Perioral dermatitis: what it is and natural treatment

Perioral dermatitis is a skin disorder that looks like acne or rosacea It mainly affects women between the ages of 20 and 45. However, all age groups, including men, can develop perioral dermatitis.

What are the symptoms of perioral dermatitis?

In most cases, perioral dermatitis presents with papules (small bumps with sharp edges) around the mouth or in the folds of the nose and that they can spread to larger areas.

Papules may show at the top blisters filled with fluid or pus. Around the papules the skin is red and in some cases scaly. There is also a feeling of tightness, more rarely also a burning or itching sensation. In the worst cases, the eyelids, nose, forehead, and even the entire face, the sides of the neck, and the skin behind the ears can be affected.

The papules develop in the area of ​​the hair follicles of the fine, short, and poorly pigmented hair that covers much of the body surface until puberty. Some of this hair is transformed into adult body hair in the course of physical development. Sometimes a narrow band around the lips can be seen to be free of symptoms; this is because that area has no hair.

The disease usually has a chronic course with intermittent worsening of symptoms. Improvement to complete remission can be achieved if triggering factors are avoided.

What are the causes of perioral dermatitis?

The exact mechanism by which perioral dermatitis develops has not yet been clarified. However, It is known that the flora or microbiome of the skin and the natural barrier function are altered as the disease develops. As a result, the skin is less able to retain moisture, becomes drier and tighter. Redness and scaly areas appear. Harmful substances from the environment and infectious agents can more easily penetrate the skin.

In addition to a damaged skin barrier and disturbed skin flora, dysregulation of the skin’s immune system is also an important aspect in the development of the disease. The mentioned processes influence each other and can be triggered by the causes listed in the next section.

Symptoms are the result of a combination of these processes. Damaged skin tries to repair its surface and the immune system is activated when exposed to microorganisms and toxic agents, which increases inflammation.

What are the causes of perioral dermatitis?

Various exogenous (from abroad) and endogenous (from the body itself) factors that can lead to the development of the pathology are discussed.. In each patient there can be a combination of causes that contribute to the development of the disease.

Exogenous causes:

Excessive use of cosmetic products and therefore an “overcare” of the skin.Use of inappropriate cosmetic products and harmful.Local or systemic application of glucocorticoids (cortisone).Intensive radiation exposure solar or artificial ultraviolet.wear a mask for a long time.

Endogenous causes:

Genetic factors.diseases of the gastrointestinal tract.imbalances hormonal.Stress.

Excessive skin care

The excess of cosmetic treatments – moisturizing creams, anti-wrinkle creams, peelings, masks, etc. – can have unforeseen effects. The skin has its own balance, that can be altered by the different products with which we try to take care of it or improve its appearance. For example, moisturizing creams can inflame the stratum corneum and interfere with its natural function.

Daily facial cleansing can also damage the skin. Surfactant detergents can damage the skin barrier of many ways:

The fats found between the cells of the stratum corneum can be separated. There can be an interaction between surfactants and keratin (skin’s structural protein), which in turn can cause cell membranes to swell and ultimately destroy the cells. of the skin. Collagen fibers and other skin proteins are damaged. The differentiation process of the cells of the stratum corneum may be disrupted.

As a result, the skin is less able to retain moisture, becomes dry and tight. Then the person uses other products with the intention of helping the skin, but which lead to further deterioration. A vicious circle ensues and the skin can acquire a generalized hypersensitivity to a large number of cosmetic ingredients.

harmful cosmetic products

Cosmetic products contain numerous substances that can damage the skin and contribute to irritation.. This could also be a causative factor for the development of perioral dermatitis or to aggravate an existing clinical picture. These substances include, for example:

PerfumesSome surfactantsAlcoholsCertain preservativesMineral oils and other ingredients

The surfactants Some cleaning products, in addition to the effects described above, promote a change in the skin’s natural, slightly acidic pH. This disrupts the skin’s defense function and makes it more susceptible to harmful microorganisms.

The alcohols they are also found in many cosmetic products. They lead to degreasing of the skin and therefore to increased moisture loss. They also interfere with the skin’s natural microflora.

