Perioral dermatitis
Dr. Wu's analysis
What is perioral dermatitis?
What causes perioral dermatitis?
The exact cause of clown eczema is still not fully known. However, various factors have been identified that can play a role in the onset or worsening of the condition. Below are the 5 most well-known causes.
- Creams and ointments with a sealing effect (occlusive), such as greasy skin care products.
- Make-up and foundations with irritating ingredients.
- Perfumed or strongly foaming cleansers.
- Fluoride-containing toothpastes (such as 5000 ppm fluoride).
- Weather changes: Cold wind, dry weather, or high humidity can disrupt the skin barrier.
- UV radiation: Exposure to the sun can irritate the skin and worsen symptoms.
- Mechanical irritation: Frequently touching the face, excessive scrubbing, or intensive facial treatments.
- Mouth contact with irritating substances: For example, frequently chewing gum or licking lips.
- During the premenstrual period.
- During pregnancy. When using hormonal contraception, such as the pill or the Mirena coil.
- Inhaled corticosteroids (for example, in asthma).
- Immunosuppressants that weaken the skin's defense.
What is NOT a cause?
Although clown eczema is often confused with bacterial skin infections, so far no bacterial pathogen has been identified through culture research. This means that antibiotics are not used because of an infection, but mainly to inhibit the inflammatory response.
Who is susceptible to perioral dermatitis?
Clown eczema can affect anyone, but some people are more susceptible to it. Gender, age, skin type, and environmental factors play a big role.
How do you recognize and distinguish pigmentation spots?
How can you recognize perioral dermatitis?
Clown eczema has a recognizable pattern, these are the main characteristics:
– Small red bumps (papules and pustules), sometimes with a flaky skin.
– A red, irritated skin around the mouth, nose or eyes.
– A tight or burning sensation, especially when exposed to irritating substances such as soap, sunlight or water.
– No comedones (blackheads). Comedones, better known as blackheads, are clogged hair follicles that often occur with acne; these can be open (blackheads) or closed (whiteheads). The absence of blackheads is an important characteristic that distinguishes perioral dermatitis from acne.
– An episodic course, where the rash can worsen and then decrease.
An experienced dermatologist can often diagnose it by sight. If additional research is needed, a skin biopsy can be taken. This will show a mild, non-specific inflammatory response around blood vessels (perivascular) or hair follicles (perifollicular).
Which skin problems resemble perioral dermatitis?
Clown eczema can easily be confused with other skin conditions that cause redness, bumps, or flaking. These are the 9 main conditions it can overlap with and the differences that can help you distinguish them.
- Rosacea often occurs on the cheeks, nose, forehead and chin, while clown eczema is mainly found around the mouth and sometimes around the eyes.
- With rosacea, the areas around the eyes and mouth usually remain free, while these are hotspots for clown eczema.
- Both rosacea and clown eczema lack blackheads (comedones), which is a major distinction from acne.
- A typical characteristic of rosacea is the presence of telangiectasias (small, dilated blood vessels), which does not occur with clown eczema.
What types of perioral dermatitis are there?
Although clown eczema is often considered a single condition, it can manifest in different forms. The variations are mainly determined by the location, severity, and underlying causes. Below are different forms, ranging from the most common to the rarest:
How do you effectively treat pigmentation spots?
What can I do about it myself?
Clown eczema can be annoying and persistent. Fortunately, you can do a lot yourself to get your skin calm and healthy again.
- Avoid products with alcohol, perfume, sulfates, silicones, and preservatives.
- Use a fluoride-free toothpaste if fluoride is a trigger.
- Stop using hormone ointments (corticosteroids), but taper off gradually.
- Only use lukewarm water and a mild cleanser without foaming agents.
- Calming ingredients: Ceramides, panthenol, niacinamide.
- Hydration without sealing: Hyaluronic acid.
- UV protection: Use a mineral sunscreen (zinc oxide, titanium dioxide).
- Do not use closing foundations with silicone or oil.
- Choose mineral makeup without irritating substances.
- Avoid aggressive scrubs and chemical exfoliants.
What other treatments are there?
The treatment of clown eczema mainly focuses on actively reducing inflammation and addressing specific triggers. While care focuses on daily skin care and prevention, treatment goes a step further with targeted medical interventions. These treatments work most effectively under the guidance of a dermatologist, so your skin recovers faster and stays healthy for a long time.
What should you avoid with clown eczema?
For pigmentation spots, it is important to avoid certain habits and products, as these can worsen the spots or make the skin more sensitive. Try to avoid these 6 things as much as possible:
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Tips when you have perioral dermatitis
- Sunscreen based on mineral sun filters (such as zinc oxide and titanium dioxide).
- Mineral foundation that is non-comedogenic and light in structure.
- Safflower oil with linoleic acid: an ingredient used in products for sensitive skin.
- Pay attention to skin care that does not feel greasy, but contains ingredients such as niacinamide or vitamin C, which are mentioned in the literature for their skin care properties.
- Avoid foods that can aggravate inflammation, such as sugars, dairy, and heavily processed foods.
- Maintain a diet rich in omega-3 fatty acids, antioxidants, and fiber.
- Stress can play a role in skin inflammation. Regular relaxation, sleep, and exercise can contribute to skin recovery.
- Use as few products as possible and opt for mild formulations without perfume or alcohol.
- Moisturizing ingredients such as ceramides and panthenol can help support the skin in case of dryness or sensitivity.
- Protect your skin from UV radiation with a sunscreen with SPF 30 or higher.
- Avoid irritating ingredients such as aggressive exfoliants or fragrances, especially with sensitive skin.