Perioral dermatitis. Perioral dermatitis is a facial rash that usually develops around the mouth but may also appear around the eyes, nose, or forehead. It’s not contagious.

The rash of POD is bumpy and scaly in appearance. There may be itching and pain, along with the discharge of clear fluid from the rash. Perioral dermatitis mostly occurs in women and children.

Causes of perioral dermatitis

The cause of perioral dermatitis is not always known. Factors that may trigger perioral dermatitis include the following:

• Drugs: steroid creams, ointments, and inhalers, antibiotics, painkillers, too many antihistamines etc.
• Fluoride toothpaste (and they are almost all toothpastes).
• Skincare lotions and creams, especially those containing too many perfumes, artificial oils, colors, steroids, antihistamines, zinc (oxide), chalk etc.
• Sunscreens (almost all kinds).
• Makeup products (colors, perfumes, antihistamines etc).
• Artificial Ultraviolet (UV) light.
• Heat.
• Dust.
• Wind.
• Certain infections.
• Oral contraceptives.
• Hormones.
• Vitamin A, B6 and B12 deficiency.

Signs and symptoms

Common signs and symptoms of perioral dermatitis include:

• Redness and bumps around the skin of the mouth or around the eyes.
• Itching.
• Burning sensation.
• Dry, flaky skin.
• Crusting.
• A tightening sensation on the skin around the mouth.
• Watery discharge from the rashes.
• Rash may involve the eyelids, nose, forehead, and genitals.

Allopathic treatment for perioral dermatitis

The allopathic treatment of perioral dermatitis depends on the extent of the disease and the underlying cause. Steroid creams or ointments should be discontinued. Treatment options include:

• Praziquantel cream.
• Pimecrolimus cream.
• Antibiotic creams.
• Oral vitamin analogs.
• Oral antibiotics.
• Non-steroidal anti-inflammatory drugs (NSAIDs).
• Avoid the use of cosmetics, cleansers, and moisturizers during the treatment (especially Salicylic Acid, Mandelic Acid, Glycolic Acid, Azelaic Acid, Sulfates, Phthalates, Triclosan, Toluene, Lead, Polyethylene Glycol, Formaldehyde, Diethanolamine, Alcohol etc.).
• Avoid strenuous physical exercise until the skin heals.

Perioral dermatitis may resolve on its own by avoiding the trigger factors (camouflages itself and moves inside the body into another organ). There are, however, high chances of recurrence if proper medical care is not obtained. Unexpectedly, long treatment duration may be needed to achieve a cosmetically satisfactory result. Despite proper management, recovery may take weeks and sometime months.

Diagnosed

• The diagnosis of perioral dermatitis usually does not require any tests.
• Dermatologist or physician can diagnose it by visual examination of the face.
• They should ask about the use of steroid creams and ointments apart from other relevant histories.
• Collected swabs to perform skin culture for ruling out a possible infection.
• In rare cases when the standard allopathic treatment is not effective, doctor may take a sample of the affected skin for skin biopsy.
• Blood tests may be used to rule out nutritional deficiencies.

Homeopathic treatment for Perioral Dermatitis

Natrum Muriaticum

Skin greasy, oily, especially on hairy parts. Dry eruptions, especially on margin of hairy scalp and bends of joints, mouth, eyes etc. Perioral dermatitis. Fever blisters (Herpes Zoster). Urticaria; itch and burn. Crusty eruptions in bends of limbs, margin of scalp, behind ears. Warts on palms of hands. Eczema; raw, red, and inflamed; worse, eating salt, at seashore. Affects hair follicles. Alopecia. Hives, itching after exertion. Greasy skin.

Mercurius solubilis

Almost constantly moist. Persistent dryness of the skin contra indicates mercurius. Excessive odorous viscid perspiration; worse, night. General tendency to free perspiration. Perioral dermatitis. Vesicular and pustular eruptions around eyes, face, neck etc; ulcers, irregular in shape, edges undefined. Pimples around the main eruption. Itching, worse from warmth of bed. Crusta lactea; yellowish-brown crusts, considerable suppuration. Glands swell every time patient takes cold. Buboes. Orchitis.

