Topical applications and perioral dermatitis

Abstract

Perioral dermatitis (POD) is a common dermatosis and is considered by most dermatologists to be increasing in incidence. An Australia-wide, questionnaire-based study investigating the aetiology of POD was conducted, with particular emphasis on the significance of cosmetic use. One hundred and thirty-three cases were obtained from dermatologists across Australia and were compared with 99 randomly selected controls who were matched for age and sex. Application of foundation, in addition to moisturizer and night cream resulted in a 13-fold increased risk for POD (odds ratio 13.5; P < 0.001). The combination of moisturizer and foundation was associated with a lesser but significantly increased risk for POD (odds ratio 2.9; P = 0.017). Moisturizer alone was not associated with an increased risk of POD. These findings suggest that cosmetic preparations play a vital role in the aetiology of POD, perhaps by an occlusive mechanism. In 83% of cases, topical steroid application to the face occurred after the development of a facial rash.

Critical Appraisal of Reports on the Treatment of Perioral Dermatitis

“…In this context, it may be of interest that cosmetics have been found to play a pathogenetic role [12, 40], especially in association with an atopic diathesis [39], and that topical corticosteroids aggravate but usually do not elicit POD [6, 39, 40]. …”

Efficacy and Safety Results of a Drug-Free Cosmetic Fluid for Perioral Dermatitis: The Toleriane Fluide Efficacy in Perioral Dermatitis (TOLPOD) Study

“…Particularly in POD, good compliance is important for a successful treatment. Although an intensive, alternating inappropriate use of cosmetics may lead to the development of POD9, a controlled twice-daily application of an inert topical agent like the soothing fluid may prevent "overcare" and has been beneficial in our clinical trial setting. Zero therapy, although attractive on theoretical grounds, may not be feasible for many patients in clinical reality.…”

Granulomatous Rosacea

“…Topical metronidazole is considered the first choice for topical therapy of mild rosacea. Azelaic acid is effective and safety and has been demonstrated for the treatment of moderate to severe rosacea applied as 15% or 20% cream [5].…”