Perioral dermatitis in adults treatment. Oral dermatitis treatment

Perioral dermatitis is an inflammatory disease of the facial skin of an allergic nature with a predominant location of lesions in the mouth area. During illness, the skin takes on an unaesthetic appearance, which causes constant discomfort for the patient, often leading to stress and depression.

This is a chronic pathology characterized by a long and persistent course, requiring careful selection of treatment tactics, diet, care and decorative cosmetics.

The mechanisms of development of perioral dermatitis are not completely clear. Presumably, the basis for the development of an allergic reaction and inflammatory process is a decrease in the protective function of the skin, the proliferation of opportunistic flora and individual hypersensitivity of the skin.

Etiology of the disease and causes

The disease begins after long-term or short-term exposure to internal and external factors.

Local inflammation on the face is caused by:

• use of external glucocorticosteroids;
• use of inhalations, eye drops, cosmetics and oral contraceptives with hormonal substances;
• use of fluoridated toothpastes and mouthwashes, professional teeth cleaning;
• immunodeficiencies;
• hormonal dysfunctions in the body;
• prolonged exposure to the sun, chapping of the skin;
• use of oily, thick cosmetics;
• infectious diseases;
• disruption of the gastrointestinal tract.

Pathology occurs in 0.5-1% of the population. Dermatitis is most often observed in women from 15 to 40 years old, less often in men and children. 80% of women have gynecological pathologies, 65% have gastrointestinal diseases. On average, 1/3 of patients have foci of chronic infection, disorders nervous system.

The risk group includes people with a hereditary predisposition to atopy, with light and thin skin with blood vessels located close to the surface.

Clinical picture

Perioral dermatitis manifests itself in the form of dense spherical nodules (papules) that appear on reddened or unaltered areas of the skin. They are bright red or pink in color.

The disease is characterized by a rapid onset, persistent and ongoing process, during which new elements of the rash constantly develop.

Approximately 25% of patients do not feel physical discomfort. In other cases, inflammation is accompanied by itching, burning and a feeling of tightness of the skin.

Depending on the severity of the inflammatory process, the rash can be in the form of individual pink papules or develop in areas with hyperemia in the form of numerous small bright red papules.

Upon tactile contact, roughness of the skin is noted. In some cases, crusts form on the surface of the papules. If they are removed prematurely, an area of ​​hyperpigmentation remains on the skin.

The main location is the perioral zone: the chin, the area under the nose, nasolabial folds, corners of the mouth. In rare cases, a periorbital form of pathology is noted. This is a lesion of the skin of the corners of the eyes, eyelids, and bridge of the nose.

A characteristic sign that allows you to distinguish perioral dermatitis from other types of rashes is the unaffected area of ​​skin around the border of the lips. Against the background of reddened areas, it looks like a pale rim 4 mm wide.

Papules are not prone to growth and fusion and do not affect the follicles. The process never spreads to the neck, scalp or other areas of the body.

Diagnostics

After the first signs appear, you need to consult a dermatologist. The diagnosis is made on the basis of the clinical picture characteristic of the pathology and dermatoscopy.

Laboratory methods:

• clinical blood and urine tests;
• blood chemistry;
• Demodex detection test;
• bacterial culture of the contents of rashes or skin scrapings (determination of flora);
• bacteriological study of intestinal flora.

Skin biopsy and serological tests may be needed for differential diagnosis. The disease must be distinguished from allergic contact dermatitis, rosacea and vulgaris, impetigo, seborrheic dermatitis, and neurodermatitis.

For certain indications, consultations with specialists may be necessary: ​​endocrinologist, gynecologist, psychoneurologist, gastroenterologist.

Complex treatment of perioral dermatitis on the face

Perioral dermatitis requires an integrated approach to therapy, which can last several months, and in complex cases up to a year.

During this period, patients need to completely trust the dermatologist and strictly follow all his recommendations.

The treatment package includes drug treatment, cosmetic procedures, diet therapy and adequate skin care.

First stage

The first stage of treatment begins with the abolition of glucocorticosteroids. During this period, patients should be prepared for an exacerbation of the pathology, called “withdrawal syndrome.” This is the body’s reaction to the cessation of the supply of a substance to which dependence has formed.

“Withdrawal dermatitis” is manifested by extensive redness spreading beyond the primary area of ​​​​the lesion, the appearance of abundant rash elements, swelling and increased skin temperature. An exacerbation of the disease lasts on average 7 days.

During this period, a serious mistake made by many patients is the resumption of the use of external and oral hormonal agents. The use of glucocorticosteroids leads to complete suppression protective functions skin, which creates a favorable environment for the development of microorganisms. In such conditions, recovery is impossible.

In addition, the patient's skin becomes completely dependent on steroids. The effect of using the drugs will be short-lived, after which the rash will return with renewed vigor. Therefore, the procedure for discontinuing glucocorticosteroids must be completed before the situation worsens.

• completely stop using fluoridated products;
• abolish the use of usual decorative and skincare cosmetics;
• use of hypoallergenic photoprotective and hygiene products;
• cold lotions with herbal infusions: string, chamomile, sage, nettle;
• treatment of the underlying disease by appropriate specialists.

In case of severe allergic reactions, antihistamines (Loratadine, Mebhydrolin) are prescribed; in severe cases of infection, local antibacterial agents (Metrogil gel).

Diet

Specific nutrition is followed throughout the course of treatment for perioral dermatitis. A predominantly vegetarian diet, balanced in nutrients and nutrients, is recommended.

In addition, you need to exclude foods that provoke additional allergic reactions, increase inflammatory processes and complicate the functioning of the digestive tract.

• chocolate, confectionery;
• refined products;
• flour, starchy, yeast products;
• citrus, red fruits;
• all berries;
• spicy, smoked, salted, fried foods;
• coffee, cocoa, alcohol;
• meat products;
• sea ​​fish, caviar;
• soy products, eggs, mushrooms.

To replenish the diet with protein, legumes, river fish, cereals, low-fat lactic acid products and cheeses are introduced into the diet. Brussels sprouts. It is permissible to consume offal: liver, beef tongue.

Dishes are steamed or baked. Adhere to the principles of fractional nutrition, 5-6 meals in small portions. Hot drinks and foods should be avoided.

Second phase

After exacerbation symptoms subside, they begin next stage therapy. This includes eliminating infections, allergic reactions, strengthening the immune system and nervous system, and symptomatic therapy.

Antibacterial and antimicrobial drugs

The drugs have bactericidal (destroying) and bacteriostatic (suppressing reproduction) effects on pathogenic microorganisms.

External means:

• metronidazole cream, gel 1% (Metrogil, Klion, Deflamon, Rosamet);
• erythromycin ointment 2% (Ilozon);
• clindamycin gel 1% (Dalacin, Clindatop, Klindovit);
• pimecrolimus cream 1% (Elidel);
• azelaic acid 15-20% cream, gel (Azelik, Skinoklir, Skinoren).

The preparations are applied to cleansed and dry skin in a thin layer 2 times a day. The course of treatment is individual, on average from 2 to 8 weeks.

In case of severe symptoms with persistent redness and constantly appearing new elements of the rash, antibacterial drugs are prescribed orally. Medicines: metronidazole (Trichopol, Ornidazole). The course of treatment is from 3 to 8 weeks.

If after 4 weeks of treatment with external and oral agents there is no therapeutic effect, systemic antibiotics are prescribed.

Preparations:

• tetracycline;
• minocycline;
• erythromycin;
• clarithromycin;
• doxycycline.

Duration of treatment is from 5 to 8 weeks. During this period, probiotics are additionally used.

In severe cases, when treatment with antibacterial agents does not bring results, isotretinoin (Roaccutane) is prescribed. It is a retinoid (vitamin A derivative) with anti-inflammatory and keratolytic properties.

Antihistamines

The drugs relieve itching, prevent the development of edema, reduce capillary permeability, and relieve persistent redness. The antihistamine property suppresses the development of additional allergic reactions.

Preparations:

• Suprastin;
• Semprex;
• Pipolfen;
• Zyrtec;
• Claritin.

The course of treatment is selected individually depending on the course of the disease.

Sedatives

Medicines are prescribed for stress and depression that impede recovery.

