Tuesday, December 13, 2005

Perioral Dermatitis May Be Confused With Rosacea

Perioral (around the mouth) dermatitis is a skin rash of small red bumps that may itch and burn. It may also involve the chin and facial lines around the nose. It may look like acne with its pustules, but it’s not.
There are a number of theories as to why perioral dermatitis occurs. One is that it is a form of rosacea. Hormonal fluctuations, sunlight, stress, makeup, heavy facial creams, fluoridated toothpaste, steroid nasal sprays/inhalers, and overuse of steroid creams are known to aggravate perioral dermatitis. Foods or pills like Synthroid are not believed to cause or worsen perioral dermatitis.
Steroid creams are a surprising cause of worsening perioral dermatitis. While steroid creams can help with an acute flare, the rash returns with a vengeance once the steroid cream is stopped. This is a difficult “addiction” because stopping cold turkey results in weeks of a worsened rash. Nonetheless, topical antibacterial creams and lotions are better in the long run.
For stubborn cases, oral antibiotics like Doxycycline or Flagyl are your best bet. Steroid creams (those that are non-fluorinated) and immune-suppressing creams like Elidel or Protopic are best used for short periods until the topical/oral antibiotics have kicked in. One more suggestion is to use a mild skin cleanser like Dove or Cetaphil and avoid scrubbing.