Perioral dermatitis is a chronic skin disease, the main manifestations of which are foci of inflammation and peeling of the skin around the mouth, in the area of the nasolabial triangle and chin. The disease is often recurrent. In medical practice, it is described as “perioral” or ” rosacea -like ” dermatitis, as well as “stewardess disease” due to the frequent presence of the disease in women of this profession.
Causes of perioral dermatitis
Perioral dermatitis, a photo of which can be viewed on a medical website, most often develops as a result of the irrational use of various care and / or medications. There are also other reasons that support the course of the disease. They can be divided into exogenous and endogenous.
Factors of exogenous origin:
- components of means for creation of a make-up and the looking after cosmetics. Counterfeit products with low-quality ingredients;
- Long-term therapy with hormonal ( glucocorticosteroid ) creams;
- carrying out inhalations with the addition of fluorine-containing corticosteroids (Dexamethasone, Triamcinolone , Betamethasone , Fluprednisolone );
- taking oral contraceptives;
- prolonged use of toothpaste containing fluoride;
- change in climatic conditions, high humidity, weathering;
- ultraviolet radiation, prolonged insolation;
Factors of endogenous origin:
- chronic focus of infection (inflammatory process of the sinuses, palatine tonsils, caries, cavernous cavities in the teeth);
- chronic diseases of the digestive canal, nervous system;
- abnormal levels of hormones;
- violation of the microbiome of the skin of the face;
- sensitive and delicate facial skin.
Statistically revealed, perioral dematitis on the face most often affects women aged 20 to 40 years, there are cases of skin lesions in children with the use of corticoid agents in the form of aerosols and sprays, teething, excessive salivation and late weaning from the nipple.
Symptoms of perioral dermatitis
There is a certain localization of rashes. The skin of the nasolabial triangle, chin and corners of the mouth is more often affected, in rare cases there is a rash on the cheeks, in the forehead and periorbital zone.
By the nature of the elements of the rash, the usual and granulomatous forms of the disease are distinguished. The disease debuts with the appearance of single or multiple papules prone to fusion, the color varies from pale pink to pronounced red. It looks like acne breakouts. The skin is hyperemic.
After healing of the elements, crusts form, which are easily peeled off . In the case of forced removal of crusts, hyperpigmentation remains.
Rashes are located in groups or isolated above the upper lip, gradually spreading to nearby areas. An important clinical symptom is the absence of 3-4 mm lips around the red border. The application of moisturizing cosmetics enhances the clinical picture.
In childhood, a granulomatous form of the disease is sometimes found, in which the rashes are painted in beige, pale pink or light brown.
Treatment of perioral dermatitis
The treatment of perioral dermatitis will require adherence to staged therapy, which consists in stopping contact with the trigger, following a hypoallergenic diet, and using medications.
Initially proceed to the so-called “zero therapy”. The peculiarity is the cessation of the use of toothpaste containing fluoride, hormonal ( glucocorticosteroid ) creams, decorative cosmetics and other care products. In the case of inhalations with corticoids , it is necessary to reconsider the tactics of treatment, as a result of which the attending specialist decides to cancel the drug or replace it with a similar agent.
Treatment with the inclusion of a hypoallergenic diet for perioral dermatitis on the face will help reduce the degree of rashes, the severity of clinical symptoms, or lead to a long-term remission of the disease. Meals should contain:
- Protein foods: lean veal, turkey, rabbit; river fish (perch, carp, pike); sea fish (cod and sea bass); offal (chicken liver, beef tongue); low-fat cottage cheese, kefir, butter.
- Vegetable products: cereals (rice, barley, buckwheat, corn, oatmeal, millet); vegetables (green salad, zucchini, potatoes, cauliflower, cucumber, white cabbage); berries and fruits (gooseberries, white cherries and mulberries, apples, pears, watermelon); refined vegetable oil.
- Drinks: sour milk (ayran, tan ); non-carbonated mineral waters; compote of dried apples and pears; weak green and black tea.
- Desserts: dry biscuit cookies (Maria, Belogorye); dried fruits (prunes, raisins, dried apricots).
Avoid eating with preservatives, dyes and sweeteners. It is worth giving up smoked, salty and spicy dishes for the period of stage therapy.
When determining the cause of perioral dermatitis, laboratory and instrumental diagnostic methods will be required, and then the appointment of drug etiotropic treatment in adults. Medication is needed when a hypoallergenic diet and the exclusion of trigger factors do not bring relief to the patient. Drug therapy includes the use of external (non-hormonal anti-inflammatory drugs from the group of calcineurin inhibitors or antibacterial ointments and gels) and systemic agents (tetracycline antibiotics, antihistamines, and others).
Upon completion of the main course, vitamin complexes and immunomodulatory therapy are prescribed.
Alternative treatment of perioral dermatitis
It is used in complex therapy with basic drugs or during the period of improvement. Treatment of folk remedies for perioral dermatitis involves the use of soothing, drying and wound healing lotions, decoctions and compresses. Experts do not recommend monotherapy , especially during an exacerbation.
Herbal medicine recipes:
Infusion of chamomile and calendula: a tablespoon of chamomile and a tablespoon of calendula are brewed in 400 ml of hot water, infused for 45-55 minutes. The resulting broth is filtered. Spend applications on inflamed areas lasting 15-20 minutes.
Treatment with folk remedies is effective in case of prolonged use and the correct selection of components. In addition, difficulties may arise due to the development of adverse reactions intolerance to plant materials or the exact proportions of a decoction, infusion or lotion.
Losterin for perioral dermatitis
The Losterin line of products was created specifically for therapeutic and preventive measures for chronic dermatopathy along with basic therapy. The peculiarity of the preparations is the absence of hormonal components, fragrances and dyes, which practically eliminates the appearance of intolerance and allergic reactions. With prolonged use, there is no addiction syndrome,
With perioral dermatitis on the face, first of all, such a form of Losterin is used as a cream.
Natural ingredients contained in Losterin cream have anti-inflammatory, antipruritic and soothing effects. Contribute to the natural regeneration of the epidermis, increase the barrier function, eliminate tightness and irritation.
Prevention of perioral dermatitis
Preventive measures are aimed at preventing re-contact with an irritating factor, the patient is recommended:
- personal hygiene;
- timely therapy of diseases of internal organs, elimination of the focus of chronic infection;
- regular sanitation of the oral cavity;
- avoid applying corticosteroid ointments to various parts of the body;
- use only high-quality cosmetic products in small quantities;
- changing fluoride toothpaste;
- adhere to a regular and balanced diet.
Cryomassage and electrophoresis can be prescribed as therapeutic and preventive measures.