The polyethylene glycols (PEGs) also affect the barrier function of the skin and increase its vulnerability.

Glucocorticoids

Glucocorticoids are found naturally in the body, but are produced synthetically (eg, prednisolone, dexamethasone) for use as anti-inflammatory and immunosuppressive drugs.

However, in the case of perioral dermatitis, the use of preparations containing glucocorticoids (for example, hydrocortisone ointment) on the face is prohibited, because they damage the skin barrier through various mechanisms and lead to a worsening of symptoms in the long term.

Prolonged use of an ointment containing cortisone (to treat a dermatitis, for example) can also trigger perioral dermatitis. Even the use of cortisone in the form of a spray (for example, for asthma) or in tablets can trigger oral erysipelas.

Ultraviolet (UV) radiation

Excessive skin exposure to UV radiation damages the skin and can exacerbate inflammatory conditions such as perioral dermatitis or rosacea. Consequently, strong sunlight should be avoided as much as possible and visits to the solarium altogether.

Since the use of sunscreen can also exacerbate perioral dermatitis, the only way to avoid UV radiation during the acute phase of the disease is stay in the shade

Face mask

Mouth and nose masks can also lead to the development of perioral dermatitis. Because the exhaled warm and humid air is retained under the protective mask, the horny layer of the skin swells and the skin barrier is broken. In this warm and humid environment, the proliferation of microorganisms is favored and the affected skin becomes easily inflamed.

In addition, the mechanical stimulus when wearing the mask causes constant skin irritation. Fragrances or other chemicals contained in masks can also have a negative effect on skin health. Other skin conditions such as acne, rosacea, and oral erysipelas can be aggravated by frequent use of a protective mask.

Genetic factors

Genetic factors play a role in a variety of diseases. It has been shown that patients with perioral dermatitis often have a so-called atopic diathesis or atopy, a genetic predisposition to the development of IgE-mediated hypersensitivity (allergic) reactions.

In addition to perioral dermatitis, these reactions also they may include bronchial asthma and atopic dermatitis (neurodermatitis). Dry skin is also more common in patients with a predisposition to atopy.

Gastrointestinal tract diseases

A current research topic is the connection between the gut microbiome (intestinal flora), the skin microbiota (skin flora) and the development of skin diseases. The connection between the gut and the skin is also known as the “gut-skin axis” or the “microbiota-gut-skin axis”.

The microbiota is involved in the regulation of the immune system and it is known that In many skin diseases there is a dysbiosis (disorder of the composition of the skin and intestinal flora. The exact mechanisms of how gut bacteria affect those on the skin have not yet been elucidated in detail.

hormonal imbalances

Hormonal influences are also discussed as possible triggers for perioral dermatitis. This is supported by the fact that the majority of patients are women and many also report a worsening of symptoms in relation to their period. Furthermore, taking hormonal contraceptives could also have an impact on the development of the disease.

Stress

It is well known that stress leads to a suppression of the immune system and puts a strain on the entire body in a variety of ways. For example, heHigh levels of stress can worsen skin conditions, such as perioral dermatitis.

On the one hand, stress hormones and other messenger substances that are released during stress have a direct impact on the skin. On the other hand, stress has a negative effect on the intestinal flora.

How to naturally treat perioral dermatitis?

When perioral dermatitis is diagnosed, the first and often decisive step in therapy is Completely suspend the application of all hygiene and cosmetic products used in the previous weeks.

If corticosteroid-containing preparations were used on the skin, these are also discontinued. Facial cleansing should be done very carefully. The ideal is a gentle cleansing of the face with water and careful pat-drying.

Avoid rubbing the skin with a towel, as mechanical irritation can also worsen symptoms. If necessary, the face can be washed once a day, ideally at night, with a mild, pH-neutral skin care product.

Many people who suffer from perioral dermatitis have a hard time resisting applying products. In that case, at most one could apply a high quality aloe vera gel.

A proven home remedy for severe irritation and a feeling of tightness is compresses with cold black tea, which must be left to settle for at least 5-10 minutes so that the water contains a sufficient amount of tannins. A cloth soaked with the cooled tea should then be placed on the affected skin areas for several minutes.

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