Preparations:

• Persen;
• Glycine;
• Doxepin;
• Chlozepid;
• tinctures of valerian, motherwort.

The choice of drug and course of treatment depends on the degree of neurotic disorder.

Vitamin therapy

The drugs are used to strengthen capillaries, stimulate the immune system and increase the protective properties of the skin. For treatment, vitamins B 2, B 6, C, PP (nicotinic acid) are prescribed. The course of therapy is 4-6 weeks.

Healing lotions

In the acute stage, additional medications are used to reduce itching, burning, redness, accelerate healing and disinfect the skin.

These are cold lotions:

• infusions of herbs: chamomile, sage, string;
• 1-2% resorcinol solution;
• 2% boric acid solution;
• chlorhexidine;
• 0.05% potassium permanganate solution;
• 3% sodium tetraborate solution.

In solution room temperature moisten gauze cloth and apply to the lesions. After 10 minutes, the gauze is re-wetted and applied to the skin. The recommended duration of the procedure is at least 1 hour 2 times a day.

When the pathology is combined with demodicosis, the lesions are treated with a 20% benzyl benzoate suspension and 30% sulfur ointment. At the same time, purified sulfur is used in oral form. The average course of treatment is 20 days.

Despite the openness of information about the drugs used in the treatment of perioral dermatitis, self-medication is not allowed. The combination of active substances of some medicines is not permissible. Therefore, treatment tactics should be selected by a dermatologist.

Healing procedures

Cosmetological and therapeutic procedures are prescribed at the final stage of the main course of therapy.

• cryomassage with liquid nitrogen;
• excimer laser treatment;
• microcurrent therapy;
• diathermacoagulation;
• phototherapy.

The procedures help restore microcirculation in tissues, suppress possible inflammatory processes, accelerate skin regeneration processes, and normalize the functions of the sebaceous glands.

Traditional methods of treatment

The advantage of many folk remedies is their relative safety for the patient’s body. Therefore, they are often recommended during pregnancy and breastfeeding.

Considering the complex etiology of the disease and persistent clinical course, they cannot be in an independent way treatment. Are used only as auxiliary or prophylactic agents under the supervision of a dermatologist.

Herbal remedies for oral administration

During illness, decoctions and infusions of herbs that have sedative, immunomodulatory, diuretic and antibacterial properties will be useful.

• Dried and crushed common sage, calendula flowers, nettles and birch buds are mixed in equal proportions. The mixture (40 g) is poured with boiling water (1 l) and left for 1 hour. The strained infusion is consumed in 200 ml morning and evening.
• Mix chamomile flowers, sage herbs, plantain, St. John's wort, peppermint, and elecampane root in equal proportions. The mixture (1 tablespoon) is poured with boiling water (250 ml), kept in a water bath for 15 minutes and infused in a thermos for 30 minutes. The product is taken 100 ml 3 times a day separately from meals.
• Birch buds (2 tablespoons) are poured with boiling water (0.5 l) and left in a thermos for 1 hour. Take 100 ml 3 times a day.

During illness, decoctions or teas of chamomile, wormwood, peppermint, lemon balm, peony and valerian will be useful.

Herbal remedies for external treatment

External products made from plant components are used as lotions or to cleanse the skin. For their preparation, plants were selected that have anti-inflammatory, antiseptic, antipruritic and antibacterial properties.

• dry and crushed celandine (1 tbsp) is poured with water (250 ml), boiled for 5 minutes;
• dry St. John's wort herb (1 tbsp) is poured with boiling water (250 ml), infused in a thermos for 30 minutes;
• yarrow (1 tbsp) is poured with water (250 ml), boiled for 10 minutes; vinegar 9% (1/2 tsp) and alcohol (50 ml) are added to the cooled and strained broth;
• crushed oak bark (50 g) is poured with boiling water (0.5 l), kept on fire for 2 minutes;
• sage (1 tbsp) is poured with boiling water (250 ml), left for 30 minutes;
• dry nettle leaves (50 g) are steamed in boiling water (1 l), left for 30 minutes.

Cooled to room temperature and strained, the products are used for lotions and daily cleansing of the skin.

Aloe and Kalanchoe juices, which have anti-inflammatory and bactericidal properties, are used to treat lesions. For squeezing juice, choose the fleshy leaves of plants aged from 3 to 5 years. Leftover juice can be stored in the refrigerator for no more than 3 days.

Sea salt

The large number of minerals contained in sea salt have a therapeutic effect on the skin with dermatitis.

With regular use of the medicinal solution, blood circulation and interstitial metabolic processes improve, regeneration processes are activated, itching, pain and inflammation are reduced. After exposure to sea salt, an alkaline environment is created on the skin, which is harmful to pathogenic microorganisms.

To prepare the product, sea salt (1 tsp) is dissolved in warm water (250 ml). To enhance the effect, you can add 2-3 drops essential oil tea tree.

A gauze cloth soaked in the solution is applied to the affected areas of the skin for 30 minutes. You can do 2 procedures per day.

Baking soda

Soda solution relieves skin irritation, disinfects and suppresses inflammatory processes. Additionally, it has pronounced antifungal and antimicrobial properties.

To prepare the product, baking soda (1/2 tsp) is dissolved in warm water (100 ml). The solution is applied to the affected areas, left for 10 minutes and washed off with water. Apply up to 3 times a day.

Bee products are strong natural antibiotics. However, the caffeic acid they contain can cause an allergic reaction. Therefore, before using the product, it must be tested for small area skin (neck, back of hand).

To prepare the ointment, crushed propolis (20 g) is mixed with unrefined olive oil (80 ml) and kept in a water bath until a homogeneous consistency is obtained. Apply the product to the affected areas 3 times a day.

Linseed oil

Used for treatment unrefined oil from flax seeds. It contains vitamin F, E, A and unsaturated fatty acid. Together, they nourish and moisturize the skin, suppress inflammatory processes and relieve irritation.

Supplementing the oil with the antibacterial properties of honey and onion juice enhances the therapeutic effect.

To prepare the product, heat linseed oil (1 tbsp) and honey (1 tbsp) in a water bath for 5 minutes, then add onion juice (1 tsp). Applications are made with the mixture, keeping them on the affected areas for 10 minutes, 2 times a day.

Purified sulfur

Purified sulfur has antiseptic, bacteriostatic, anti-inflammatory, and exfoliating properties. The substance dries out the skin greatly, so it must be used in combination with moisturizers. To treat dermatitis, sulfur mash is prepared.

Mix the components in a dark glass container:

• purified sulfur powder 7 g;
• streptocide powder 7 g;
• 2% boric acid solution 50 ml;
• 2% salicylic acid solution 50 ml.

The product is used for daily wiping of lesions 3 times a day.

Birch tar

The product has antiseptic, antimicrobial and anesthetic properties. Tar-based products promote the resorption of inflammatory infiltrates, reduce itching and burning.

A 10-20% ointment is prepared based on tar, mixing it with Vaseline or castor oil.

Following this recipe, you need to mix tar (2 tbsp), honey (3 tbsp), castor oil (2 tbsp) and the white of one egg. The mixture is placed in a glass container and kept for 3 days in a dark room. Use 1-2 times a day, applying a thin layer to the affected areas.

Possible complications

Lack of treatment or the use of inappropriate drugs leads to complications of the pathology. First of all, these are irreversible violations of the functionality and structure of the skin.

Patients with long-term perioral dermatitis develop atrophy and thinning of the skin. The vessels become brittle and begin to show through the skin (telangiectasia). Long-term inflammatory processes lead to the development of acne.

Gradually the redness acquires a bluish tint. Long-term inflammatory processes lead to thickening of the skin and lumpy swellings appear. This can cause the development of rhinophyma, a benign change in the skin of the nose.

Lifestyle and skin care

Since relapses of perioral dermatitis are completely dependent on external factors, patients need to adhere to certain rules in lifestyle, skin care and nutrition. They are of great preventive value.

Daily hygiene

To wash your face, use only warm water, avoiding high and low temperatures. Even with minor irritation from water, it is replaced with boiled, melted or thermal water.

It is necessary to completely abandon procedures that steam the skin and visit the bathhouse. Sponges and brushes for washing, towels should be made of soft and natural materials. Men are recommended to use an electric razor.

