Perioral Dermatitis in Children

Perioral dermatitis is a chronic papulopustular and eczematous facial dermatitis A distinct papular variant occurs in children but mostly it occurs in women.  The histological and clinical features of the lesions resemble those of rosacea. Perioral dermatitis in children is limited to the skin and it is not life threatening. Due to the nature and chronic course of the disease, emotional complications may develop because the condition tends to leave scars and disfigurement.

Symptoms of Perioral Dermatitis

The symptoms of perioral dermatitis in children are burning and tension. Itching is rare but it is chronic. Perioral dermatitis in children is limited to the skin. Grouped follicular reddish papules, papulovesicles, and papulopustules on an erythematous base with a confluent aspect are the skin lesions that occur. The pustule and papules have mainly perioral locations. The predominant locations of perioral lesions are the perioral area, nasolabial fold, and lateral portions of the lower eyelids are the predominant locations of the perioral dermatitis lesions.

Children may have a marked lifestyle due to disfiguring facial lesions. This can affect the child’s attitude towards himself and his physical attributes and make him insecure and shy. Drugs, cosmetics, physical factors, microbiologic factors and other miscellaneous factors are said to be the causes of perioral dermatitis.

Treatment of Perioral Dermatitis

Systemic treatment with anti-acne drugs is required for the severe forms of perioral dermatitis.  Drugs of many dermatologists choice are tetracycline or doxycycline and minocycline. In cases with minor presentations in children or young adults, it is generally recommended as an individual topical therapy. Anti-inflammatory agents are administered in a non-greasy base. Ointments should be avoided since their base may contribute to the sebum in the face.

Perioral dermatitis in children or young adults is almost exclusively treated on an outpatient basis and care includes assessment of the effectiveness of systematic therapy. Topical therapy should be adapted in accordance to the condition of the skin and in severity of the disease. There are medications that suit the severity of the condition.

Anti-acne medications such as doxycycline, tetracycline, minocycline, and isotretinoin are needed to control the condition. For topical treatment antibiotics such as metronidazole and erythromycin are used. In non-controlled studies, anti-acne drugs such as adapalene and azelaic acid have been used. In worse case scenarios, individuals need surgery or laser treatment of their face to improve the surface and make the presence of the scars less noticeable. These procedures can be expensive and sometimes even painful.