Mezereum

Skin sensitivity to touch to chemicals etc. General desquamation of skin of face, neck or anywhere on body; liver spots on chest and arms become dark and desquamate. Red rash, itching violently better in bed, from touch; burning and change of place after scratching.

Cutaneous ulcers form over bony protuberances. Ulcers on face, neck, ears, around mouth etc, with thick, whitish, yellow scabs, under which thick, yellow pus collects. Skin covered with elevated white scabs; Itching especially at night/in bed, more violent and painful (and changed to burning) after scratching the parts, and sometimes with swelling of the part that has been scratched.

Gnawing itching as from vermin. Miliary eruptions, sometimes chronic. Furunculi. Inflamed ulcers, with burning and shooting, or with gnawing pain of excoriation. Inflammation and swelling of the bones, rachitic, caries. Perioral dermatitis.

Ulcers: with an areola, sensitive and easily bleeding when removing the linen, which sticks, painful at night, the pus tends to form an adherent scab, under which a quantity of pus collects, burning and stinging with inflammation. Vesicles around the ulcers, itching violently and burning like fire. Suppuration after inflammation.

Casuticum

Perioral dermatitis: soreness in folds of skin, back of ears, mouth, eyes, neck, between thighs etc. Warts large, jagged, bleeding easily, on tips of fingers and nose.

Muriatic Acid

Papula and vesicular eruptions, with great itching. Carbuncles; foul-smelling ulcers on face, neck joints lower extremities. Scarlet fever, livid, with petechiae; scanty eruption. Eczema on back of hands. Perioral dermatitis.

Apis Mellifica

Face swollen, red, with piercing pain. Waxy, pale, edematous. Erysipelas with stinging burning oedema. Perioral dermatitis. Swellings after bites; sore, sensitive. Stinging. Erysipelas, with sensitiveness and swelling, rosy hue. Carbuncles, with burning, stinging pain. Sudden puffing up of whole body.

Graphites

Eczema of nose, around mouth, ears, neck etc. Itching pimples. Moist eczema around mouth and chin. Erysipelas, burning and stinging. Skin: Rough, hard, persistent dryness of portions of skin unaffected by eczema. Early stage of keloid and fibroma. Pimples and acne. Perioral dermatitis. Eruptions, oozing out a sticky exudation. Rawness in bends of limbs, groins, neck, behind ears. Unhealthy skin: every little injury suppurates. Ulcers discharging a glutinous fluid, thin and sticky. Swelling and induration of glands. Gouty nosed. Cracks in nipples, mouth, between toes, anus. Phlegmonous erysipelas of face; burning and stinging pain. Swelling of feet. Wens.

Agaricus Muscarious

Facial muscles feel stiff. Herpes. Perioral dermatitis. Face itches and burns. Lancinating, tearing pain in cheeks, as of splinters. Neuralgia, as if cold needles ran through nerves or sharp ice touched them. Burning, itching, redness, and swelling on the face and all folding parts/extremities as from frostbites. Pimples, hard, like fleabites. Miliary eruption, with intolerable itching and burning. Chilblains. Angioneurotic oedema; rosacea. Swollen veins with cold skin. Circumscribed erythematous, papular and pustular and edematous lesions.

Rhus Toxicodendron

Skin vesicular erysipelas where the vesicles are large. Exanthemas on face, on chin, cheeks, mouth, nose, forehead, causing much burning itching. Pustules chilblains. Exanthema in general; burning; burning itching; pustules; with swelling; blotches; like milk crust; moist; like nettle-rash; blue with erysipelas; scurfy; tensive or tight feeling in; pock-shaped; black; purulent; zona or shingles; petechiae; prickling; tickling; blisters which will sometimes spread up the limb, and are sometimes circular in form, spreading with a red edge in the advance, which gradually turns to a blister, the red border still keeping in advance. Eyes swollen, red, edematous; orbital cellulitis. Pustular inflammations. Perioral dermatitis.