You cannot use hygiene products with alkali. For daily hygiene, we recommend soaps from the children's series, specialized products for hypersensitive skin or the anti-rosacea series.

Cosmetical tools

In summer and spring, you should use a non-greasy sunscreen before going out into the sun. It is allowed to use foundation with a loose texture, loose powder, concealers and correctors in green shades. You cannot use cream powders, blushes, or scrubs.

There should always be a pause of at least 30 minutes between the use of medications and the application of cosmetics.

For daily moisturizing and nourishing of the skin, dermatocosmetics are used, developed taking into account all the characteristics of hypersensitive skin. The texture of the products should be non-greasy and non-sticky.

They must not contain:

• alcohol, alkali, acetone;
• menthol, calendula, peppermint, honey;
• essential oils of clove, eucalyptus;
• synthetic flavors;
• biologically active substances.

After purchasing a new product, you need to test it. To do this, apply a small amount of the product to the wrist and monitor the skin reaction throughout the day.

People who are sick or have had perioral dermatitis should not use hormonal medications in any form. You should completely avoid toothpastes and other products containing fluoride. Avoid professional teeth cleaning for a certain period of time.

After acute symptoms are relieved, patients do not need to adhere to strict diet. The diet is based on the principles of healthy eating. At the same time, avoid foods that contain individual allergens, spicy and fatty foods, excessive hot foods and drinks, and alcohol.

It is important to constantly visit a dermatologist, undergo regular examinations for gastrointestinal pathologies, and promptly treat chronic infections.

Many people are aware of the problem of painful pimples near the mouth. This is called “perioral dermatitis” and is treated with certain medications. The disease often returns after treatment and affects new areas. The main symptoms are the appearance of a red rash near the lips, nose or eyes, as well as peeling of the skin. There are many reasons for the appearance of the disease, ranging from reduced immunity to a neurotic disorder. It is important to identify the real reason deterioration of the skin condition, this may require the help of several specialists at once. Self-medication can cure the disease only in isolated cases, but most often it is possible to simply mask the symptoms.

Why does a rash appear?

Scientists have not yet been able to fully study the causes of the disease, as well as whether it is contagious or not, but there are factors that provoke the appearance of a rash. Women are most often affected by the disease (their rashes may appear before menstruation), elderly people and boys under 15 years of age. In women aged 30 years, the disease is diagnosed 12 times more often than in men.

Experts have several versions of why it appears. One of them is an allergic predisposition, and the provoking factor is the frequent use of certain cosmetics. Products containing glucocorticoids and fluoride can have a negative impact on the health of an allergic person. In addition, the development of pathology is influenced by:

• long stay in the open sun, as well as frequent visits to the solarium;
• long-term use of contraceptives;
• chronic diseases, which include sinusitis, tonsillitis;
• poor dental condition, including deep caries;
• hormonal imbalances;
• tuberculosis, HIV infection.

Sometimes perioral dermatitis occurs during pregnancy, which is difficult to cure due to the woman's position. The reasons for its appearance are hormonal imbalance and lack of vitamins. Nutrition, climate and care cosmetics play a huge role. Sometimes a deterioration in the condition is observed after sudden weight loss, the use of low-quality decorative cosmetics or a strict diet. Frequent stressful situations, as well as previous serious illnesses, cause the development of rashes. Before treating perioral dermatitis, it is necessary to determine the cause of the irritation on the body.

For dermatitis on the face, it is possible to take an analysis from the opened blisters. Sometimes they contain microorganisms of the genus Fusobacteria, which is evidence of the presence of infection. This is diagnosed in patients infected with demodicosis mites or a fungal disease.

How to identify the disease

Experts distinguish several types of disease, each of them has symptoms and location. This type characterized by a reddish rash around the mouth, nose and chin. In children, the disease does not appear so often (only 7% of all registered cases), but it is easy to notice. The skin on the face quickly becomes covered with small reddish pimples. After treatment, some may leave marks or pigmentation.

Manifestation of the disease

Symptoms of the disease are often similar to rosacea, allergies, acne and other skin pathologies. Signs of the disease are:

• redness of the skin around the mouth, which worsens in the heat;
• peeling of the dermis and change in color to brown or bluish;
• painful sensations, itching or burning;
• transition of small pimples to the cheeks, nose or forehead;
• When the nodules rupture, first clear liquid comes out, and then pus.

At first, a single rash may appear, then it spreads to healthy areas. Over time, the disease affects large areas, and several small spots merge together. Untimely treatment of perioral dermatitis on the face causes deep tissue damage, which is fraught with pigmentation and unevenness.

Is the disease contagious? The disease can infect healthy people if left untreated. When the skin is treated with special ointments, the microbes die and the rash becomes safe for others.

Diagnostic methods

To find out the cause of the rash and how to treat it, you need to visit a dermatologist and get tested. The pathology itself can easily be confused with acne or allergies. A biochemical blood test most often does not show any abnormalities in the body due to skin disease. But it is mandatory to take it to identify concomitant illnesses. In addition, based on the results, the doctor will draw a conclusion about the general condition of the body and immunity; in the doctor’s certificate, the doctor notes the disease under the code – ICD 10, which includes perioral dermatitis and rosacea.

A mandatory step is an examination of the affected area by a dermatologist. If there is insufficient material to make a diagnosis, the patient is prescribed a histological examination or scraping for bacteriological culture. In both cases, a small amount of epidermal cells or purulent discharge is collected from the skin. Skin diseases are dangerous because they can be accompanied by another infection, causing dangerous consequences.

How to cure perioral dermatitis correctly

It is possible to cure rashes only with complex therapy. For this, the patient is prescribed the use of drugs for local and internal administration. However, a mild course of the disease, when only a few pimples are noticeable on the body, can be treated with ointments and creams. In advanced cases, it is recommended to visit other doctors - a gynecologist, otolaryngologist, infectious disease specialist and endocrinologist. This is how it will be possible to identify disorders in the body and carry out effective therapy. Treatment of perioral dermatitis on the face is divided into 2 stages: zero and therapeutic. At the first stage, provoking factors are eliminated, and at the second stage, the therapy itself occurs.

First stage

After identifying the disease, it is important to stop using moisturizing cosmetics or shampoo with glucocorticoids, as well as fluoride-containing toothpaste. Elena Malysheva advises replacing care products with tar soap during therapy.

Tar soap

After stopping your usual cosmetics, “withdrawal dermatitis” may occur, which manifests itself in large red spots on the face and severe itching. Many people are frightened by this phenomenon and they try to mask the problem with creams and cosmetics, which is why treatment of perioral dermatitis on the face takes a long time. A special diet that excludes junk food and, if possible, meat, eggs, citrus fruits, and alcohol will help relieve redness and swelling. Not recommended for use Foundation in case of illness, as it will only worsen the situation.

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Itching around the mouth can be reduced with the help of antihistamines - Suprastin, Zyrtec, Loratadine. It is allowed to wipe the skin with chamomile infusion or tea leaves to relieve inflammation and alleviate the condition. Before going outside on sunny days, be sure to apply a protective cream to the skin with a protection level of at least 30. For such ailments, zinc ointment will relieve itching and dry out sores on the body.

Creams, ointments or gels can be applied to the skin. For this, Metronidazole-based products are prescribed, which are used to treat a clean face 2-4 times a day. Skin milk Protopic (in a concentration of 0.01 to 0.03%) will help relieve itching and burning, apply to the skin several times a day. Zinc has been used for treatment for a long time; now there are many drugs based on it, for example, Sken-Cap and Qing dol. Levomekol can be used for dermatitis if there are no open wounds.

If itching interferes with sleep and causes a nervous condition, the doctor may prescribe sedative medications - Novo-Passit or valerian extract. It may also be helpful to undergo a course of reflexology or acupuncture. Such treatment of perioral dermatitis on the face is not always able to bring results. Severe damage requires treating the skin with medications and taking tablets orally.

