Rash near the nose. Redness and flaking of the skin under the nose: how to treat, causes. Causes of non-infectious dermatitis

Perioral dermatitis is a characteristic scaly papular rash around the mouth, nose and eyes that occurs almost exclusively in women. The rash may start around the mouth, but can also affect areas around the nose and eyes. The disease is asymptomatic, sometimes itching is noted.

Patients sometimes try topical steroids, which provide temporary relief but may contribute to a torpid progression.

Perioral dermatitis typically affects young women and can occur in children. Isolation of a Fusobacterium culture suggests a bacterial etiology. Routine use of moisturizing cosmetics and fluoridated products can cause the disease.

Clinical picture of perioral dermatitis

Pinhead-sized papules and pustules with a red, scaly base are localized on the chin and nasolabial folds. The border zone around the lip border is not affected. Pustules on the cheeks in the area adjacent to the nostrils are typical. Sometimes the localization of perioral dermatitis is limited only to the perinasal area.

Pinhead pustules in the nostril area may be the first sign or the only manifestation of the disease.

Papules the size of a pinhead and similar pustules observed in the nostril area sometimes appear at the lateral corners of the eyes.

In children, lesions are often located in the perinasal and periocular areas.

Diagnosis of perioral dermatitis

Differential diagnosis of perioral dermatitis is carried out with the following diseases:

Acne.
Seborrheic dermatitis.
Atopic (eczematous) dermatitis.
Impetigo.

Course and prognosis of perioral dermatitis

The degree of damage varies. Persistent rashes last for months. With systemic treatment of perioral dermatitis, most problems resolve within 2 weeks. Relapses are typical. Patients are also re-treated actively, sometimes requiring long-term maintenance treatment.

Treatment of perioral dermatitis

Topical treatment of perioral dermatitis involves daily use of metronidazole, sodium sulfacetamide, clindamycin or erythromycin solution or gel, pimecrolimus cream, and tacrolimus ointments.

If a 4-6 week course local treatment does not bring success, systemic antibiotics are prescribed. Tetracycline, erythromycin, doxycycline or minocycline are prescribed for 2-4 weeks.

Long-term use of topical steroids on the face may worsen the disease. Stopping the use of topical steroids causes a flare of the disease, but it is necessary for treatment.

T.P.Hebif

"Rash around the mouth, nose and eyes due to perioral dermatitis" and other articles from the section

Skin is a mirror image internal state the whole body. Rash around the mouth in an adult - not only cosmetic defect, but also an internal problem. May lead to rash food allergy, incorrectly chosen cosmetics, depression, intake medicines, disruption of the digestive and gastrointestinal tract etc. Treatment is always aimed at the source, which helps get rid of the symptom.

What kind of rash happens?

Rashes are of primary and secondary nature. Primary - bubbles, blisters, spots, nodules in the mouth. They appear on a changed area of the skin. Secondary - ulcerative lesions, scales, erosions, develop as a result of the evolution of the primary ones.

The rash is classified according to clinical manifestations:

Bubbles are localized in the epidermis or under it, filled with light contents. Often accompanied by chickenpox, herpes and pemphigus;
Pustules vary depending on their location in the skin - deep and superficial. The cavity is filled with cloudy liquid;
Blisters are characterized by the absence of a cavity. Occurs for a short time. The main reasons are insect bites and allergies. Almost always accompanied by severe itching;
Spots are discolored skin. There are inflammatory and non-inflammatory, pigmented;
The nodules are localized under the epidermis. Only in some pathologies is their growth and fusion observed, for example, candidiasis;
Ulcer – evolution of vesicles, ulcers. Detected in severe form chickenpox, purulent infections skin, lupus erythematosus;
Scales appear as strong or weak peeling.

Please note that rashes around the mouth are caused by for various reasons. Some of them are harmless - an allergic reaction to food or cosmetics, while others are life-threatening - cancer.

Etiology of rash around the mouth in adults

The medical name for a rash in the mouth area is perioral dermatitis. This pathology refers to dermatological diseases, accompanied by rashes and the presence of pimples. They appear not only around the mouth, but also under the nose, in the mouth, and on the palate.

Depending on the specific clinical manifestations, the disease can be infectious or non-infectious.

Causes of infectious dermatitis

Herpes is a viral disease that begins with the appearance of one pimple in the lip area; the pathological element is filled with transparent contents. After a short time, skin numbness and itching are observed. Lack of therapy leads to the formation of wounds with a dry surface.

Impetigo develops due to damage to the body by staphylococci. Neoplasms around the mouth are characterized by large sizes. Initially they white, the edges are distinct, and then open, which leads to the formation of ulcers.