Phlegmonous erysipelas, esp. where the erysipelas begins in the ankle, and moves gradually up the leg, running up in the deeper tissues, no fever. Itching over whole body, chiefly in hairy parts. Humidity of skin. Hardness of skin with thickening. Swelling (hard) of affected parts. Erysipelatous inflammations. Nettle-rash. Eruptions, generally vesicular, scabby.

Eruption of small pustules on a red bottom, like zona. Gangrenous ulcers resulting from small vesicles, with violent fever. Petechiae, with great weakness, amounting to entire prostration. Black pustules. Herpes, sometimes alternately with asthmatic sufferings and dysenteric looseness.

Staphysagria

Eczema of head, ears, face, and body; thick scabs, dry, and itch violently; scratching changes location of itching. Perioral dermatitis. Fig-warts pedunculated. Arthritic nodes. Inflammation of phalanges. Night-sweats.  Affections of angles of eye, particularly the inner.

Dulcamara

Humid eruption on cheeks and face. Perioral dermatitis. Adenitis. Pruritus, always worse in cold, wet weather. Herpes zoster, pemphigus. Swelling and indurated glands from cold. Vesicular eruptions. Sensitive bleeding ulcers. Little boils. Red spots, urticaria, brought on by exposure, or sour stomach. Humid eruptions on face, genitals, hands, etc. Warts, large, smooth, on face and palmar surface of hands. Anasarca. Thick, brown-yellow crusts, bleeding when scratched. Granular lids.

Hepar Sulph

Eyes and lids red and inflammation. Scurf on and behind the ears. Discharge of fetid pus from the ears. Sore, ulcerated. Soreness of nostrils. Vesicular erysipelas on face with pricking pain. Ulcers in corners of mouth. Unhealthy skin: every little injury suppurates. Perioral dermatitis. Chapped skin, with deep cracks on hands and feet. Ulcers, with bloody suppuration. Sticking or pricking in afflicted parts. Putrid ulcers, surrounded by little pimples. Great sensitiveness to slightest touch. Chronic and reoccurring urticaria. Smallpox. Herpes circinate. Constant offensive exhalation from the body.

Bovista Lycoperdon

Scurf and crusts about nostrils and corners of mouth. Lips chapped. Bleeding of nose and gums. Cheeks and lips feel swollen. Perioral dermatitis. Acne worse in summer; due to use of cosmetics. Itching on getting warm. Eczema, moist; formation of thick crusts. Pimples cover the entire body; scurvy; herpetic eruptions. Pruritus ani. Urticaria on waking in the morning, worse from bathing. Pellagra.

Silicea

Felons, abscesses, boils, old fistulous ulcers, crusts. Delicate, pale, waxy. Cracks around eyes, behind ears, around mouth, neck at end of fingers, elbows etc. Painless swelling of glands. Rose-colored blotches. Scars suddenly become painful. Pus offensive. Promotes expulsion of foreign bodies from tissues. Perioral dermatitis. Every little injury suppurates. Long lasting suppuration and fistulous tracts. Dry fingertips. Eruptions itch only in daytime and evening. Crippled nails. Indurated tumors. Abscesses of joints. After impure vaccination and/or allopathic medication. Bursa. Lepra, nodes, and coppery spots. Keloid growths. Fetid discharge from ears. Caries of mastoid.

Petroleum

Itching at night. Chilblains, moist, itch and burn. Bed-sores. Perioral dermatitis: facial skin dry, constricted, very sensitive, rough and cracked, leathery. Herpes. Slightest scratch makes skin suppurate. Intertrigo; psoriasis of hands. Thick, greenish crusts, burning and itching; redness, raw; cracks bleed easily. Eczema. Rhagades worse in winter. Moist eruption on scalp; worse, back and ears. Loss of eyelashes.  Canthi fissured. Skin around eyes dry and scurfy.