Second phase

After eliminating all irritating factors, you should begin antibacterial therapy. Most often, patients are prescribed Metronidazole, Azithromycin, Doxycycline, Minocycline, Tetracycline or Azelaic acid. The treatment course must last at least 2 months, after which a re-examination is required. The treatment regimen for perioral dermatitis is prescribed individually by a doctor, but most often it looks like this:

1. Metronidazole. It must be used for 1 to 2 months several times a day, but the dosage should not exceed 1 gram per day for adults. The product is applied to the area of ​​inflammation, the skin should be dry and clean.
2. Doxycycline. The active substance quickly penetrates the cells and destroys the causative agent of the disease. It should be used 2 times a day, the maximum dosage is 100 mg. The first effect is noticeable within 2 hours after the first dose.
3. Erythromycin ointment. This remedy is one of the safest medicines; it can even be used to treat children. The drug is applied to the affected areas several times a day and left until dry.

With the help of Metronidazole therapy, it is possible to cure the disease in 60% of patients, and in the rest - to reduce symptoms and eliminate inflammation. As a rule, there are no side effects, but sometimes a white coating on the tongue or an unpleasant taste in the mouth appears.

Metrogyl gel has an anti-inflammatory effect in case of illness and also destroys bacteria. It is necessary to apply only to the affected area, since the components of the medicine sometimes cause dryness and a feeling of tightness. It is possible to get rid of peeling with zinc-based talkers or retinoic ointment. Not recommended for use by pregnant women or children.

Perioral dermatitis during pregnancy is caused by changes in the woman’s body, so it is quite difficult to cure the disease. In addition, expectant mothers are not allowed to use all medications. In their case, a mandatory consultation is necessary not only with a dermatologist, but also with a doctor who is managing the pregnancy.

Dermatitis in children

Perioral dermatitis in a child requires special care. Drugs approved for treating adults at home are not always suitable for small patients. How to treat illness in children? It is necessary to select the dosage so that the medicine brings benefit and does not harm the baby.

Manifestation of the disease in children

The reasons for the appearance of oral rash in children are the same as in adults. Children are more susceptible to the disease because their immunity is not yet strong. Sores can appear on the face after a long cold, nervous exhaustion or climate change. In infants, skin lesions are observed after chapping of the skin in winter or autumn time. The disease can be triggered by a hormonal imbalance that occurs immediately after birth. It is impossible to accurately identify the causes, so it is better to undergo a full examination and find out which system failed.

Symptoms of the disease are redness around the mouth, followed by pimples that cause itching and burning. Because of this, the child becomes capricious, irritable, and may refuse to eat and sleep. When dermatitis on the face is in advanced form, small pimples merge into large spots, become covered with pustules and acquire a bright red color. Zinc ointment will have a beneficial effect on the skin when a rash appears.

Do not use topical steroid drugs under any circumstances! Such treatment only causes a worsening of the condition in both children and adults. First, you need to make sure that the child does not wet his face with water, and also stop applying face creams and brushing his teeth with fluoride-containing paste. The main therapy consists of taking antihistamines (Suprastin or Loratadine), treating the skin with antibacterial ointments and antiseptic solutions (Bepanten, Metrogyl for perioral dermatitis, Chlorhexidine). Erythromycin or Metronidazole is prescribed in small dosages as antibacterial drugs. Levomekol for pathologies in children will help relieve itching and burning, as well as remove redness. To do this, apply dermatitis ointment to the affected area and apply a bandage. Additionally, it is recommended to give the child vitamins to boost immunity.

Nutrition when sick

A special diet for perioral dermatitis plays an important role in treatment. It is important to exclude certain foods and make the diet hypoallergenic. The following products should not be used for dermatitis on the face:

• any fish, seafood and fatty meat;
• oranges, lemons, tangerines;
• soy products;
• tea or coffee;
• mushrooms;
• baked goods and sweets;
• chicken eggs.

You should not add seasonings to your diet and it is better to limit salt. Let's eat more vegetables and fruits. It is also recommended to avoid meat broth; during treatment, soup should be prepared in vegetable broth. The ban applies to sweet soda and alcoholic beverages. They need to be replaced with fruit drinks, compotes, green tea and clean water. The volume of liquid drunk should be at least 1 liter.

The rash around the lips looks unpleasant and gives a person a lot of discomfort. At the first sign, it is better to consult a doctor and find out what it is. Don't be afraid to visit several doctors at once - comprehensive examination sometimes necessary to make a diagnosis. During treatment, it is recommended to review cosmetic skin care products and diet; compliance with all doctor’s recommendations guarantees a quick recovery. Perioral dermatitis during pregnancy requires care; it is better not to experiment and discuss the problem with a specialist.

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Perioral dermatitis is a local inflammation of the skin that occurs for various reasons. Many people mistakenly believe that deterioration in facial aesthetics and psychological discomfort are the only problems that are present with this diagnosis.

In fact, this disease can become chronic, progress and cause a number of more dangerous complications. This article will discuss the main symptoms of this disease and the features of its course, as well as methods of diagnosis and subsequent treatment.

What is perioral dermatitis?

This disease is a lesion of the skin around the mouth, which is accompanied by inflammatory processes. Women of reproductive age are at risk, although the occurrence of perioral dermatitis in men or small children cannot be ruled out.

To date this diagnosis is registered all over the world, it does not depend on the standard of living of a particular person or in the country as a whole.

Causes of perioral dermatitis in adults

Perioral dermatitis has been researched by experts for a long time, after which they came to the conclusion that the main reason is a decrease in the basic protective functions of the skin, after which it cannot withstand aggressive external influences.

Among the factors that can provoke such a phenomenon are:

1. Too long and frequent use of toothpastes with a high concentration of fluoride in the composition.
2. Systematic use cosmetics, characterized by a rough effect on the skin, for example, various scrubs.
3. Undergoing potentially harmful and dangerous cosmetic procedures, primarily this concerns chemical exposure and mechanical peeling.
4. The use of pharmacological or cosmetic products that contain hormonal components.
5. Use of corticosteroids for medical reasons.
6. Presence of seborrhea. Seborrhea on the face forms in the area of ​​the forehead, eyebrows and cheekbones. you can look in another article on the site.
7. Disruption of the functioning of the digestive, vegetative-vascular or endocrine system.
8. Frequent exposure to straight lines sun rays or receiving an excess amount ultraviolet radiation in other ways.
9. Change of residence, implying a sharp and radical change in climatic conditions.
10. Taking contraceptives that lead to hormonal imbalance in the body.
11. General deterioration of the immune system.

Causes of perioral dermatitis in children

As already mentioned, perioral dermatitis can also occur in children, in which case immediate consultation with a pediatrician is always required.

The causes of this disease in younger patients may be the following factors:

1. Hormonal changes that occur in the body and are associated with the process of growth and maturation of the child.
2. Age-related changes in the structure of the skin, which can cause a number of dermatological problems.
3. Other lesions of the facial skin, most often accompanied by purulent inflammation. In the most difficult cases, hormonal ointments are prescribed for topical use, which provokes the parallel occurrence of perioral dermatitis.
4. Disturbances and deterioration of the immune system, which is typical for a growing organism.
5. Increased need for nutrients, acute lack of vitamins, minerals or any chemical elements in the body.

The external manifestations of perioral dermatitis are similar to many other skin diseases, so only a dermatologist should make a diagnosis.

The main symptom is the appearance of small rashes and pimples, which have the following features:

1. The main affected areas may be areas around the lips, nasolabial fold and chin area.
2. The location of all rashes is usually symmetrical.
3. The sizes of pimples can be very different and vary from very small to quite large, and also merge into a single lesion.
4. At the initial stage, the rash is red or has a light pink tint, but over time they become brown.
5. The rash can develop into a purulent irritation if third-party infections enter it.
6. After the rash passes, hyperpigmentation remains in its place for a long time.
7. A small strip 1.5-2 mm thick remains near the lip border, which is not subject to inflammation. This is the hallmark of perioral dermatitis, which is observed in most patients.

Photo

To better understand what perioral dermatitis looks like, below is , which depicts the main manifestations of this disease:

Symptoms

The clinical picture in each case looks individual, since the main symptoms can be pronounced or appear slightly.

Typically, the presence of perioral dermatitis is indicated by the following signs:

1. Drying of the skin and peeling of areas around the mouth.
2. Overflow of blood vessels observed in the same area.
3. The occurrence of edema.
4. The formation of small rashes and pimples that may have different kind, in some cases they are filled with serous exudate.
5. A feeling of increased skin tightness in the affected areas.

