc ointment: The active ingredient zinc oxide helps with persistent rashes due to its anti-inflammatory and antiseptic properties. The ointment forms a protective layer on the skin. As a result, zinc ointment for perioral dermatitis can protect the affected areas from further irritation.
- Sodium bituminosulphate gel: Sodium bituminosulphate gel can absorb excess sebum or secretion. This helps to relieve inflammation and itching.
- Pimecrolimus cream: The active ingredient belongs to the calcineurin inhibitors and suppresses the immune system. In patients with perioral dermatitis, it can weaken the inflammatory reactions in the skin.
- Antibiotics: If bacteria are involved in erysipelas, they can be killed by antibiotic ointments or solutions with active ingredients such as metronidazole or erythromycin. Some antibiotics also have anti-inflammatory properties. They can help reduce redness, swelling and itching associated with perioral dermatitis.
- Isotretinoin: For severe erysipelas, the acne medication isotretinoin may be used. The active ingredient regulates the sebum production of the skin.
Antibiotics and isotretinoin should only be used after close consultation with the doctor. Isotretinoin is prohibited for pregnant women.
How is itching treated in perioral dermatitis?
Scratching or rubbing the skin may temporarily relieve the itching. But in the long run, it worsens the symptoms and further irritates the skin. Therefore, scratching should be avoided. The following measures can help:
- [Witch hazel](), also known as witch hazel, is a plant used for skin care. Products made from witch hazel contain, among other things, tannins with anti-inflammatory and astringent properties. These cause the skin to contract. As a result, witch hazel can help to alleviate the inflammatory symptoms and strengthen the skin barrier in perioral dermatitis.
- Cold compresses: Cotton cloths with cold water can be placed locally on the affected areas. This alleviates the itching during this time.
What is the healing process for perioral dermatitis?
The healing process for perioral dermatitis can take several weeks to months. Above all, zero therapy is indispensable to achieve an improvement. However, a worsening of the symptoms, the so-called "rebound phenomenon", occurs first. Only after about three weeks of abstaining from cosmetic products can many patients register a first improvement. If patients find it very difficult to stick to the zero therapy, in some cases a medical skin care can be prescribed by the doctor. If the therapy is followed consistently, perioral dermatitis heals without any problems and without scars. Because erysipelas is chronic or chronic-recurrent, relapses can occur again. This can be partially prevented by an adapted facial care.
Which cream for perioral dermatitis?
To avoid further flare-ups, continue to pay attention to skin care after the inflammation has healed. The renewed excessive use of cosmetics can cause a flare-up of erysipelas. After the skin has calmed down again, a very mild skin care cream can slowly be started again. This should be pH neutral and free of fragrances, alcohol, preservatives. Those affected should avoid cortisone preparations and comedogenic ingredients such as silicones, lanolin and cocoa butter. If relapses occur regularly, the permanent use of a medical skin care product may be advisable. This should be discussed with the dermatologist in charge.
How is perioral dermatitis treated in children?
In children, perioral dermatitis appears on the face, often also on the nose and other areas. In many cases, the cause is the use of products containing cortisone, especially by inhalation. Children are also initially treated with zero therapy. The exact treatment should be discussed with a paediatrician or dermatologist.
What home remedies help with perioral dermatitis?
For erysipelas, some natural home remedies can help to relieve the symptoms.
- Chamomile tea: Chamomile tea has anti-inflammatory properties and can help reduce redness and inflammation. To do this, dab a cotton pad in cooled chamomile tea and gently place it on the affected area.
- Black tea: In the case of perioral dermatitis, black tea can reduce itching and support healing due to the tannins it contains. To do this, use the cooled tea as a compress or wash.
- Pansies: The plants contain active ingredients such as saponins, flavonoids and salicylates, which can have anti-inflammatory and soothing properties. A cooled tea is placed as a compress on the affected areas for several minutes and then rinsed off.
- Oatmeal: Oatmeal has anti-inflammatory and soothing properties. A paste is prepared from ground oat flakes and water. After about 20 minutes of application on the affected areas, the oat flakes are rinsed off again.
- Aloe vera gel: Aloe vera gel has anti-inflammatory and cooling properties. Fresh aloe vera gel is applied to the affected areas. After about 20 minutes, any gel that has not been absorbed is rinsed off again. Aloe vera money should not be used in the zero phase.
What measures can support the healing of perioral dermatitis?
Patients with perioral dermatitis can take some measures to help heal perioral dermatitis or prevent a flare-up.
- Sunbathing: Avoid prolonged sunbathing and use sunscreen and a hat to protect against UV rays.
- Diet: Patients should eat few convenience foods and lots of natural meals. Many dairy products strengthen the intestinal flora.
- Make-up: Patients should avoid wearing make-up. If make-up is used, foundation should not be used. Avoid waterproof products for mascara and eyeliner.