Perioral dermatitis: Modern methods of therapy

Abstract

One of the most common causes of perioral dermatitis (PD) is the use of glucocorticosteroids (topically, intranasally, inhaled, systemically). If PD is caused by topical corticosteroids, they must be canceled (according to the authors, without using a sparing reduction technique: a decrease in the frequency of application of corticosteroids and the strength of corticosteroid activity). With a pronounced withdrawal syndrome, it is advisable to start treatment with ‘zero’ therapy: either a complete rejection of the use of external agents, or a lotion with chamomile (5–10 minutes 2 times a day) followed by the use of dermatolichthyol paste (exposure in increasing from 10 minutes to 40 minutes) for 7–10 days, as well as irrigation with hypochlorite thermal water (5–6 times a day). With mild severity of oral dermatitis, monotopic therapy may be prescribed, including cream with activated zinc pyrithione and calcineurin inhibitors. The duration of therapy is determined individually and averages 1.0–1.5 months. In moderate to severe cases, topical therapy should be supplemented with systemic drugs: tetracycline antibiotics (7–10 days) or low-dose isotretinoin (2–4 months). The duration of therapy is determined individually and averages 2 months.