Diagnostics

Diagnostics and diagnosis are carried out by a specialist dermatologist; the following methods are usually used for this:

1. Conducting a visual examination, studying the clinical picture and obtaining information from the patient about factors that could trigger the appearance of perioral dermatitis. Usually, the above measures are sufficient to establish the causes of irritation.
2. Carrying out skin allergy tests.
3. Taking blood for analysis and studying pathological changes in its chemical composition.
4. Consultation with other specialists; first of all, the patient may be referred to a gastroenterologist, general practitioner or allergist. Similar measures may be required to make an accurate diagnosis if symptoms of other diseases occur in parallel with perioral dermatitis. Sometimes an examination by an ophthalmologist is prescribed if the lesion affects the eyelid area, but this only happens in rare cases.

Treatment

Therapy is prescribed by a specialist, usually the choice of drugs for treatment is made taking into account individual characteristics course of the disease. The duration of the course varies from 2-3 weeks to 2-3 months and depends on many factors, including the stage of the disease at which professional medical help was sought.

In some cases, for example, when climate conditions change, multiple relapses may occur, therefore, after completion of treatment, a course of preventive measures is required to maintain the achieved positive result.

The main methods of getting rid of perioral dermatitis that are practiced today are discussed in detail below in the relevant chapters.

Zero therapy

“Zero therapy” is understood as one of the first stages of treatment, which implies the following conditions must be met:

1. Buying and using toothpaste that does not contain fluoride.
2. Stop taking a course of corticosteroid treatment if it was practiced before.
3. Refusal to use decorative cosmetics on affected areas of the face.
4. Using special products for washing that do not cause an allergic reaction even if you are not prone to it.
5. Compliance with a special dietary complex.

If you follow the indicated rules, positive dynamics will be observed in just a week. The structure of the skin will begin to gradually recover, the body will launch natural regeneration processes, in addition, inflammation will be relieved and new rashes will stop occurring.

When treating severe forms of perioral dermatitis, the following side effects may occur:

1. The appearance of red spots on the skin.
2. The appearance of additional swelling.
3. Local increase in temperature in the lesions.

Many people are frightened by such symptoms, and they, at their own discretion, change the course of treatment, starting to use potent pharmacological preparations or resume use of corticosteroids. This can only worsen the situation and make the recovery process even longer.

Skin care

During the treatment of perioral dermatitis, it is necessary to pay attention to the following skin care features:

1. All cosmetics and products, previously used should no longer be used for skin care. It is allowed to use only medicinal products prescribed by the attending physician, as well as special powders and creams with a moisturizing effect.
2. After removing all existing inflammation You can gradually start using your usual skin care products again, but this can only be done with the permission of your doctor. At the same time, you should not start using all your existing cosmetics at once; you need to return to them gradually.
3. The best way to take care of your skin will be taking complexes containing vitamin B and nicotinic acid. This will have a positive effect on the regeneration of damaged epidermis, and will also strengthen the immune system. Such a course must be agreed upon with a specialist.

Sun protection

Protection from ultraviolet radiation and temperature changes is another important condition that must be observed during treatment.

It is enough to adhere to the following rules:

1. It may be impossible to completely avoid exposure to the sun's rays on your face, but such situations should be kept to a minimum.
2. When going outside in sunny weather, you need to use special creams to protect against ultraviolet radiation, but they must be selected by a dermatologist so as not to provoke an allergic reaction.
3. Needs to be normalized temperature regime indoors should be normalized, since heat can slow down positive dynamics.

Folk remedies

Official medicine often does not approve of the use of traditional medicine methods, but today they still have not lost their relevance and demand.

Some known methods Treatments for perioral dermatitis are given below:

1. One teaspoon of baking soda is diluted in a glass of water, and the resulting solution is used to treat the affected areas of the face.
2. The pumpkin is grated, after which the pulp is mixed with juice and the resulting product is used as a face mask. You will need to remove it after 10-15 minutes.
3. To prepare a healing infusion, take one tablespoon of birch buds per glass of water. The finished product can be used both for oral administration and for treating affected areas.
4. An infusion prepared from St. John's wort or plantain is used to treat affected areas of the skin. To obtain a positive result, the procedure must be repeated 2-3 times a day.

Prevention

To minimize the risk of oral dermatitis, the following precautions are recommended:

1. Avoid corticosteroid-type cosmetics and ointments.
2. Do not use fluoride toothpastes for a long time or unless absolutely necessary.
3. Try not to use household chemicals or detergent containing allergenic components.
4. Follow therapeutic diets, avoid eating potentially harmful foods, and healthy image life without smoking and drinking alcoholic beverages.
5. Observe personal hygiene rules.

The prognosis for oral dermatitis is positive, but only when treatment is prescribed by an experienced specialist.

It is not allowed to independently take any measures to eliminate emerging symptoms, as this can lead to complications or the preservation of visible marks on the skin in places where there was inflammation. It must be remembered that the sooner you seek qualified medical help, the faster and easier it is to get rid of an unpleasant illness.

Another name for the disease is perioral or rosacea-like dermatitis. Perioral dermatitis is characterized by the appearance of small papules and pimples on the skin around the mouth.

As the disease progresses, irritation and redness appear, papules grow on larger area. This causes a person considerable discomfort: both physical and psycho-emotional.

Causes of the disease

Perioral dermatitis has been studied by specialists for a very long time, after which they came to the conclusion that the main reason is a decrease in the basic protective functions of the skin, after which it cannot withstand aggressive external influences.

Among the factors that can provoke such a phenomenon are:

1. Too long and frequent use of toothpastes with a high concentration of fluoride in the composition.
2. Systematic use of cosmetics that have a harsh effect on the skin, for example, various scrubs.
3. Undergoing potentially harmful and dangerous cosmetic procedures, primarily this concerns chemical exposure and mechanical peeling.
4. The use of pharmacological or cosmetic products that contain hormonal components.
5. Use of corticosteroids for medical reasons.
6. Presence of seborrhea.
7. Disruption of the functioning of the digestive, vegetative-vascular or endocrine system.
8. Frequent exposure to direct sunlight or exposure to excessive amounts of ultraviolet radiation in other ways.
9. Change of residence, implying a sharp and radical change in climatic conditions.
10. Taking contraceptives that lead to hormonal imbalance in the body.
11. General deterioration of the immune system.

Causes of perioral dermatitis in children

As already mentioned, perioral dermatitis can also occur in children, in which case immediate consultation with a pediatrician is always required.

The causes of this disease in younger patients may be the following factors:

The causes of perioral dermatitis are not completely clear.

First symptoms and signs

The first sign by which one can judge the appearance of perioral dermatitis is slight redness of the face. It becomes more pronounced when eating spicy and hot foods.

After some time, it acquires a brighter shade, and the skin becomes covered with small pustules 0.4-2.5 mm, similar to acne. Over time, they turn into crusts and peel off.

During the course of the disease, the color of the rash changes from red-brown to light brown.

The localization of the rash is more or less symmetrical on the chin, nasolabial folds, nearby areas of the lips, cheeks, and does not merge together. Single rashes may be observed on the temples and bridge of the nose.

Diffuse inflammation of the entire face occurs. A specific feature of the disease is a whitish stripe between the labial border and the area of ​​inflammation.

The disease begins with the appearance of pimple-like bumps that are pink or bright red in color.

Symptoms

The clinical picture in each case looks individual, since the main symptoms can be pronounced or appear slightly.

Typically, the presence of perioral dermatitis is indicated by the following signs:

Perioral dermatitis is characterized by rashes in the mouth and chin area. The rash is usually small and resembles small pimples or pinkish bumpy dots. The rash may spread to the forehead, nose and cheeks, but this is uncommon.

The rash is somewhat similar to acne, but in this case we are not talking about acne. The skin under the papules acquires a reddish tint and becomes rough to the touch. After the acne goes away, pigment spots remain on the skin.

Oral dermatitis is manifested by the following symptoms in which the skin becomes covered:

• small papules;
• acne;
• redness;
• irritation;
• the affected area increases;
• red pimples merge with white heads and form pustules;
• Transparent scales appear on the inflammation.

Other manifestations of oral dermatitis:

• burning, itching;
• pain;
• feeling of tightness.

