Do I have eczema, acne, rosacea? It could be perioral dermatitis. Unfortunately, although common, is a condition that is misdiagnosed again and again. We’ve all heard of it. But what actually is it? In this article we delve into the complex process and diagnosis of perioral dermatitis.
Dr Stephen Lewellis, is an integrative dermatologist from New York and his expertise includes perioral dermatitis, rosacea and acne.
He has answered all our questions so you can have all the information possible on this stubborn condition.
What is perioral dermatitis?
It is a combination of red pimples or pustules that tends to spread around the mouth area, hence its name, but also can be found around the nostrils and the openings of the eyes. It normally affects people between the ages of 20 and 45.
It presents as a mix between dry, scaly and just really irritated looking skin which can look more similar to acne bumps or eczema depending on the person.
It is a skin disease that comes from irritation. First your skin is triggered by something and if you treat it incorrectly it often spirals even more from that.
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Is it curable?
You can get rid of it, yes. I always tell my patients it is a lot less chronic than rosacea, however it can become it and potential flares in the future are possible.
What causes it?
A very common trigger for it is topical steroids. There are some steroids that are often used as anti-inflammatory medications. These are often used inappropriately as they sometimes make skin conditions look better in the beginning but they actually make it get worse in the end. I always ask my patients if they have been using them or messing around with things like toothpaste, which contains fluoride, that can exacerbate your skin.
Many high profile celebrities have been open about suffering with perioral dermatitis, like Amanda Seyfried.
What should my skincare routine look like?
We try to take away the non-essentials and give just a very minimalist skincare routine at the beginning and then make sure they’re not using any of the products I stated above. With any condition I always recommend removing fragrances too. A gentle cleanser and a light moisturiser and maybe a niacinamide.
What other treatments are available?
I will often start with a customized compounded topical medication so they get three or four ingredients in one (For example, metronidazole combined with niacinamide and ivermectin).
I often recommend azelaic acid, which is commonly used for a variety of different conditions, including rosacea. There are oral medications and antibiotic treatments as well. If I go via the antibiotic route I alway prefer a low dose that won’t kill bacteria but does have anti-inflammatory properties.
For more information on topical medication and oral medications please consult your personal doctor and/or dermatologist and get a prescription when necessary.
I always say to have patience. The treatments do not tend to work very fast. Some people notice a difference within a couple of weeks, before making a judgement about whether it worked or not, unless of course you are having side-effects.
I know it is annoying, but sometimes it can even get worse before it gets better! So please trust the process, stay calm and if the first treatment doesn’t suit you after a while then there will be something else that does.
If you believe you may have perioral dermatitis, please investigate further here and book an appointment with your medical professional.
