Perioral Dermatitis

What is Perioral Dermatitis?

Perioral dermatitis is a nuisance of a condition that plagues the area around or just inside the mouth, around or just inside the nostrils and, least commonly, just around the eyes. These areas are called the perioral, perinasal and periocular zones, respectively, and they are notably much more sensitive than most of the dermis. Perioral dermatitis manifests as small red pustules in these zones. These pustules can be quite irritating and even painful if left unchecked. However, perioral dermatitis is not serious, even when it manifests fully in the mouth or nostrils, or near the eyes. It is entirely benign, but it is quite irritating.

Perioral dermatitis is frequently mistaken for a sexually transmitted infection. This is an erroneous link. First and foremost, perioral dermatitis is not an infection. It is a dermatitis condition caused by external irritation of the skin. Secondly, this irritation is not linked to sexual activity. It may bear a passing resemblance to some types of sexually-transmitted herpes in description only, but the link is just that—a link in description only. Photos of each are completely distinct and impossible to mistake.

Who gets Perioral Dermatitis?

Perioral dermatitis may afflict anyone. It is a fairly common condition to develop, and many individuals may suffer from it without ever becoming aware of it. Much unlike acne, it can come and go without notice.

Perioral dermatitis is most common in post-pubescent individuals. Androgens in the blood make it more likely to occur, but any hormonal imbalances can help to coax it into presenting. Among these post-pubescents, young to middle-aged women are the most likely to have perioral dermatitis present. This is due, in large part, to their regular monthly cycles affecting their hormonal balance. In the case of perioral dermatitis, the lower androgens in females may actually contribute to the rise. With most acne conditions, the presence or fluxuation of androgens leads to sebaceous hyperplasia (overactivity of the glands that produce sebum, causing breakouts of blackheads and whiteheads. However, in perioral dermatitis, the irritation and subsequent pustules are not the result of sebaceous hyperplasia, but rather the dryness of the skin, usually provoking pustules as a defensive reaction. Thus, the lack of androgens and thus the lack of sebaceous activity becomes a liability; the sebaceous glands exist to lubricate the skin. While this is an almost vestigial process (it is not required to protect the skin from water, necessarily, for example) it does keep the skin protected from drying out too much unnecessarily.

Men may suffer from perioral dermatitis as well. This is usually due to their own hormonal imbalances, which are most notable during puberty. Thus, perioral dermatitis has a tendency to present itself earlier in males.

Caucasians are somewhat more susceptible to perioral dermatitis. This is a simple extension of Caucasian individuals’ vulnerability to a number of other irritating skin conditions; the fairer and paler the skin, the more likely it is to be affected by an irritant.

Individuals that have had perioral dermatitis are far more likely to suffer from perioral dermatitis again in the future. Having perioral dermatitis is by no means a guarantee that one will suffer from it again, but the probability does have a markedly distinct increase.

Individuals that suffer from severe acne and are receiving certain acne treatments may develop cases of perioral dermatitis as a reaction to the treatment. Topical treatments with any kind of steroidal content are the primary offenders in this. These treatments frequently advise that an individual be very careful about applying their topical creams anywhere near their face, nose or eyes, however, so this should not come as a surprise.

What causes Perioral Dermatitis?

Perioral dermatitis can be caused by a number of factors. Generally, perioral dermatitis arises after a long period of persistent skin irritation. This irritation, however, may come from a very broad range of sources. The primary offender is usually womens’ cosmetics. These can dry the skin out and conflict with natural moisturization, causing irritation severe enough to provoke an outbreak of the telltale pustules. Other dessicating substances may also suffice. Flourinated dental products are often implicated as well, although this may not be as fair an assessment given their commonality.

Perioral dermatitis can be caused by the application of topical steroids, especially around the mouth. These steroids may have been prescribed to deal with a case of severe acne; this is the primary reason steroids may become implicated. In some cases, the dermatitis will be mistaken for acne and ignored as such, although it is a distinct condition.

Around the nose and eyes, cosmetics are frequently the only products that are applied close enough to the sensitive membranes. However, some harsh astringents may be sufficient to cause the same symptoms here as well. Individuals will usually be disinclined to apply such chemicals in these zones by the extreme sensitivity of these areas relative to the rest of the face, but this is still a frequent cause.

Contrary to rumor, perioral dermatitis is not a venereal disease. It is not and cannot be transmitted through sex, nor is it contagious to begin with.

What does Perioral Dermatitis cause?

Perioral dermatitis primarily causes minor irritation. It is a benign condition. It has no morbidity rate and the absolute most minor of complications to deal with. Most of what perioral dermatitis causes is entirely secondary to the actions of the condition itself.

Minor psychological issues may be associated with perioral dermatitis if an individual is particularly sensitive about their appearance or is in a peer group that is notably judgmental. This is primarily because perioral dermatitis is erroneously mistaken for a sexually transmitted infection, when it is nothing of the sort. This is usually only an issue in the rarer cases in which it presents relatively early in life. Among those of middle age or older, it is usually a matter of self-esteem if it is an issue at all.

How serious is Perioral Dermatitis?

Perioral dermatitis is not serious. It is very common, and treatment is symptomatic. Perioral dermatitis, at worst, indicates that there is an external influence that should be dealt with at the next possible opportunity. However, this is uncommon. Perioral dermatitis has no mortality rate and no co-morbid conditions to be concerned with. Any true harm that perioral dermatitis might be related to would be secondary and extraordinary.

Perioral dermatitis may constitute a stumbling block for an individual’s self-esteem, although this will usually be reserved for either the most vain individuals or the absolute worst cases of perioral dermatitis. That said, for individuals who find that perioral dermatitis presents while they are young, children can be very cruel, and the mocking that an outbreak of perioral dermatitis may spark can be quite damaging to one’s psyche. This is, however, an indirect effect.

What does Perioral Dermatitis treatment look like?

Perioral dermatitis treatment is very similar to acne treatment, without the hormonal component. Simple acne washes generally alleviate the pustules, and mild antibiotic treatment may be applied if an outbreak is exceptionally persistent and uncomfortable. Some cosmetics made for sensitive skin may be applied to hide the appearance of perioral dermatitis, although this can be very difficult given its tendency to present near very sensitive skin and the eyes.

Perioral dermatitis prevention is a matter of isolating the causal factors and circumventing them. Usually, all that is required is a change in habits related to cosmetic application, brushing, or the products one uses for either. Regular moisturization can help, although one must be careful to select a moisturizer. Some lotions may actually leave the skin drier than it started.

How do I know if I have Perioral Dermatitis?

Perioral dermatitis is fairly easy to identify by dryness around the mouth and the signature red pustules surrounding or just inside the mouth, surrounding or just inside the nasal passages or near the eyes. While perioral dermatitis is not a serious condition, it is generally advised that it be addressed with one’s dermatologist or general practitioner at the next opportunity, as it may indicate habits or circumstances that require a change of habit. A medical professional is best qualified to advise an individual what habits may be problematic and how they should change, so even though perioral dermatitis is not a serious condition, one shouldn’t stop with self-diagnosis.

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