Sometimes rashes appear on the bridge of the nose, around the eyes, and even on the surface of the entire face. To make a correct diagnosis, culture of the contents of the rash and scraping are necessary.

Perioral dermatitis, as we have already noted, is characterized by the appearance of a rash in the area around the mouth. This rash has small sizes, it looks like small pimples or lumpy dots (pink or red).

Such a rash can also appear in the area of ​​the chin, forehead, nose or cheeks, which, however, occurs much less frequently. The rash itself is similar to acne (or acne), but it is not acne.

The skin located directly under the bumps or pimples often also has a pink or red tint; when you feel it, you can detect a pronounced roughness, which is ensured by the appearance of small but multiple bumps along its surface.

Gradually, as the process progresses and the changes that accompany it, pigment spots remain on the skin after such pimples and bumps.

The strip of skin located near the lips itself is, as a rule, not affected; in rare cases, although damage to this area is noted, it is on a much smaller scale than the skin located some distance from the mouth.

This creates a kind of “ring” surrounding the mouth. Sometimes the skin around the eyes, especially in the temple area, is also affected by perioral dermatitis.

Diagnostics

Diagnostics and diagnosis are carried out by a specialist dermatologist; the following methods are usually used for this:

To make a diagnosis of perioral dermatitis, a medical history, objective examination and dermatoscopy are performed. In some cases, a histological examination may be required.

If a secondary infection is suspected and there is a need to identify the infectious agent, bacteriological culture of scrapings from the affected areas of the skin and/or the contents of the rash elements is carried out.

The specific causative agent of perioral dermatitis has not been identified. Patients may be found to have an increased contamination of the skin with microorganisms, as well as fungi of the genus Candida and acne (Demodex folliculorum).

Differential diagnosis of perioral dermatitis with diseases such as sarcoidosis, rosacea, atopic dermatitis, seborrheic dermatitis, acne, eczema, herpes simplex, demodicosis, acne vulgaris is necessary.

Treatment

Let's figure out how to treat oral dermatitis? The duration and effectiveness of treatment depends on the correct selection of drugs and the severity of dermatitis. The course of therapy can last up to 2 months. The sooner measures are taken to eliminate the disease, the more effective the result will be.

Traditional treatment of the disease can be divided into 2 stages: “zero therapy” and medication.

Therapy is prescribed by a specialist; usually the choice of drugs for treatment is made taking into account the individual characteristics of the disease. The duration of the course varies from 2-3 weeks to 2-3 months and depends on many factors, including the stage of the disease at which professional medical help was sought.

In some cases, for example, when climate conditions change, multiple relapses may occur, therefore, after completion of treatment, a course of preventive measures is required to maintain the achieved positive result.

The main methods of getting rid of perioral dermatitis that are practiced today are discussed in detail below in the relevant chapters.

Zero therapy

“Zero therapy” is understood as one of the first stages of treatment, which implies the following conditions must be met:

1. Buying and using toothpaste that does not contain fluoride.
2. Stop taking a course of corticosteroid treatment if it was practiced before.
3. Refusal to use decorative cosmetics on affected areas of the face.
4. Using special products for washing that do not cause an allergic reaction even if you are not prone to it.
5. Compliance with a special dietary complex.

Treatment of any skin disease, including perioral dermatitis, is a long process. The duration of treatment is at least one and a half months. In advanced cases, treatment can last up to three months.

A doctor should treat dermatitis, and the sooner you go to him, the faster a positive result will be obtained.

Treatment, organized according to all the rules and leading to the disappearance of the rash, does not guarantee that perioral dermatitis will not make itself felt again.

Relapses can happen. So, where should you start treating oral dermatitis if your doctor has diagnosed this?

To begin with, so-called zero therapy is carried out. You need to stop using any cosmetics and medicinal ointments, fluoridated toothpaste.

The rash may get worse after stopping corticosteroids, but things should get better after a few weeks.

Keeping in mind the allergic nature of dermatitis, you can take antihistamines during zero therapy.

If zero therapy does not help, antibiotics are used. For oral dermatitis, antibiotics are a fairly effective measure and can completely cure the disease.

The doctor will prescribe a treatment that includes Minocycline or Doxycycline tablets, as well as Tetracycline or Metronidazole tablets or Metronidazole cream. Instead of Metronidazole cream, Erythromycin gel can be used.

The results of antibiotic treatment can be seen within three weeks. By this time, the skin is noticeably improving, but treatment should not be stopped prematurely.

The first manifestations of this disease can be eliminated in a couple of days, but in order to completely get rid of its progressive form, you will have to spend a couple of months on therapy.

Treatment of perioral dermatitis begins with replacing creams, shampoos and other cosmetics with chemically neutral ones. After this, the doctor waits a couple of days and then prescribes antibiotics, special ointments, sunscreens and antihistamines to the patient.

Gels for psoriasis and acne will not help cure dermatitis.

Rashes in children and adults can be reduced using traditional medicine. Cooled infusion of chamomile, celandine, calendula or St. John's wort is used to treat reddened skin.

If you are allergic to the listed plants, then apply a 1% solution of boric acid to small pimples. In case of oral ailments, special attention is paid to skin care.

You should pat your face lightly after washing. Before leaving the house, you need to apply indifferent powders and neutral cooling gels to your skin.

Ointment for perioral dermatitis

When treating skin ailments, antibiotic-based creams work well. The most famous ointment for oral dermatitis is metronidazole.

It is applied to areas affected by the disease 2 times a day. Erythromycin has a similar effect.

It is rubbed into the chin and lip area 2-3 times a day. If the inflammatory process does not stop, the doctor prescribes facial gels with pimecrolimus.

The product must be used carefully, because... it reduces local immunity.

Diet for perioral dermatitis

A vegetarian diet is considered ideal. Products classified as allergenic should be excluded from the menu.

The diet for perioral dermatitis should be balanced, i.e. include boiled meat, porridge with water, vegetables. Fruits are rarely given.

Spicy, fried, fatty and sweet foods should be removed from the diet. If a child under 10 years of age is being treated for an illness, all dairy products are excluded from the menu.

The diet should be followed for 3-4 months after the symptoms of the disease disappear.

When the diagnosis is confirmed, it is first necessary to stop taking medications that contain corticosteroids. In addition, you should avoid using decorative cosmetics and toothpaste containing fluoride.

Treatment of perioral dermatitis is medicinal. If itching is present, antihistamines are indicated, and sedatives may also be required.

In case of pronounced swelling, diuretic drugs may be prescribed. When a bacterial infection occurs, local or systemic antibiotics are used.

Reception shown vitamin complexes, immunomodulators.

For local treatment of perioral dermatitis, medications with a cooling effect in the form of creams, as well as infusions, are used. medicinal plants(calendula, chamomile, celandine, St. John's wort, etc.), lotions from a solution of boric acid.

Treatment of perioral dermatitis lasts from several weeks to several months, depending on the severity of the pathological process. Since the disease is prone to recurrence (especially with the use of cosmetics, decreased immunity and changes in climatic conditions), patients are advised to follow preventive measures.

Treatment of perioral dermatitis is long-term; the duration of therapy can be several months and depends on the severity of symptoms.

Perioral dermatitis should be treated as prescribed by a dermatologist. You need to see a doctor as early as possible, the effectiveness of therapy and the speed of recovery depend on this.

It must be taken into account that even correct treatment does not exclude the possibility of relapses of the disease, but they have a milder course and are easily stopped.

Treatment of perioral dermatitis excludes the use of steroid ointments and creams - this must be remembered.