Causes of non-infectious dermatitis

There is an opinion that pimples around the mouth are the prerogative of people with oily skin. But in reality this is not true. Dry skin is more susceptible mechanical impact, so a pathogen can penetrate even the smallest damage.

Types of dermatitis that lead to the formation of rashes around the mouth:

Hormonal type. Evolving in the background hormonal imbalance in organism. In most cases in puberty, during pregnancy and breastfeeding. Sometimes it signals disorders of the reproductive system.
Atopic appearance. It is quite rare in adults. As a rule, it is transmitted from mother to child. Long time inflammation is in a latent state, but is activated under the influence of negative factors.
Allergic type is the most common. Rashes affect the area around the mouth due to the harmful effects of irritants. The reason is low-quality or inappropriate cosmetics, environmental conditions, and food products.
Seborrheic appearance; characterized by malfunction sebaceous glands. The etiology is based on frequent stress, depression, neuroses, nervous experiences, and emotional instability.

Important: symptomatic treatment will not eradicate the problem, but will worsen it clinical picture, leading to even greater cosmetic defects.

Stomatitis as a cause of mouth rash

The disease affects inner surface lips It is a viral pathology leading to inflammation with purulent manifestations. The rash is extremely painful and spreads quickly oral cavity.

IN medical practice There are cases when stomatitis is brought out. In most paintings this happens when the form is neglected. In turn, stomatitis causes diseases:

Herpes. Due to the weakening of the immune system, it is created favorable environment for a virus that quickly activates and multiplies;
Streptococcal and staphylococcal infection lead to the formation of ulcers and wound surfaces in and around the mouth. Strong painful sensations make it difficult to eat;
Enterovirus affects inner part oral cavity, but is capable of being transferred to the lips and the area around them.

Most often, a rash around the mouth is caused by a combination of several negative factors that enhance harmful influence each other.

Allergic rash on the face in adults

The main cause of allergies is the negative impact of an irritant. Unlike a food allergic reaction, clinical manifestations in and around the mouth due to many factors:

Use of medications – corticosteroids, oral contraceptives, hormonal ointments, creams and gels.
Contact with chemicals contained in lipstick, toothpaste, etc.
Allergic symptoms can be caused by fillings or objects that come into contact with the lips, for example, a musical instrument.
Endocrine disorders in the body lead to changes hormonal levels, which manifests itself as rashes on the face.

The very first sign of an allergy is a slight swelling in the lip area. Only then does a rash, pimples and redness appear. According to the clinical manifestations, the symptoms are similar to herpes rashes.

Important: blue lips, difficulty breathing are warning signs anaphylactic shock requiring emergency medical care.

Symptoms accompanying the rash

Depending on the pathological processes, occurring in the body, other clinical manifestations are observed. Their presence makes it easier to search for the nature of the pathology and allows you to quickly establish an accurate diagnosis.

Associated symptoms:

A high temperature indicates an infection. The patient experiences lethargy, weakness, headaches, decreased performance;
Allergic reactions almost always occur against a background of severe itching and burning;
Pain, swelling, hyperemia of the oral mucosa are direct symptoms of inflammatory processes;
Loss of body weight in combination with enlarged lymph nodes is a sign of an oncological neoplasm, usually of a malignant nature;
Increase lymph nodes in combination with fever – infection or inflammation.

By external signs one or another disease may be suspected.

A rash around the mouth in an adult may indicate problems in the body or a certain disease called perioral dermatitis.

Photo 1: There can be many causes of rashes around the mouth, and you can determine what caused the problem by the nature of the acne and the additional symptoms that accompany it. Source: flickr (#Shuba #Norka).

Causes of the rash

Formations around the lips and on the chin can occur as an allergic reaction for: cosmetics; cold; animal fur; toothpaste; hormone-containing drugs.
Pimples near the lips may also indicate digestive problems., namely about a disruption in the functioning of any part of the intestine. Dysfunction, in turn, may occur due to a condition nervous system, long-term use antibiotics, and due to the constant consumption of junk food.
Acne formations (inflamed comedones, papules) indicate blockage of the sebaceous ducts of the skin. This happens when: hormonal imbalances; stress (the skin produces more fat); overweight; endocrine diseases; constant intoxication of the body (alcohol, nicotine, harmful substances).
If the rash around the mouth appears as clustered small red bumps, causing the area to appear pinkish-red, a dermatologist may diagnose perioral dermatitis. The symptoms of this disease, in addition to rashes, are late stage include itching and flaking of the skin, it changes color after inflammation passes. This disease manifests itself gradually, usually the skin around the mouth turns red after eating hot or spicy food, then small rashes begin to appear. They have a symmetrical pattern, leaving a free strip of skin directly around the lips.

