Perioral dermatitis is a common facial skin problem in adult women. It rarely occurs in men. It may occasionally affect children. Groups of itchy or tender small red papules (bumps) appear most often around the mouth. They spare the skin bordering the lips (which then appears pale) but develop on the sides of the chin, then spreading to include upper lip and cheeks. The surrounding skin may be pink, and the skin surface often becomes dry and flaky.
Often the skin around the nose is affected too, and sometimes that around the eyes (when it should more correctly be called ‘periocular', or better still, ‘periorificial' dermatitis.) Rarely, periorificial dermatitis may affect genital skin or the skin surrounding the anus.
The exact cause of perioral dermatitis and/or periorificial dermatitis is not understood. Patients who are susceptible to perioral dermatitis tend to have an oily face, at least in the affected areas. The rash is probably induced by:
- Neglecting to wash the face with water, using soap or a soap-free cleanser.
- Face creams applied to the area bounded by the cheek folds and chin, or around the eyes in the case of periocular dermatitis. Moisturisers, cream cleansers, make-up foundation and sunscreens may all provoke perioral dermatitis.
-Topical steroid creams or ointments, which appear to be the most frequent cause. They are sometimes applied quite inadvertently, touched by the fingers that are treating another part of the body. The more potent the steroid cream, the more rapid and severe the perioral dermatitis which may result.
Recent research suggests perioral dermatitis may be related to proliferating bacteria and/or yeasts in the hair follicles.
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