From the Guidelines
For periorificial dermatitis, the recommended moisturizer is a fragrance-free, non-comedogenic, and gentle moisturizer such as Vanicream, CeraVe, or Cetaphil, as they lack potential irritants that could worsen the condition. These products are preferred because they do not contain fragrances, essential oils, and harsh preservatives that could exacerbate the condition 1. When using moisturizer, apply it after cleansing with a gentle, soap-free cleanser and allow your skin to dry completely first. Use the moisturizer sparingly, focusing on dry areas while avoiding excessive application around the affected perioral, perinasal, or periocular regions.
Key Considerations
- Moisturizing should be part of a comprehensive treatment approach that may include discontinuing topical steroids (if previously used), avoiding potential irritants like fluorinated toothpaste, and possibly using prescribed treatments such as topical metronidazole, azelaic acid, or oral antibiotics like doxycycline.
- Moisturizers help repair the skin barrier function, which is often compromised in periorificial dermatitis, reducing inflammation and supporting the healing process while preventing excessive dryness that can occur during treatment.
Additional Recommendations
- Avoid greasy creams for basic care, as they might facilitate the development of folliculitis due to their occlusive properties 1.
- Avoid alcoholic solutions and soaps, and instead use urea- or glycerin-based moisturizers 1.
- In inflammatory lesions, consider topical steroids, but only under the supervision of a dermatologist, as they may cause perioral dermatitis and skin atrophy if used inadequately 1.
From the Research
Treatment Options for Periorificial Dermatitis
The recommended treatment for periorificial dermatitis includes:
- Oral tetracyclines, which have been considered the first line treatment for years 2, 3
- Topical erythromycin, which reduces the time to resolution 2
- Topical pimecrolimus, which rapidly reduces the severity of the disease, particularly if prior corticosteroid use has occurred 2
- Topical metronidazole, which is frequently used to treat perioral dermatitis in children, although the evidence supporting its use is relatively weak 2, 3
Moisturizer Recommendations
There is no specific moisturizer recommended for periorificial dermatitis in the provided studies. However, it is suggested that treatment should emphasize repairing the impaired skin barrier function to minimize associated skin inflammation and sensitivity 4.
Additional Treatment Considerations
Other treatment options that have shown promise include:
- Topical calcineurin inhibitors, which have been effective in treating pediatric periorificial dermatitis 5
- Topical/oral metronidazole, which has been shown to be effective in treating pediatric periorificial dermatitis 5
- Tetracyclines, topical metronidazole, topical azelaic acid, adapalene gel, and oral isotretinoin, which require further research to robustly investigate their effectiveness 6