Perioral dermatitis is the appearance of signs of inflammation of the skin around the lips and in the chin area. Dermatologists have recognized it as an independent disease relatively recently.
Causes and predisposing factors
The main reason for the development of perioral dermatitis is a violation of the rules for the use of local corticosteroid ointments in the treatment of skin pathologies (in particular, rosacea, vulgar acne and seborrheic dermatitis). This leads to thinning of the skin in the most vulnerable – the pericarp – area, and a decrease in their resistance to the action of pathogenic, including conditionally pathogenic, microorganisms.
Predispose to the development of the disease:
decrease in the level of activity of the immune system;
increased sensitivity to the waste products of some microorganisms;
changes in the hormonal background of the body, including those caused by gynecological diseases;
chronic somatic diseases, especially pathologies of the digestive, endocrine and nervous systems;
active use of cosmetics containing petroleum jelly, paraffin and some other components.
There is a version that the development of dermatitis in the near-oral area is also promoted by wearing dentures made of fluoride-containing polymers, and the frequent use of fluoride-containing products for the care of tooth enamel.
Leading symptoms
The main problem that bothers the patient with the development of perioral dermatitis is the appearance of an abundant rash in the near–oral area: in the upper and lower lip area, nasolabial folds, in the corners of the mouth and chin area. In rare cases, a rash can be observed in other areas of the face.
The rash is represented by small, merging with each other, bumps located against the background of unchanged or reddened skin. Persistent redness of the skin of the perioral cavity and the formation of vascular asterisks is possible.
As a rule, the appearance of new morphological elements is accompanied by a burning sensation, tightness, itching. But every third patient has no unpleasant sensations.
The disease causes psychological discomfort to the patient, reduces the level of self-esteem and often causes the development of neurotic disorders.
Diagnosis of pathology
The diagnosis is made on the basis of the patient’s characteristic complaints and objective examination data. If it is necessary to carry out a differential diagnosis, the doctor resorts to additional methods of examination: blood analysis, microscopic and bacteriological examination of scraping from the inflamed area of the skin. In some cases, the patient is recommended to consult a general practitioner, endocrinologist, gynecologist and other specialized specialists.
Basic principles of treatment
With the development of perioral dermatitis against the background of therapy with local corticosteroid drugs, their use is discontinued. As a rule, after the withdrawal of drugs, the patient notes an aggravation of the severity of the condition, severe burning, abundant formation of new rash elements, which should not serve as a reason for resuming corticosteroids. At this stage , the following are assigned:
Hypoallergenic diet. Histamine-rich foods are excluded from the diet, and the consumption of meat products is minimized.
Antihistamines.
Diuretics. It is advisable to combine their use with an abundant drinking regime, which together helps to relieve swelling of tissues, accelerate the evacuation of hormonal residues and toxins secreted by bacteria from the body.
Restorative drugs, multivitamin and mineral complexes.
Cool lotions with decoctions of herbs with anti-inflammatory effects (chamomile, turnip, calendula), frequent irrigation with thermal water, moisturizing hypoallergenic creams are used locally.
Before going outside, with a high degree of solar activity, sunscreens with a protection factor of 30 to 60 are applied to the skin.
With increased irritability of the patient, the development of neurological disorders, sedative medications are prescribed. It is possible to use acupuncture.
After the removal of acute inflammation, therapy is carried out aimed at restoring the normal balance of the microflora of the skin of the face. For this purpose, metronidazole, tetracycline, and erythromycin drugs are prescribed.
The duration of the course of treatment is from one to three months.
