Perioral dermatitis

Clown eczema, medical term for this is Perioral Dermatitis. This literally means red bumps around the mouth. A variant around the eyes is called Dermatitis Periorbitalis. This condition is most common in women between the ages of 16 and 45. But children between the ages of 7 months and 13 years are not spared either. This form of eczema is rare in men.

What can you find on this page about a clown eczema

  • Wat is perioral dermatitis?
  • How can you get perioral dermatitis?
    • Around the mouth
    • Around the eyes
  • Causes of perioral dermatitis
    • Do you get perioral dermatitis from certain foods
  • Who can suffer from perioral dermatitis
    • Perioral dermatitis with a baby
    • Perioral dermatitis with a child
    • Perioral dermatitis with woman
  • How do you treat perioral dermatitis?
  • Tips on perioral dermatitis
  • Which Iconic Elements products are recommended if you suffer from perioral dermatitis

Written by dr. Francis Wu

Published 24 April 2018

Edited 8 November 2022

Dr Francis Wu on perioral dermatitis

Below explains Dr. Francis Wu briefly explains the complaints, causes and tips for clown dermatitis

Tips when you have perioral dermatitis

Below you will find tips from Dr. Francis Wu

Tip #1 - what ingredients can I safely use?

  • Mineral-based sunscreen (zinc oxide and titanium dioxide).
  • Mineral foundation.
  • Safflower oil with linoleic acid: It improves the barrier function of the skin.
  • Use skin care products that are not greasy, but have a restorative and calming capacity.
  • Products such as niacinamide and vitamin C.

Tip #2 - how do I distinguish clown eczema from acne and rosacea?

One of the related skin diseases is rosacea. Both rosacea and perioral dermatitis are characterized by erythematous papules, red raised bumps on the face. However, rosacea is more common on the cheeks, nose, forehead and chin. The regions around the eyes and mouth are often free of papules in rosacea, while those are the hot spots in perioral dermatitis. There are no blackheads (comedones) in both rosacea and perioral dermatitis. What we do see with rosacea are telangiectasias (small dilated blood vessels). Despite being clinically similar, they differ in cause and prognosis.

Perioral dermatitis is confused not only with rosacea, but also with acne. Redness, papules and pustules are also symptoms that occur with acne. This sometimes makes diagnosis difficult. The preferred location and origin/belonging play an important role here. In addition, comedones are present in acne, which is not the case in perioral dermatitis. More on: recognize the different forms of acne.

What other conditions can resemble perioral dermatitis?

Also called differential diagnosis (DD). Conditions such as: contact eczema, lip licking dermatitis, atopic eczema, lupus miliaris, malabsorption syndrome (zinc deficiency) and demodex folliculitis.

Tip 3 - what are the treatment steps at home?

  • Avoid using (strong-acting) corticosteroid creams on the face.

    If you have atopic eczema and need treatment. Then a calcineurin inhibitor (such as protopic or elidel) ointment is an option. Elidel cream can be used from 2 years old, Protopic 0.03% and 0.1% ointment for teenagers and adults respectively. These are available only by doctor’s prescription. Try it on a small area of skin first, in some it may cause burning. The burning sensation diminishes after a few minutes to even an hour and after several days of consecutive smearing it disappears.

    For people with psoriasis, Calcipotriol (Silkis) ointment, contains vitamin D is an option. New on the way is Tapinarof 1% cream, a hormone-free cream suitable for mild to severe psoriasis. Based on lubricating once a day, the severity of the psoriasis decreased for 12 weeks.

  • Do not use greasy closing cosmetics such as foundation, Vaseline, silicone.
  • Cleanse your skin daily with lukewarm water and use nourishing skin care products.

Tip 4 - The best care products

Natural Moisturizer Cream has a 3-fold action. The combination of glycerin, ceramide, squalane and an Iconic natural balm ensure that the moisture remains in your skin. This unique composition keeps the skin hydrated without feeling heavy on the skin.

Sensitive cream is suitable for people with sensitive skin or a tendency to develop skin irritation. The Sensitive cream is suitable for this group of people to keep the fragile skin optimal.

Calming cream is there for when skin irritation, flakes, red areas are present. It is one phase further, it calms irritated skin, itching, redness.

Dry Skin

Tip 5 - Vitamin B3 (Niacinamide)

Niacinamide makes the skin less sensitive and removes redness. A recent clinical study investigated how facial redness changed in 59 female participants with cutaneous erythema (redness of the skin). The study included two test treatment groups with volunteers applying two different niacinamide substances twice a day for 28 days. The researchers found a statistically significant reduction in facial redness for both groups after 15 days compared to baseline. They also reported that after 29, treatment was more effective in subjects with severe erythema than in subjects with moderate facial redness.

The best products for perioral dermatitis

Below are some products that can help you.

  • All products have the ideal pH 5 acidity – for good skin resistance and skin barrier.
  • Vegan, Zero Plastic inside
  • Iconic Elements skincare has been named the Best Holistic skincare line 2022 by EU Business News.

