Perioral dermatitis (rose of the mouth) occurs predominantly around the mouth and cheeks, but can also manifest itself around the eyes or, in rare cases, on the neck. It most often occurs on constitutionally dry skin or as part of anti-wrinkle treatment as a result of over-moisturizing or over-oiling of the skin through routine use of moisturizers. The swelling and change in environment of the horny layer causes an impairment of the barrier function, which manifests itself in the form of a feeling of tension and reddened, possibly painful nodules. These subjective complaints and skin changes are often exacerbated by increased application of moisturizers and frequent changes of preparations.
Typical for perioral dermatitis are nodules up to 4 mm in size, some with the hint of a small pus head. Areas of redness and flaking may also occur. As a rule, women between the ages of 30 and 50 are affected.
The term “stewardess disease” can also be found in the older dermatology textbooks, as this clinical picture was more common in this professional group.
The epidermis also absorbs these substances, but apparently cannot process them properly. The state of tension increases. Believing that the skin lacks cream, we now apply cream more often. Now small redness appears for the first time, which then becomes palpable as papules. In an attempt to remove the unsightly pimples, other creams are now used that further reinforce this vicious circle.
In contrast to allergic reactions or neurodermatitis, itching is very rare. However, itching can occur if preparations containing cortisone have previously been used or if there is a predisposition to neurodermatitis. If itching occurs, a contact allergy must be ruled out in any case.
It is obvious that these skin changes can be very stressful for those affected, as their appearance can be significantly affected.
As a rule, no specific medications need to be used. It is enough to stop using all moisturizers and use a light, low-fat cream as care. However, it takes several weeks for the pimples to disappear. If there are reasons that require faster healing, local erythromycin gels, metronidazole cream or antibiotics such as tetracycline or minocycline can be used orally.
In order to avoid a recurrence of the disease after healing, a dermatologist’s skin type determination and care advice is recommended. Other care products can be found that are compatible.
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