Eczema, intertrigo, etc, in and behind ears, with intense itching. Parts sore to touch. Fissures in meatus. Dry catarrh, with deafness and noises. Ringing and crackling in ears. Chronic Eustachian catarrh. Diminished hearing. Nostrils ulcerated, cracked, burn, tip of nose itches.

Sepia

Roots of hair sensitive. Pimples on forehead near hair. Thick, greenish discharge; thick plugs and crusts. Yellowish saddle across nose. Atrophic catarrh with greenish crusts from anterior nose and pain at root of nose. Herpes behind ears on nape of neck. Pain as if from sub-cutaneous ulceration. Swelling and eruption of external ear.

Face yellow blotches; pale or sallow; yellow about mouth. Rosacea; saddle-like brownish distribution on nose and cheeks. Perioral dermatitis. Herpes circinate in isolated spots. Itching; not relieved by scratching; worse in bends of elbows and knees. Chloasma; herpetic eruption on lips, about mouth and nose. Ringworm-like eruption every spring. Urticaria on going in open air; better in warm room. Hyperhidrosis and bromhidrosis. Sweat on feet, worse on toes, intolerable odor. Lentigo in young women. Ichthyosis with offensive odor of skin.

Sulphur

Tinea capitis, dry form. Scalp dry, falling of hair; worse, washing. Itching; scratching causes burning. Dry, scaly, unhealthy; every little injury suppurates. Freckles. Itching, burning; worse scratching and washing. Pimply eruption, pustules, rhagades, hangnails. Excoriation, especially in folds. Feeling of a band around bones. Skin affections after local medication. Pruritus, especially from warmth, is evening, often recurs in springtime, in damp weather. Lips dry, bright red, burning. Perioral dermatitis.

Burning ulceration of margin of lids. Whizzing in ears. Bad effects from the suppression of an otorrhea. Deafness, preceded by exceedingly sensitive hearing, catarrhal deafness. Herpes across the nose. Nose stuffed indoors. Imaginary foul smells. Alae red and scabby. Chronic dry catarrh; dry scabs and readily bleeding. Polyps and adenoids.

Thuja Occidentalis

White, scaly dandruff; hair dry and falling out. Greasy skin of face. Polypi, tubercles, warts epithelioma, naevi, carbuncles; ulcers, especially in ano-genital region. Perioral dermatitis. Freckles and blotches. Perspiration sweetish, and strong. Dry skin, with brown spots. Zona; herpetic eruptions. Tearing pains in glands. Glandular enlargement. Nails crippled; brittle and soft. Eruptions only on covered parts; worse after scratching. Very sensitive to touch. Coldness of one side. Sarcoma; polypi. Brown spots on hands and arms. Eyelids agglutinated at night; dry, scaly. Styes and tarsal tumors. Acute and subacute inflammation of sclera. Chronic otitis; discharge purulent. Creaking when swallowing. Polypi.

Mercuris Solubus

Stinging, burning, fetid eruptions on scalp. Loss of hair. Exostosis, with feeling of soreness. Scalp tense; oily sweat on head. Almost constantly moist. Lids red, thick, swollen. Profuse, burning, acrid discharge. Perioral dermatitis. Excessive odorous viscid perspiration; worse, night. General tendency to free perspiration, but patient is not relieved thereby. Vesicular and pustular eruptions. Ulcers, irregular in shape, edges undefined. Pimples around the main eruption. Itching, worse from warmth of bed. Crusta lactea; yellowish-brown crusts, considerable suppuration. Glands swell every time patient takes cold. Buboes. Orchitis. Thick, yellow discharge; fetid and bloody. Otalgia, worse warmth of bed; at night sticking pains. Boils in external canal.

