Perioral Dermatitis - Memphis Dermatologist's Perspective
George Woodbury MD 2/16/2023
Perioral dermatitis is an inflammation (irritation) of the skin around the mouth ("peri" means around, and "oral" means mouth). This skin problem affects both men and women between the ages of 16 and 45, although it is more common for women, and it has been reported in children as well.
What causes Perioral Dermatitis?
The exact cause is not known. Many Board-certified Dermatologists think of the condition as an overlap of Acne (clogged pores) and Eczema (sensitive skin eruption, sometimes touched off by an allergy). Because Perioral Dermatitis is an overlap condition, Dermatologists are generally cautious about using products that are too drying (which could cause the Eczema component to flare) or products that are too greasy (which could promote outbreaks of Acne). We need our care plan to include both Acne treatment and Eczema treatment, or Atopic Dermatitis Treatment. So we have to walk a fine line in designing a care plan for our patients with Perioral Dermatitis.
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Should certain products be avoided by patients with Perioral Dermatitis?
Generally sunscreens are quite beneficial in cutting down on flares of the condition (most preferably oil-free sunscreens). We often recommend avoidance of cosmetics and toiletry products with cinnamon oil, also called cassia oil (a component of certain lipsticks, chewing gums, bitters, and alcoholic and nonalcoholic beverages). Also suspected as trigger factors for flares of Perioral Dermatitis are several components of cosmetics, in particular jasmine synthetic, cinnamic alcohol, and hydroxycitronellal. There are also several papers pointing to fluoride (fluorine) in toothpastes. Some Dermatologists suspect that hormonal factors may be involved.
Are there certain types of testing that can help the condition?
Allergy Patch Testing is a helpful test that can reveal trigger factors, which can include components of latex, dyes, fragrances, latex ingredients, or even metals such as Nickel and Cobalt. As a member of the American Contact Dermatitis Society, I have been offering Allergy Patch Testing in my Memphis Dermatology practice since 2004. It generally requires 3 visits: on the Monday visit, we place the patches, and then we read them on the Wednesday and Friday visits. Depending upon which patches are positive, we can then recommend what types of products to avoid, or to be wary of. The test code for insurance purposes is 95044, and many (but not all) insurance companies cover for this type of testing. Patients may wish to check with their own insurance companies as to whether this is a type of covered benefit.
The best part about perioral dermatitis is the fact that we Dermatologists are often able to manage the condition with moderate strength prescription topical steroid creams or ointments, such as Desonide or prescription Hydrocortisone cream, usually applied to the area once a day. Oral antibiotics (i.e., taken by mouth) tend to be quite helpful, such as tetracycline, doxycycline, or minocycline. Generally, I also use a topical antibiotic once a day as well, such as clindamycin gel or Erythromycin Solution.
Are there certain toiletry products that tend to be helpful?
After 25 years of practicing dermatology, in 2016 I decided to establish a skincare products company - Big River Silk Skincare™ Inc. – of which I am the President - to manufacture and distribute organic skincare products for people with Perioral Dermatitis: AmberSoy™ Soap Gel and the GlycoShea™ Creams and Lotions. These products have been used for many years by thousands of acne patients in Tennessee and Arkansas, and they’re now available nationally. For more on these products, go to https://www.Bigriversilkskincare.com.
So if you or a family member has complexion issues or acne, consider getting a checkup from a Board-certified Dermatologist. My own Memphis Dermatology practice since 1993 has been with Rheumatology and Dermatology Associates, as a Memphis Dermatologist or a Cordova Dermatologist, in Tennessee (www.Rheumderm.com or www.Bigriversilkskincare.com) (1-901-753-0168). Or you can find a Dermatologist in your own neighborhood by going to the American Academy of Dermatology web site, AAD.org, then plugging your zip code into the “Find a Dermatologist” tab.
George Woodbury MD 2/16/2023