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THE SKIN CARE SCOOP

Perioral Dermatitis—Red Bumps Around the Mouth
If you’ve been struggling to get rid of red, swollen, sometimes crusty bumps around your lips and at the sides of your nose, yet nothing seems to help, don’t fret--there is an answer for you. These persistent bumps can be a sign of a perioral dermatitis. According to the American Academy of Dermatology (www.aad.org), “Perioral dermatitis [POD] is a common skin problem that mostly affects young women [20 to 45 years of age]. Occasionally men or children are affected. Perioral refers to the area around the mouth, and dermatitis indicates redness of the skin. In addition to redness, there are usually small red bumps or even pus-filled bumps and mild peeling. Sometimes the bumps are the most obvious feature, and the disease can look a lot like acne. The areas most affected are within the borders of the lines from the nose to the sides of the lips, and the chin. Sometimes there is mild itching and/or burning.”

POD is actually quite common and is considered by most dermatologists to be increasing in incidence (Source: Australasian Journal of Dermatology, February 2000, pages 34–38). While little is known about what causes this disorder, there are theories that overuse of topical cortisone creams, fluorinated toothpaste, or heavy or occlusive skin-care ointments and creams (especially those with a petrolatum or thick wax base) and foundations may be responsible for the problem. Exposure to sunlight, heat, and wind can also make matters worse (Source: eMedicine Journal, August 1, 2001, volume 2, number 8).

If you suspect that you have POD, it is best to be diagnosed by a dermatologist because there are no over-the-counter medications that can treat the condition. If you want to try and experiment first, you can begin by stopping the use of any topical cortisone creams. Be advised, though, that this step can initially make matters worse before any improvement takes place. Be patient, at least for a few weeks, to see if the condition finally improves.

You can also try brushing with fluoride-free toothpaste such as Tom’s of Maine Natural Fluoride-Free Toothpaste ($2.99 for 4 ounces) and see if that makes a difference. If fluoride-free toothpaste turns out to be the solution, check with your dentist to see how this will affect your dental health. Finally, stop using your foundation and emollient moisturizers to see if that helps the situation improve.

A dermatologist can prescribe topical metronidazole (MetroGel, MetroLotion, or MetroCream) alone or in combination with either oral tetracycline or erythromycin. Even though topical cortisone creams may be the cause of POD, you may be prescribed a low-potency cortisone cream to reduce the inflammation and to help you wean off the stronger topical cortisone cream you may have been using (Source: Seminars in Cutaneous Medical Surgery, September 1999, pages 206–209). For more information on perioral dermatitis, visit www.aad.org/pamphlets/Perioral.html