Clematis Erecta

Eruptions on the head. Moist phlyctenules on the occiput and at the nape of the neck. Red, burning, vesicular, scaly, scabby. Itches terribly; worse, washing in cold water; worse face and hands and scalp around occiput. Perioral dermatitis. Glands hot, painful, swollen; worse inguinal glands. Glandular indurations and tumors of breast. Varicose ulcers. Inflammation of the eyes, of the eyelids. Photophobia. Purulent pimples on nose, painful. White vesicles on the nose and on the face, as from a sunburn. Moist eruption on the face, preceded by stinging pain. Purulent pimples on the chin. Swelling of the submaxillary glands, with nodes, hard, tensive, pulsative, and painful.

Tellurium Metallicum

Eyelids thickened, inflamed, itching. Pterygium; pustular conjunctivitis. Cataract. Perioral dermatitis. Itching of hands and feet. Herpetic spots; ringworm. Ring-shaped lesions, offensive odors from affected parts. Barber’s itch. Stinging in skin. Fetid exhalations. Offensive foot-sweat. Eczema, back of ears and occiput. Circular patches of eczema. Eczema behind ear. Catarrh of middle ear, discharge acrid, smells like fish-pickle. Itching, swelling, throbbing in meatus. Deafness.

Thyroidinum

Psoriasis associated with adiposity (not in developing stage). Face/skin dry, impoverished. Cold hands and feet. Eczema. Uterine fibroids. Browne swelling. Perioral dermatitis. Swelling of glands of stony hardness. Sluggish cases. Jaundice with pruritus. Ichthyosis, lupus. Itching without eruption, worse night.

Tuberculinum

Small boils, intensely painful, successively appear in the nose; green, fetid pus. Persistent, offensive otorrhea. Perforation in membrana tympani, with ragged edges. Perioral dermatitis. Chronic eczema; itching intense; worse at night. Acne in tuberculous children. Measles; psoriasis.

Kalium Sulphuricum

Psoriasis. Eczema; burning, itching, papular eruption. Nettle-rash. Polypi. Epithelioma. Seborrhoea. Favus. Ringworm of scalp or beard with abundant scales. Perioral dermatitis.

Hamamelis Virginiana

Bluish chilblains. Phlebitis. Purpura. Varicose veins and ulcers; very sore. Burns. Ecchymosis. Traumatic inflammations. Perioral dermatitis.

Calcarea carbonica

Flaccidity of the skin. Visible quivering of the skin. Burning, smarting, itching. Syphilis. Nettle rash. Eruption of lenticular red and raised spots. Skin hot and dry during motion. Skin rough, dry, miliary eruption. Humid, scabby eruptions and titters, or in form of clusters, with burning pains. Perioral dermatitis. Itching pemphigus in the face and over the whole body.

Skin excoriated, unhealthy; every injury tends to ulceration; even small wounds suppurate and do not heal. Ulcers deep; fistulous; carious. Ulcers with too little pus. Erysipelatous inflammations. Furunculi. Warts. Corns.

Arsenicum Album

Scalp itches intolerably; circular patches of bare spots; rough, dirty, sensitive, and covered with dry scales. Itching, burning, swellings; oedema, eruption, papular, dry, rough, scaly; worse cold and scratching. Perioral dermatitis. Malignant pustules. Ulcers on face, behind ears, on neck etc, with offensive discharge. Anthrax. Poisoned wounds. Urticaria, with burning and restlessness. Psoriasis. Scirrhous. Icy coldness of body. Epithelioma of the skin. Gangrenous inflammations. Lids red, ulcerated, scabby, scaly, granulated. Edema around eyes. External inflammation, with extreme painfulness; burning, hot, and excoriating lachrymation. Thin, excoriating, offensive otorrhea. Burning and bleeding. Acne of nose. Lupus.

Arsenic Iodatum

Scrofulous ophthalmia. Otitis, with fetid, corrosive discharge. Thickening of tympanum. Burning, acrid coryza. Skin dry, scaly, itching. Marked exfoliation of skin in large scales, leaving a raw exuding surface beneath. Perioral dermatitis. Ichthyosis. Enlarged scrofulous glands. Venereal bubo. Debilitating night-sweats. Eczema of the beard; watery, oozing, itching; worse, washing. Emaciation. Psoriasis. Acne hard, shotty, indurated base with pustule at apex.