What do our customers think of our products?

Read More
This cream contains high-quality, safe ingredients. The packaging is very hygienic. The cream works perfectly for my sensitive skin. I think it is a top cream that fits in the higher segment in terms of effect. While the cream is still very affordable
SonjavdLely Wonderful day cream!
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This cream is perfect for my aging skin. It lubricates very well and because of the pump you can easily dose it. Great value for money!
Felicia32 Very happy with this skincare line
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Lubricates very nicely and feels good. Didn't know at first that UVA rays are present year-round. Been looking for a brand without microplastics in ingredients for a while.
Lotus72233Lotus Top product
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I have been using Targeted Pigment Serum for two weeks now. The pigment spots have already decreased by 50 0/0. Had a pigment spot on my nose for five years and is gone now. Skin pores have become less coarse and skin even. Product is great. Would recommend this product to anyone.
NathalieLem very satisfied with Iconic Elements
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I am very happy that my skin reacts well to it and that the products do not contain certain ingredients and that it is environmentally friendly!

Frequently Asked Questions About Perioral Dermatitis?

No hard evidence on this, but indirect indications.

People with diagnosed inflammatory bowel diseases such as ulcerative colitis and Crohn's disease are sometimes also diagnosed with perioral dermatitis. The question is whether it is due to treatment with immunosuppressive medication such as prednisone or due to intestinal inflammation itself.

There are no controlled studies - linking a relationship between carbohydrate or gluten intake to perioral dermatitis.

Did demonstrate a strong link between diet and rosacea. Rosacea is known to be aggravated by alcohol, hot or spicy foods, and chocolate.

Dr. Francis Wu's practical experience is that there is sometimes a connection between perioral dermatitis and nutrition.

If you actively ask whether there are also abdominal complaints in addition to perioral dermatitis, the answer is sometimes YES.

When these patients switch to a gluten-free diet, their skin condition improves. Even patients without clinically diagnosed gluten sensitivity may benefit from a carbohydrate-free or low glycemic index*, gluten-free and high-protein diet.

*Foods with a high Glycemic Index (GI) cause a rapid rise in blood sugar.

The starting point is of course to stop using cosmetic products that cause perioral dermatitis. Perioral dermatitis often responds readily to therapy, but can be chronic and recurrent. The prognosis of perioral dermatitis is good. Avoiding all externalities often leads to improvement. The scar that remains after the treatment heals on its own, although it can sometimes take a long time.

There is no clear answer to the question of whether Vaseline can be used for perioralis dermatitis, as different sources give different recommendations. Some sources recommend not applying anything for a few weeks, while other sources recommend using a greasy base ointment or cream, such as paraffin/Vaseline

  1. Use a mild, unscented cleanser designed specifically for sensitive skin. Avoid products containing sulfates, alcohol or perfume as these can dry out and irritate the skin.
  2. Don't wash your face too often and don't use water that is too hot. This can dry out the skin and worsen symptoms.
  3. Gently pat your face dry with a soft towel. Do not rub too hard as this can damage the skin.
  4. Avoid using scrubs, toners and other harsh products that can irritate the skin.
  5. Apply a moisturizer to hydrate and soothe the skin. Choose a product that is specifically designed for sensitive skin and is free from irritating ingredients.
  6. Avoid using makeup or only use products specifically designed for sensitive skin. Choose products that are non-comedogenic and free of irritating ingredients

Perioral dermatitis is not a contagious condition and cannot be transmitted through kissing or other physical contact. It is an inflammation of the skin around the mouth caused by the use of corticosteroid creams or ointments, cosmetics or other irritants. However, it is important to prevent the skin from becoming further irritated, so it is advisable to be careful when touching the skin around the mouth and to avoid using irritating products.

It is generally not recommended to apply retinol to the skin if you have perioralis dermatitis, as it can irritate the skin and worsen symptoms. Retinol is a powerful ingredient that can dry out and irritate the skin, especially when used in high concentrations.

There is no clear answer to whether zinc supplements can help with perioralis dermatitis, as there is little scientific evidence to support this claim. Some sources suggest that zinc supplements may help reduce inflammation and promote skin healing, while other sources make no specific recommendations for the use of zinc supplements for perioral dermatitis

The thin skin around the eyes can be more sensitive to allergens, making these areas more prone to allergies. A study of 101,403 patients showed that 4779 suffered from perioral dermatitis, with allergic contact dermatitis being a major cause.

Common allergens included metals, fragrances and preservatives. Nickel sulfate was the major allergen in this and other studies testing patients with dermatitis. The highest scoring allergens among ophthalmic preparations were preservatives, with phenylmercuric acetate being the major allergen. Another common sensitizer was thimerosal. It was found as an additive in multiple doses of eye or ear drops in concentrations ranging from 0.001% to 0.004%, contact lens solutions, mascara and other cosmetics.

It is important to consider patch testing in patients with dermatitis when contact allergy is suspected, to identify and avoid the allergens.

Below are more articles by Francis Wu on skin

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