Perioral Dermatitis 

  • Author: Hans J Kammler, MD, PhD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Mar 9, 2011
 

Background

Perioral dermatitis (POD) is a chronic papulopustular and eczematous facial dermatitis. It mostly occurs in women, although a distinct papular variant occurs in children.[1] The clinical and histologic features of the perioral dermatitis lesions resemble those of rosacea. Patients require systemic and/or topical treatment, an evaluation of the underlying factors, and reassurance.

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Pathophysiology

The etiology of perioral dermatitis (POD) is unknown; however, the uncritical use of topical steroids for minor skin alterations of the face often precedes the manifestation of perioral dermatitis. Neurogenic inflammation has been proposed as a pathogenic mechanism.[2] Perioral dermatitis is limited to the skin.

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Epidemiology

Frequency

United States

The incidence of perioral dermatitis is estimated to be 0.5-1% in industrialized countries, independent of geographic factors.

International

The incidence of perioral dermatitis seems to be lower in less developed countries, but no statistics are available.

Mortality/Morbidity

Perioral dermatitis is limited to the skin and is not life threatening. Emotional complications may develop because of the nature and chronic course of the disease (see Complications).

Sex

Perioral dermatitis predominantly affects women, who account for an estimated 90% of the cases. The number of male patients is assumed to be increasing because of changes in their cosmetic habits.

Age

Perioral dermatitis can occur in children, but it is seldom diagnosed. The vast majority of patients are women aged 20-45 years.

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Contributor Information and Disclosures
Author

Hans J Kammler, MD, PhD  Head of Licensing Unit for Dermatology, ENT, Ophthalmology, and Respiratory System, German Federal Institute for Drugs and Medical Devices (BfArM)

Disclosure: Nothing to disclose.

Specialty Editor Board

James Fulton Jr, MD, PhD  Center for Cosmetic Dermatology; Consultant, Vivant Pharmaceuticals, LLC

James Fulton Jr, MD, PhD is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Dermatology, American Society for Laser Medicine and Surgery, Dermatology Foundation, International Society of Cosmetic and Laser Surgeons, and Skin Cancer Foundation

Disclosure: Vivant Pharmaceuticals Grant/research funds Consulting

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD  Assistant Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, and Texas Dermatological Society

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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  2. Guarneri F, Marini H. An unusual case of perioral dermatitis: possible pathogenic role of neurogenic inflammation. J Eur Acad Dermatol Venereol. Mar 2007;21(3):410-2. [Medline].

  3. Chen AY, Zirwas MJ. Steroid-induced rosacealike dermatitis: case report and review of the literature. Cutis. Apr 2009;83(4):198-204. [Medline].

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  13. Miller SR, Shalita AR. Topical metronidazole gel (0.75%) for the treatment of perioral dermatitis in children. J Am Acad Dermatol. Nov 1994;31(5 Pt 2):847-8. [Medline].

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  15. Oppel T, Pavicic T, Kamann S, Brautigam M, Wollenberg A. Pimecrolimus cream (1%) efficacy in perioral dermatitis - results of a randomized, double-blind, vehicle-controlled study in 40 patients. J Eur Acad Dermatol Venereol. Oct 2007;21(9):1175-80. [Medline].

  16. Jansen T. Perioral dermatitis successfully treated with topical adapalene. J Eur Acad Dermatol Venereol. Mar 2002;16(2):175-7. [Medline].

  17. Jansen T. Azelaic acid as a new treatment for perioral dermatitis: results from an open study. Br J Dermatol. Oct 2004;151(4):933-4. [Medline].

  18. Schwarz T, Kreiselmaier I, Bieber T, et al. A randomized, double-blind, vehicle-controlled study of 1% pimecrolimus cream in adult patients with perioral dermatitis. J Am Acad Dermatol. Jul 2008;59(1):34-40. [Medline].

  19. Del Rosso JQ. The use of topical azelaic acid for common skin disorders other than inflammatory rosacea. Cutis. Feb 2006;77(2 Suppl):22-4. [Medline].

  20. Hafeez ZH. Perioral dermatitis: an update. Int J Dermatol. Jul 2003;42(7):514-7. [Medline].

  21. Katsambas AD, Nicolaidou E. Acne, perioral dermatitis, flushing, and rosacea: unapproved treatments or indications. Clin Dermatol. Mar-Apr 2000;18(2):171-6. [Medline].

  22. Hengge UR, Ruzicka T, Schwartz RA, Cork MJ. Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol. Jan 2006;54(1):1-15; quiz 16-8. [Medline].

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