Medorrhinum

Hair dry, crispy. Itching of scalp; dandruff. Yellow. Intense and incessant itching; worse night and when thinking of it. Fiery red rash about anus in babies. Copper-colored spots. Favus. Tumors and abnormal growth. Partial deafness, pulsation in ears. Quick, darting pains in right ear. Nose intense itching. Coldness of tip. Perioral dermatitis. Face pallor, acne, blotches of reddish color. Small boils break out during menses.

Kali Arsenicum

Intolerable itching, worse undressing. Dry, scaly, wilted. Perioral dermatitis. Acne; pustules worse during menses. Chronic eczema; itching worse from warmth, walking, undressing. Psoriasis, lichen. Phagedenic ulcers. Fissures in bends of arms and knees. Gouty nodes; worse, change of weather. Skin cancer, where suddenly an alarming malignancy without any external signs sets in. Numerous small nodules under skin.

Antimonium Crudum

Eyes dull, sunken, red, itch, inflamed, agglutinated. Canthi raw and fissured. Chronic blepharitis. Pustules on cornea and lids. Ears redness; swelling; pain in eustachian tube. Ringing and deafness. Moist eruption around ear. Nostrils chapped and covered with crusts. Eczema of nostrils, sore, cracked and scurfy. Perioral dermatitis. Pimples, pustules, and boils on face. Yellow crusted eruption on cheeks and chin. Sallow and haggard. Eczema with gastric derangements. Pimples, vesicles, and pustules. Sensitive to cold bathing. Thick, hard, honey-colored scabs. Urticaria; measle-like eruption. Itching when warm in bed. Dry skin. Warts. Dry gangrene. Scaly, pustular eruption with burning and itching, worse at night.

Phosphorus

Skin of forehead feels too tight. Itching of scalp, dandruff, falling out of hair in large bunches. The skin of elbows and knees is covered with dry, scaly eruptions. Itching appears in the eruptions. Perioral dermatitis. Other accompanying features are a burning and stinging sensation in the eruptions. In a few cases a formication on the area affected is present. Wounds bleed very much, even if small; they heal and break out again. Jaundice. Little ulcer outside of large ones. Petechiae. Ecchymosis. Purpura hemorrhagic. Scurvy. Fungus haematoidin and excrescences.

Lycopodium Clavatum

Falling out of hair. Eczema; moist oozing behind ears. Ulcerates. Abscesses beneath skin; worse warm applications. Hives; worse, warmth. Violent itching; fissured eruptions. Acne. Chronic eczema associated with urinary, gastric and hepatic disorders, bleeds easily. Skin becomes thick and indurated. Styes. Ulceration and redness of lids. Thick, yellow, offensive discharge. Perioral dermatitis. Eczema about and behind ears. Otorrhea and deafness with or without tinnitus. Ulcerated nostrils. Crusts and elastic plugs in nose. Itching; scaly herpes in face and corner of mouth.

Ulcerates. Abscesses beneath skin; worse warm applications. Hives; worse, warmth. Violent itching; fissured eruptions. Acne. Chronic eczema associated with urinary, gastric and hepatic disorders, bleeds easily. Perioral dermatitis. Skin becomes thick and indurated. Varicose veins, naevi, erectile tumors. Brown spots, freckles worse on left side of face and nose. Dry, shrunken, especially palms; hair becomes prematurely gray. Dropsies. Offensive secretions; viscid and offensive perspiration, especially of feet and axilla. Psoriasis.

P. S: This article is only for doctors having good knowledge about Homeopathy and allopathy, for learning purpose(s).

For proper consultation and treatment, please visit our clinic.

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Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS), Abdominal Surgeries, Oncological surgeries, Gastroenterologist, Specialist Homeopathic Medicines.

  Senior research officer at Dnepropetrovsk state medical academy Ukraine.

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