Aspects of medical treatment of perioral dermatitis

Read our previous article on the causes and clinical manifestations of perioral dermatitis. When identifying the first symptoms of the disease, it is important to establish a diagnosis in a timely manner and begin treatment of perioral dermatitis. Differential diagnosis is carried out with allergic contact dermatitis, diffuse neurodermatitis, seborrheic dermatitis, rosacea, acne vulgaris, steroid acne, impetigo, discoid lupus erythematosus, sarcoidosis, sometimes – with skin epithelioma. What is the treatment of perioral dermatitis, read more on estet-portal.com.

"Rules of Conduct" patient in the treatment of perioral dermatitis

In the process of making a diagnosis, the patient should be consulted by an endocrinologist, gastroenterologist, neuropathologist and psychiatrist, and women also by a gynecologist.

In the treatment of perioral dermatitis, it is necessary to exclude the use of obligate food allergens, spicy and spicy foods, canned foods, alcohol, carbohydrates, very hot foods.

For skin care, it is recommended to avoid the use of abrasive cleansers, heavy moisturizers, astringents, scrubs and peels.

Mild, alkali-free cleansers must be used. What substances are indicated for the local treatment of perioral dermatitis, read further on estet-portal.com.  It is also recommended to use a light moisturizing cream with ceramides, products containing a green pigment that masks the redness of the skin (rosaliac, dirosil, rosellane, dermalibur), and use sunscreen as often as possible.

What is the topical treatment for perioral dermatitis?

In the acute stage, in the treatment of perioral dermatitis, cold lotions from herbal infusions (chamomile, string, sage, nettle), from 1 & ndash; 2% aqueous solution of resorcinol or 2% solution of boric acid are recommended. Zinc agitated suspensions are used.

Characteristics of the main topical preparations for the treatment of perioral dermatitis:

• Metronidazole gel 2 times a day (antibiotic of the imidazole group, inhibits the generation of reactive oxygen species, has a pronounced anti-inflammatory effect).
• Erythromycin 2 times a day (acts bacteriostatically on microorganisms, not contraindicated in the treatment of pregnant women and children).
• Clindamycin 2 times a day (a semi-synthetic antibiotic of the lincomycin group).
• Azelaic acid 2 times a day for 3-4 months (a dicarboxylic acid derivative with a pronounced antimicrobial, anti-inflammatory and keratolytic effect).
• Sodium sulfacetamide 10% + 5% sulfur (as lotion, cream, gel); has antibacterial properties, antifungal, anti-demodectic and keratolytic effect. Assigned within 8 weeks.
• Pimecrolimus 1% cream (Elidel) – applied 2 times a day until the disappearance of the clinical manifestations of PD.
• 0.03% and 0.1% tacrolimus ointment – applied 2 times a day until the disappearance of the clinical manifestations of PD.

If 4 weeks of topical treatment fails, systemic antibiotics are given.

Desensitizing drugs for the treatment of perioral dermatitis:

• clemastine, chloropyramine, acrivastine, cyproheptadine are taken 2-3 times a day;
• astemizole, loratadine, fexofenadine, desloratadine, cetirizine, levocetirizine – 1 time per day.

Treatment of perioral dermatitis with antibacterial drugs

Therapy of perioral dermatitis with systemic antibiotics consists in the use of one of the following drugs: tetracycline – 500 mg 2 times a day; doxycycline – 100 mg 2 times a day; minocycline – 100 mg 2 times a day; erythromycin – 500 mg 2 times a day; josamycin – 250 & ndash; 500 mg 2 times a day; clarithromycin – 250–500 mg 2 times a day.

Systemic antibiotic therapy is carried out for 2-4 weeks. When remission occurs in the process of taking them, the dose is halved within 2 weeks, then – by 1/4 over the next 2 weeks.

Treatment of perioral dermatitis with drugs of the nitroimidazole group. In case of resistance to the above antibiotics, oral administration of drugs of the nitroimidazole group is often effective:

• metronidazole 1.0–1.5 g per day from 10 days to 4–6 weeks;
• ornidazole 1,000 mg daily for 10-14 days.

Complex timely treatment of perioral dermatitis will certainly bring the desired result.