So, how to treat the disease:

• "Zero" treatment. This is the first step after diagnosis. The patient stops using any ointments, creams and cosmetics, not to mention steroid drugs. Fluoridated toothpaste is replaced with regular toothpaste. After a short deterioration of the condition, improvement soon occurs.
• Antihistamines. A dermatologist may prescribe anti-allergy medications (Suprastin, Kestin, calcium chloride, sodium thiosulfate, etc.).
• Antibacterial therapy. Treatment with antibiotics for this diagnosis is quite effective. The progression of the disease is stopped by Metronidazole gel or cream (0.75%), Erythromycin gel (2%). The prescribed drug is applied twice a day until the rash stops. Internal antibiotics Doxycillin or Minocycline can be prescribed. The initial dose is set by the doctor (usually 100 mg twice a day until the rash stops), the maintenance dose is 100 mg once a day for a month and 50 mg once a day for another. Metronidazole and Tetracycline can be prescribed orally. Improvement in skin condition is observed three weeks after the start of antibacterial therapy.
• Skin care. Treatment of the disease involves soft, gentle facial care. You should wash your face normally, moderately. warm water. You cannot rub your face with a towel; you need to lightly blot your skin. On the recommendation of a dermatologist, you can use neutral talcs and powders, moisturizing creams that do not contain substances that can aggravate symptoms.
• Phytotherapy. In acute cases, lotions with chamomile infusion (if there is no allergy to the plant) or 1% boric acid will help treat the disease and alleviate the symptoms. Washes and compresses with infusions of celandine, calendula and St. John's wort are effective.
• Normalization of the functioning of the whole body. If foci of infection are present, concomitant diseases must be treated. Treatment also includes normalization of the endocrine and nervous systems, and the gastrointestinal tract. The doctor may prescribe general strengthening and immunomodulating medications, drugs to maintain the functioning of the central nervous system. It is recommended to treat perioral dermatitis in conjunction with a course of vitamin therapy (vitamins B, A, C, folic acid).
• UV protection. Treatment is not compatible with constant exposure of the skin to direct sunlight, since ultraviolet radiation only aggravates the symptoms. In summer, you need to apply sunscreen with a protection factor of 30.

The therapeutic regimen for a child is similar to that for adults

In general, the prognosis is favorable, since perioral dermatitis is not a health-threatening disease and in some cases goes away on its own.

One way or another, with any manifestation of characteristic symptoms, you need to contact a dermatologist as soon as possible so that he can make an accurate diagnosis and prescribe adequate treatment.

Treatment of oral dermatitis should be carried out comprehensively and in stages. During preparation for treatment, the doctor cancels everything hormonal drugs, cosmetics and personal care products.

The epidermis must rest. The use of hormonal drugs should be discontinued gradually to avoid exacerbation of the pathology.

Proper facial skin care is important. If the manifestations of oral dermatitis are mild, you can use a decoction of chamomile and sage. For complicated symptoms, it is better to use special emulsions with oil base. For acute manifestations, it is possible to use naphthalene-tar paste 2%.

Antibacterial agents for oral dermatitis are used for about two months. The course of treatment and methods are determined by the doctor individually for each patient.

But additional drugs are also needed:

In the presence of infectious foci, it is necessary to treat concomitant pathologies, as well as normalize the endocrine and nervous systems, and the functioning of the gastrointestinal tract. Immunostimulating drugs are also prescribed to treat oral dermatitis. Monthly courses of vitamins B, C, A, and folic acid will help.

In especially severe cases, therapy is supplemented with physiotherapy, cryomassage and other medical procedures.

Treatment of oral dermatitis during pregnancy

Treatment is certainly necessary for perioral dermatitis, because without it, the rash can remain on the skin for many months or even years.

Meanwhile, adequate therapy for the disease often provides the opportunity to quickly get rid of the rash, and for a long time.

Possible complications and consequences

Due to the fact that this form of dermatitis is quite resistant to treatment, as a result the patient may develop irritability, become depressed, nervous, and depressed.

Aesthetically, the face does not look attractive. This is a chronic disease, and each subsequent relapse may have more severe symptoms.

After improper treatment, the face remains with scars and age spots. Areas of skin affected by dermatitis become dry and pale. But in most cases, the prognosis for treatment is favorable, without serious consequences.

There is a separate article on our website about how to treat toenail fungus. All about the reasons for the appearance of moles on the body is at this address.

Perioral dermatitis is characterized by a relapsing course, and with relapses of the disease, more intense rashes and more painful sensations accompanying the appearance of the rash may be observed.

If perioral dermatitis is not adequately treated, pigment spots and scars may remain on the skin.

Prevention

To prevent the development of perioral dermatitis, the use of glucocorticoid creams for the treatment of seborrheic dermatitis, acne and rosacea should be limited. This especially applies to predisposed patients with chronic infectious diseases or hormonal disorders.

To prevent the development of perioral dermatitis, it is recommended:

• timely treatment of diseases internal organs, especially the digestive system;
• avoiding the use of medications for external use (ointments, creams) that contain corticosteroids;
• refusal to abuse decorative cosmetics;
• refusal to use low-quality cosmetics;
• refusal to use fluoride-containing toothpastes;
• balanced diet (limiting fatty, salty, spicy foods, alcoholic drinks);
• compliance with personal hygiene rules.

Video from YouTube on the topic of the article:

Those who have treated oral dermatitis should take the following preventive measures to avoid relapses:

• stop using corticosteroid ointments and creams to neutralize skin diseases on the face;
• follow a diet and do not forget about personal hygiene;
• treat rosacea-like manifestations with drugs without hormones;
• limit the use of cosmetics with allergic components;
• use products that protect the skin from ultraviolet radiation;
• Brush your teeth less often with fluoride toothpastes.

Oral dermatitis is treated comprehensively. The prognosis is favorable if treatment measures begin on time.

Diet

You should avoid drinking tea, coffee, alcoholic beverages, citrus fruits, eggs, mushrooms, fish, sausage products, canned food, yeast dough products, spices, and limit the consumption of salt and sugar.

To normalize metabolism, patients need plenty of drinking regime.

To eliminate the symptoms of oral dermatitis, the specialist also prescribes a hypoallergenic diet. If there is no effect, it is replaced with a short therapeutic fast. The scheme is selected individually.

Spices, smoked, spicy, fried foods are excluded from the diet. Food should be rich in vitamins.

Preference is given to boiled vegetable foods. Limit mushrooms, carrots, eggs, fish, caviar, soy, salt, sugar.

You can eat wholemeal bread, dairy products, cereals, beans, vegetables, green fruits, boiled lean meat.

The patient should drink two liters of fluid per day to normalize the flow of microelements into the tissues.

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Perioral (around the mouth) dermatitis is a disease of the skin of the face. It is typical for women, but also occurs in men and children. The cause of dermatitis in women is most often associated with the use of cosmetics. Their composition, as well as some medications, can change the local vascular system, destroying collagen and elastin. Side effects are fraught with the development of erythema, dilation of small vessels and microcracks in the epidermis.

Other names for perioral dermatitis– steroid-induced, photosensitive, rosacea-like. Essentially, it is a skin irritation with rashes in the mouth area. The disease has a social aspect, since actually healthy people are forced to take sick leave and undergo a long course of treatment.

Doctors are unable to reliably determine the cause of perioral dermatitis.. But an analysis of the anamnesis of numerous patients revealed a number of factors that provoke rosacea on the face. This:

1. Use of steroid drugs (Prednisolone, Hydrocortisone).
2. Skin care using low-quality cosmetics, while skin rashes often appear from foundation.
3. Using toothpaste containing fluoride.
4. Exposure to strong winds and ultraviolet rays.
5. Oral use of contraceptives.
6. Hormonal fluctuations, including before menstruation.
7. Fungal and bacterial infections.

It is noted that perioral dermatitis is more common in patients who abuse caring procedures. It is not recommended to use several creams at the same time (day, night, foundation). The development of perioral dermatitis in men is also associated with the use of cosmetics. In children - using inhalers and hormonal sprays containing glucocorticosteroids. It is noteworthy that during treatment with such agents there is no skin discomfort. Symptoms appear some time after completion of therapy.

Perioral dermatitis during pregnancy

After conception, a woman’s body needs a lot of strength for normal development and formation of the fetus. The appearance of perioral dermatitis during pregnancy is caused by the physiological immunodeficiency of the expectant mother. The disease manifests itself on early stages gestation. Treatment of patients in the “position” requires an individual approach, since in the first trimester of pregnancy the use of antibiotics and other effective medications is contraindicated. Starting from the second trimester, they are prescribed in limited dosages, and corticosteroids are not used.

In pregnant patients, photosensitive dermatitis rashes are red and pale pink.

The areas where the rash appears may become pigmented over time.

