Perioral Dermatitis

Last Updated: 2020-11-19

Author(s): Anzengruber, Navarini

Frumess and Lewis 1957.

Dermatitis perioralis, rosacea-like dermatitis, stewardess disease, steroid rosacea, periorificial dermatitis.

Frequent, itchy to painful skin changes in the face.

  • Incidence: approx. 1%/ year
  • Peak age: 20-40 years.
  • Women >> Men
  • Unknown
  • Probably a ↑↑ use of skin care products
  • Use of topical glucocorticoids, too high a class of active ingredients or too long
  • UV light (is not a trigger, but can lead to deterioration)

Perioral, but also often periorbital erythematous, often grouped, pruriginous to burning, confluent, often slightly scaling papules, papulovesicles and papulopustules.

Zero therapy:

  • No cosmetics, no perfumes, no creams or ointments.

Cleaning:

  • Undecylenic acid
  • #Der-med® Extra Mild liq
  • Commercial cleansing products
  • Sebamed®-liquid Washing emulsion
  • Excipial® Clean

Topical therapy:

  • Calcineurin inhibitors
  • Pimecrolimus
  • #Elidel®-Cream 1% 2x daily for 2 weeks

Tanning agents:

  • Tannosynt®- Ltd. (for hand baths).
  • Black tea hand baths.

Azelaic acid:

  • #Skinoren®- Gel 1-2x daily

Topical antibiotics:

  • Erythromycin
  • #Akne-mycin® solution 20 mg/g.
  • #Aknilox ® Gel 2 % .
  • Metronidazole
  • #Rozex®-Gel. 2x daily
  • #Rosalox® cream. 2x daily.

Make up[AF1]​​​​​​

  • Only if absolutely necessary for patients, for example: Unifiance Cream Make-up® from La Roche Posay

Internal therapy:

Systemic therapy:

  • Systemic antibiotics:
  • Doxycycline
    #Doxycycline® p.o. 100 mg 2x daily for 14-21 days
  • Minocycline
    #Minac® p.o. 50 mg 2x daily

Systemic retinoids:

  • #Isotretinoin p.o. 10.30 mg 1x a day.
  1. Frieden IJ. Granulomatous Perioral Dermatitis in Children. Arch Dermatol 1989;125:369.
  2. Hafeez ZH. Perioral dermatitis: an update. International Journal of Dermatology 2003;42:514-7.
  3. Takiwaki H, Tsuda H, Arase S, Takeichi H. Differences between intrafollicular microorganism profiles in perioral and seborrhoeic dermatitis. Clin Exp Dermatol 2003;28:531-4.
  4. Dirschka T, Tronnier H, Folster-Holst R. Epithelial barrier function and atopic diathesis in rosacea and perioral dermatitis. Br J Dermatol 2004;150:1136-41.
  5. Wilkinson DS, Kirton V, Wilkinson JD. Perioral dermatitis: a 12-year review. British Journal of Dermatology 2006;101:245-57.
  6. Weston WL, Morelli JG. IDENTICAL TWINS WITH PERIORAL DERMATITIS. Pediatric Dermatology 2009;15:144-.