- If you’ve noticed small pimples around your mouth you may be wondering what’s causing them. There are a few different things that can cause this including hormonal changes allergies and even certain medications.
- If you’re not sure what’s causing your pimples it’s best to see a dermatologist so they can help you determine the best course of treatment.
Perioral dermatitis
- Perioral dermatitis (POD) is an inflammatory and chronic papulopustular and vesicular dermatitis that primarily affects youngsters and middle-aged females.
- In addition to identifying the probable causes, topical or systemic therapy is frequently performed.
- Most dermatologists are aware of its link with corticosteroid use, but less is known about other associations such as infectious, cosmetic, disrupting skin barrier, dental fillings, and toothpaste.
1. Symptoms
- Perioral dermatitis appears as pruritic or sensitive erythematous papules in the perioral (sparing the vermillion) and periorbital areas, with rare vaginal involvement.
2. Causes of Perioral dermatitis
- There is no single known cause of perioral dermatitis. However, there are a few things that may contribute to the development of the condition.
1. Corticosteroids
- Chronic use of topical, nasal, inhaled, and oral corticosteroids has been linked to Perioral dermatitis.
- Perioral dermatitis is frequently successfully treated with topical steroids at first, but relapse occurs with corticosteroid removal.
- Topical steroids may change the microbiota of hair follicles, resulting in a microflora imbalance that contributes to Perioral dermatitis.
2. Infections
- Perioral dermatitis has been linked to infectious by some researchers.
- Fusobacteria, Demodex folliculorum, and Candida albicans are possibly involved in the pathogenesis of perioral dermatitis.
3. Sunscreens, Cosmetics, and Moisturizers
- The relationship between cosmetics, moisturizers, sunscreens, and POD was examined. Experts believe that POD was caused by an occlusive mechanism.
4. Skin Barrier Dysfunc Tion and Allergy
- Perioral dermatitis patients are considered to be "hyper-reactive," with poor skin barriers, particularly in the perioral area.
3. Treatment Of Perioral Dermatitis
- There are many different treatments for perioral dermatitis including over-the-counter creams, ointments prescriptions, and medications. Treatments are chosen based on the severity of symptoms, the treatments that have already been tried, and the patient's personality.
- Topical treatment efficacy is evaluated after 3 weeks. Systemic therapies should be used for no longer than 8 weeks.
1. First line treatment
- In terms of topical treatments, treatment abstinence is an alternative.
- If this strategy is unsuccessful, patients may be given topical antibiotics (metronidazole or erythromycin) or pimecrolimus.
2. Systemic medications
- Systemic medications should be avoided in first-line therapy a positive response is usually obtained quickly when steroid creams or cosmetics are stopped or when topical treatments are prescribed.
- Systemic medication should be reserved for instances that are resistant to topical therapies.
- Tetracycline or one of its derivatives is the therapy of choice if systemic treatment is required.
- Erythromycin should only be used in pediatric cases of the disease or when tetracyclines are contraindicated.
- The use of retinoids is an intriguing treatment option for granulomatous forms of the disease.
Other Causes of Small Pimples Around Mouth
- Steroid-induced rosacea, lupus miliaris of the face, and acne should be ruled out because they can have a similar distribution to POD.
1. Rosacea
- Rosacea typically has a centrofacial distribution with no comedones and, in certain cases, rhinophyma or ocular symptoms, which are uncommon in POD.
2. Lupus miliaris disseminatus faciei
- Red-brown papules and nodules, as well as atrophic tiny scars, are seen in lupus miliaris disseminatus faciei, with spontaneous regression.
3. Acne vulgaris
- Acne vulgaris is distinguished by the presence of comedones, papules, pustules, nodules, and cysts, which are not typical of POD.
4. Sarcoidosis
- Sarcoidosis can also appear with red-brown papules on the periorificial parts of the face, comparable to perioral dermatitis. Sarcoidosis can also appear with red-brown papules on the periorificial parts of the face, comparable to perioral dermatitis.
- Sarcoidosis lesions are typically more widespread and can occur in other areas of the skin, and patients frequently experience systemic sarcoidosis symptoms.
- A biopsy can help differentiate sarcoidosis.
5. Seborrheic dermatitis
- Seborrheic dermatitis is characterized by red patches with greasy scales on the brows, glabella, paranasal skin, nasolabial folds, and chest.
6. Allergic contact dermatitis
- Allergic contact dermatitis is another possibility, however, it typically manifests as patches with probable lichenification.
- If traditional therapies fail to improve perioral dermatitis, patch testing should be considered to rule out allergic contact dermatitis from skincare or oral care products.
7.
Lip licker's cheilitis
- Lip licker's cheilitis, for example, is characterized by erythema and scaling of the cutaneous lip.
- This often affects the vermillion lip as well as the vermillion border. Perioral dermatitis, on the other hand, spares the vermillion border.
Conclusion
- Perioral dermatitis has been linked to a variety of causes, including the overuse of topical or inhaled corticosteroids, infection with fusobacteria, reactions to cosmetics, dental fillings, toothpaste, and even skin barrier disorder.
- New research is needed to thoroughly evaluate promising therapeutic possibilities such as tetracyclines, topical metronidazole, topical azelaic acid, adapalene gel, and oral isotretinoin.
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