Perioral dermatitis in a child At an early age, perioral dermatitis occurs in different ways

• . One child has pale pink papules, while the other has noticeable yellow-brown spots. When irritated lesions are still observed on the face, the baby should undergo tests:
• scraping the contents of papules;

tank. sowing the area affected by the disease. Often, the child’s skin responds to treatment with negative reactions. hormonal agents and inhalers

. Severe symptoms become noticeable after discontinuation of the medication. Rashes in the eye area require very careful treatment. In general, perioral dermatitis in children is painless, but sometimes the patient complains of a burning sensation in the affected areas. In pediatrics, perioral dermatitis is classified as rosacea.

, since it is in childhood that the disease takes on a rosacea-like form. Skin pathology is not dangerous for the health and proper development of the baby, but without medical help it causes significant discomfort.

Symptoms of the disease:

• Perioral dermatitis rashes occur on various parts of the face
• in the mouth area;
• on the cheeks;
• on the chin;
• nasolabial folds;
• outer corners of the eyelids.

area around the eyes. The disease can be perioral (at the mouth) or only periorbital, affecting the periocular area . There is a mixed type of rosacea: in this case different shapes

dermatitis appears alternately. Mild dermatitis occurs without acne, only with redness of the skin and small flat elements. The rash is a semicircular cavity-free seal of red color, 1-2 mm in size

. Peeling of the skin near small blisters is possible. Pathological lesions gradually spread throughout the neck, arms, and torso.. The rest of the space is affected by the disease. At least this occurs in 87% of all patients who apply. Some people have had signs of telangiectasia. Itching is not typical for this dermatitis; the only concern is a burning sensation and a feeling of tightness of the skin.

Without treatment, the process becomes chronic, but gradually disappears. A cosmetic defect can lead to neurotic disorders. Worried about their appearance, people withdraw into themselves, enter into conflict more easily, and quit their jobs.

A thorough examination of patients reveals diseases of the intestines and other parts of the digestive system. 83% of women with signs of perioral dermatitis additionally suffer from gynecological diseases. A third of patients have psychoemotional disorders and chronic infectious abnormalities in the oral cavity and nasopharynx.

Diagnostic methods

To prescribe adequate treatment it is necessary to exclude the following diseases in the anamnesis:

1. Acne.
2. True rosacea.
3. Seborrheic dermatitis.
4. Sarcoidosis of the skin.
5. Atopic dermatitis.
6. Contact dermatitis.

Blood tests (general, biochemical) do not show significant changes. In rare cases, a slight increase in the ESR value is recorded in the laboratory. This is explained by the development of concomitant pathologies. This happens with a prolonged infection in the nasopharynx.

If PD is suspected, it is effective to make a tank. sowing. The analysis easily identifies fungal strains that are responsible for the development of oral thrush. However, no diagnostics can detect specific pathogens of rosacea-like dermatitis.

Histological examinations of the skin are not prescribed. Subacute inflammation and isolated changes in the skin are easily confused with similar diseases, and therefore histology is ineffective.

What examination is performed for perioral dermatitis?:

• study of surface and nail tissue;
• Ultrasound and examination of the skin and subcutaneous fat.

Tests that are prescribed to determine PD:

1. Eosinophils.
2. General blood analysis.
3. Immunoglobulin E in the blood.

In the international classification of diseases tenth revision (ICD-10), perioral dermatitis is listed under code L71.0.

How to treat

When starting treatment for perioral dermatitis, hormonal medications are immediately canceled and the use of cosmetics and hygiene products is stopped. Decoctions of medicinal herbs (chamomile, sage) are used for washing. In case of complex symptoms, the face is cleansed with special emulsions based on oils, and also treated with naphthalene-tar paste (2%).

Ointments

External therapy is based on the use of medications containing metronidazole or trichopolum. Prescribed by a dermatologist medicine Apply to problem areas morning and evening. If there is no effect, Metronidazole gel or macrolide Erythromycin is additionally used. Both drugs are sold in pharmacies at an affordable price.

Besides, Protopic is prescribed for facial treatment. A non-toxic ointment with a concentration of 0.003% is prescribed for children 2–16 years old. For adult patients, increased concentrations are recommended - 0.03% and 0.1%. Various dermatitis can be treated with Vishnevsky's balm (liniment).

For perioral dermatitis, preparations containing zinc have shown high effectiveness. They dry out the skin and have an antipruritic effect. Irritation is quickly relieved by Zinokap, Tsindol, zinc talker, Skin-Cap.

Adapalene – an analogue of retinoic acid, used for anti-inflammatory and camelolytic effects. The product improves the intercellular processes that occur in the epidermis and stimulates the production of epithelial tissue. Adapalene in gel form is suitable for oily skin, cream - for dry skin. It is allowed to combine the medicine with moisturizers. In the treatment of perioral dermatitis, the use of Sinaflan-Fitopharm ointment is prohibited (this disease is included in the list of contraindications).

Elidel for perioral dermatitis is prescribed to children from three months of age and adults. Within 6 weeks of treatment, the medicine completely relieves inflammation. But its long-term use is unacceptable. The drug should be used in short courses in complex therapy.

For steroid dermatitis, the use of Rosamet ointment is effective. It is forbidden to apply it to the mucous membrane of the eyes. After facial treatment, it is recommended to avoid exposure to direct sunlight. The good thing about rozamet is that it can be used as a base for makeup. Hormonal ointment Momat-C is not prescribed for perioral dermatitis.

On initial stage therapy for perioral dermatitis use other groups of drugs according to indications:

• sedatives - Valerian, Novo-Passit;
• antihistamines - Zirtec, Telfast, Erius, Suprastin, Parlazin, Claritin (for children - Diazolin, L-cet);
• diuretics - Veroshpiron, Furosemide, Spironolactone.

Patients are also prescribed cryomassage courses and acupuncture.

Antibiotics

When the first stage of treatment does not give positive dynamics, Antibiotics are prescribed to the patient for perioral dermatitis:

1. Isotretinoin.
2. Tetracycline.
3. Trichopolum.
4. Lincomycin.
5. Doxycycline.
6. Metronidazole.
7. Azelaic acid.
8. Monocycline.

The duration of antibiotic therapy depends on the severity of the disease, but the period is not less than 1.5-2 months. Most often, patients are prescribed Metronidazole or Trichopolum tablets.

To suppress the active pathogen, complex therapy is carried out. In this case, 3 drugs are used at once - Doxycycline, Clindamycin and Gentamicin. The main remedy is taken in a dosage of 100 mg twice a day. It begins to act 2 hours after administration. This treatment is not suitable for women during pregnancy.

Other medications are prescribed in combination with Doxycycline:

• Monocycline.
• Pimecrolimus.
• Tacrolimus.

If necessary, patients with dermatitis are prescribed medications to strengthening the nervous system, immunostimulants, folic acid and vitamins.

Traditional methods

Drug treatment of perioral dermatitis in children and adults is more effective with simultaneous treatment with folk remedies. Over the years, some recipes have gained the greatest popularity and are successfully used in the treatment of skin diseases.

How to treat perioral dermatitis folk remedies:

1. Lotions. They are made by soaking a gauze pad in a decoction of medicinal herbs (chamomile, chamomile, calendula and plantain leaves). Applications are applied 3-4 times a day.
2. Compress with linseed oil and honey. Take 50 g of each component, heat until completely dissolved and add 25 ml of onion juice. Saturate a clean, soft cloth with the warm mixture and apply to the sore skin.
3. Birch bud decoction. The liquid is taken orally and the affected areas are wiped with it.

If the patient has access to thermal springs, effectively irrigating problem areas of the body with healing water. Frequent treatments are recommended.

Diet for perioral dermatitis on the face

If there are signs of perioral dermatitis on the face, the patient is prescribed a hypoallergenic diet. If it turns out to be useless, an individual fasting regimen is prescribed. It is mandatory to limit the consumption of salt and sugar, and adjust the drinking regime - you must drink at least 2 liters clean water per day. This amount of liquid supports proper metabolism and improves the absorption of microelements beneficial to tissues.

What can you eat if you have perioral dermatitis?:

• fruits;
• cereals;
• green vegetables;
• legumes;
• boiled lean meat;
• dairy products;
• wholemeal bread.

Prohibited products include:

1. Fish.
2. Carrot.
3. Mushrooms.
4. Sweets.
5. Eggs.
6. Spices.
7. Citruses.
8. Caviar.
9. Alcoholic drinks, coffee, tea.
10. Sausage products.