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Perioral dermatitis: what is it?
Perioral dermatitis is a fairly common inflammatory skin disease, localized mainly in the area around the mouth - the perioral zone. Its characteristic feature is the appearance of specific symptoms: persistent redness (erythema), numerous small red papules (nodules) resembling pimples, severe flaking and dryness.
Patients often experience very unpleasant subjective sensations: intense itching, a burning sensation, and tightness of the skin, especially noticeable after washing or contact with cosmetics. Visually, the affected skin appears irritated, inflamed, with a characteristic rash. This dermatological problem is most often diagnosed in women aged 18 to 45, which may be associated with more active use of cosmetics and hormonal factors.
The development of perioral dermatitis is associated with the complex effects of various provoking factors. Among the key triggers, dermatologists highlight excessive and irrational use of decorative and skin care cosmetics, especially products with comedogenic or irritating ingredients. A significant role is played by long-term, especially uncontrolled, use of topical corticosteroid creams or ointments, even weak ones, which initially provide apparent improvement, but then provoke withdrawal syndrome and worsening of the condition.
A negative reaction can be caused by the use of fluoridated toothpastes, the components of which irritate the sensitive skin around the mouth. Significant factors also include hormonal fluctuations (for example, before menstruation, while taking birth control pills, during pregnancy), imbalances in the skin's natural microbiome that weaken its protective barrier, chronic stress, which negatively impacts the skin's immunity, and aggressive external influences such as intense ultraviolet radiation and sudden changes in ambient temperature.
The clinical picture of perioral dermatitis typically includes not only visible small red papules, dryness, and flaking, but also subjective discomfort in the form of burning and itching, with symptoms often significantly intensifying after skin contact with water or any cosmetic products. Successful management of the condition requires the mandatory identification and elimination of individual triggers, targeted restoration of the damaged hydrolipidic barrier of the skin and the implementation of the most gentle care routine, which can significantly reduce the frequency and severity of exacerbations, achieving stable remission.
How is perioral dermatitis treated?
Treatment of perioral dermatitis is always a complex and step-by-step process, initiated with a mandatory consultation with a qualified dermatologist. Self-diagnosis and self-medication are unacceptable and may worsen the condition.
A doctor conducts a thorough diagnosis to differentiate perioral dermatitis from other skin diseases (rosacea, seborrheic dermatitis, acne) and rule out possible secondary infections. It is crucial to determine the underlying or concomitant causes of inflammation in a particular patient.
The independent use of hormonal (corticosteroid) ointments is strictly contraindicated, as they provide only temporary and deceptive improvement, leading to a severe exacerbation (withdrawal syndrome), the development of tolerance, and significant complications of further therapy after discontinuation.
The fundamental first step in treatment is the complete and unconditional withdrawal of all identified trigger factors. This involves temporarily or permanently eliminating any potentially aggressive cosmetics (foundations, powders, heavy concealers, products containing fragrances, alcohol, or SLS), replacing fluoridated toothpaste with a neutral one that does not contain sodium lauryl sulfate or menthol, and strict sun protection using mineral sunscreens with an SPF of 30 or higher.
If dermatitis developed while using corticosteroids, their discontinuation should occur exclusively under medical supervision, sometimes using a specific regimen that reduces the concentration or frequency of application. Drug therapy is individualized and may include topical antibacterial and anti-inflammatory medications, such as creams or gels containing metronidazole or erythromycin. For more severe or widespread forms, a doctor may prescribe systemic antibiotics (tetracycline, less commonly macrolides) for several weeks. Topical nonsteroidal anti-inflammatory drugs based on azelaic acid are also effective, as they normalize keratinization processes and reduce inflammation.
The modern approach places great emphasis on restoring a healthy skin microbiome—its natural protective microflora. For this purpose, both topical agents containing prebiotics (a nutrient medium for beneficial bacteria) and oral probiotics can be used.
Dietary adjustments are necessary: it is recommended to exclude or limit as much as possible spicy, too hot foods, sweets and simple carbohydrates that can provoke inflammation, and enrich the diet with foods rich in Omega-3 fatty acids (fatty fish, flaxseed oil, walnuts) and antioxidants (vegetables, fruits, berries).
Skin care for perioral dermatitis
Competent, delicate and consistent skin care is an integral part of the treatment of perioral dermatitis and the prevention of its relapses. Its main goal is to minimize any contact of damaged and hyperreactive skin with potentially irritating factors.
Standard mass-market cosmetics containing aggressive surfactants, alcohols, fragrances, preservatives, or comedogenic oils often worsen the condition, so absolute priority should be given to specialized pharmacy dermatological brands, such as those from the Cerafavit LIBREDERM line, as these products are developed with the needs of sensitive, inflammation-prone skin in mind and contain soothing, restorative, and protective ingredients.
The skin cleansing process should be extremely gentle. For washing, choose gentle gels or mousses without soap, sulfates (SLS, SLES), and alkaline components that can destroy the lipid layer and increase transepidermal water loss. It is recommended to wash with cool or lukewarm water, as hot water inevitably increases redness, itching, and irritation. Micellar water can be used, but it must be alcohol- and fragrance-free. Rinse with clean water afterward to prevent surfactants from remaining on the skin. After cleansing, a softening toner, such as the one in the Cerafavit LIBREDERM line, is ideal for soothing, relieving tightness, and preparing the skin for treatment or care products. This product effectively soothes irritated skin, helps restore optimal moisture levels, and creates ideal conditions for the penetration of the active ingredients of subsequent products. Restoring and protecting the damaged skin barrier is a key, critically important step in daily skincare. This requires creams containing natural-identical lipid components such as ceramides, as well as prebiotics to support the microbiome and vitamin F (linoleic acid), which strengthens intercellular bonds in the stratum corneum. Emollients (softening and moisturizing components) create a protective film on the skin's surface, preventing excessive moisture loss.
Since ultraviolet radiation is a proven factor in aggravating inflammation in perioral dermatitis, daily use of a sunscreen with SPF 30+ (preferably with mineral filters - titanium dioxide, zinc oxide) is strictly necessary, even in cloudy weather and in winter.
The Cerafavit LIBREDERM line was developed by dermatologists and ideally meets the needs of skin prone to perioral dermatitis:
Cerafavit Lipid-Restoring Balm intensively nourishes and deeply moisturizes the skin, effectively eliminating flaking and dryness.
Cream with Cerafavit prebiotics and ceramides specifically work to restore the protective barrier layer of the skin, strengthening its natural protective functions.
- For gentle cleansing of the body and face without the risk of overdrying or irritation, the soothing shower gel Cerafavit or the oil Cerafavit on an anhydrous basis are ideal.
The previously mentioned tonic-softener Cerafavit completes the cleansing stage, additionally moisturizing, softening the skin and preparing it for the most effective perception of a restorative cream or balm.
For itching, it is recommended to use emollient cream with colloidal oatmeal, ceramides and prebiotic.
- As A convenient lip balm with ceramides and vitamin F has been developed in this Cerafavit line for the lip area. This balm is suitable for sensitive lips and other problem areas of the face and does not leave a greasy residue, and will also provide excellent protection in the winter.
This comprehensive approach, combining medical treatment with carefully selected, gentle and restorative pharmacy care cosmetics, is the key to successful control of perioral dermatitis, achieving stable remission and restoring the health and comfort of the skin.