Most often women suffer from this disease, this is due to:

hormonal imbalances; stress;
use of hormonal drugs, creams, ointments;
using toothpaste with fluoride;
diseases of the female genital organs;
a chronic process occurring in the body.

If treatment is not started in time, complications will arise., such as pigmentation of the area around the mouth, the appearance of wrinkles, and in severe cases, the disease can lead to demodicosis.

You cannot start treatment on your own, it is necessary to undergo an examination by a dermatologist, gastroenterologist, and pass necessary tests on the content of hormones in the blood.

As a preventive measure you need to strengthen your immune system, take care of facial hygiene, do not use cheap cosmetics, and do not self-medicate hormonal drugs.

Photo 3: Correct mode nutrition, healthy food and refusal bad habits will be a good help in maintaining general health body. Source: flickr (janelle).

Homeopathy against rashes around the mouth

A drug	Purpose
	To boost immunity and remove toxins from the body.
Chole-gran	For problems with the gastrointestinal tract.
	Dysbacteriosis, accompanied by constipation or diarrhea, stomach pain.
	Gastrointestinal diseases, menopause, gynecological tumors.
	Pustular rash on the face, around the mouth; severe itching rashes on the face associated with allergic manifestations.
	Inflammations of a severe, advanced nature on the face, which lead to scarring.
	The skin of the face is prone to the formation of acne, small red and painful ulcers.

Update: September 2019

Perioral dermatitis - in medicine it is also called rosacea-like or perioral dermatitis. This rare disease, it occurs in approximately 1% of the population, most often in women 20-40 years old.

With perioral dermatitis, small papules and pimples appear on the skin around the mouth and on the chin, the skin turns red, irritation appears and papules grow over a larger area. This creates considerable aesthetic, physical and psychological discomfort for a person.

This is how most patients describe the onset of the disease - “... recently I noticed that several small red pimples had formed on my chin, I began to use acne cream and wash my face more often, but this only made it worse.

After just a few months, the skin around the mouth and chin became simply red, and when the pimples healed, they left dark spots. Moreover, there is a clear stripe between the lips and the affected areas around the mouth healthy skin no redness..."

Symptoms of perioral dermatitis

If these symptoms appear:

Pain, itching, burning, redness, a feeling of tightness of the skin, and small red pimples appear in the area of the chin and mouth.
Pimples may have heads, which discharge when emptied. clear liquid Over time, pimples become ulcers
Pimples form colonies, group clusters
The skin in the inflamed areas begins to become covered with thin transparent scales, which then fall off

Most likely, this skin inflammation is caused by perioral dermatitis. But to clarify the diagnosis, you should definitely consult a dermatologist, since the appearance of acne and irritation on the face can be due to other reasons:

Diffuse
Allergic contact dermatitis
Acne vulgaris, rosacea, steroid acne.

To isolate the microflora of the lesion site and determine the pathogen, a bacterial culture of the scraping or contents of the rash is carried out.

The skin around the mouth may not be changed and present a normally colored border of up to 2 cm. Usually, the rashes are located on slightly reddened skin or the skin does not change color.

Causes of perioral dermatitis

Decreased humoral and cellular immunity
Climate change, excessive exposure to ultraviolet radiation
Increased sensitivity to bacterial allergens
Long-term or even short-term use of topical corticosteroids in the form of creams, ointments (see. full list all hormonal creams and ointments - )
Predisposition to allergic reactions, presence of bronchial asthma
Enough sensitive skin faces
Excessive use of various facial cosmetics
Hormonal imbalance in gynecological disorders
Use of dentures, toothpastes containing fluoride
Disorders of the gastrointestinal tract, nervous system, endocrine system

If dermatitis is caused by cosmetics, carefully study the composition of all creams, lotions, etc. Here is a list of some ingredients that most often cause perioral dermatitis:

Paraffin
Sodium lauryl sulfate
Cinnamon flavors
Isopropyl myristate
Petrolatum

Treatment of perioral dermatitis

Treatment of this skin disease is quite long, the duration of therapy ranges from 1.5 to 3 months and depends on the severity of the manifestations of perioral dermatitis. Treatment perioral dermatitis is prescribed by a dermatologist and the sooner you contact a specialist, the more effective the result will be. Even with proper treatment Recurrences of the disease are possible in the future, but they are much easier and are eliminated faster.

Use of corticosteroids ( hormonal ointments, creams) are contraindicated for perioral dermatitis.

Zero therapy

The first thing that is recommended to be done after diagnosis is called zero therapy. That is, cancel all ointments, creams, cosmetical tools, especially with corticosteroid substances, and also change toothpaste to regular one. In this case, the condition may worsen for some time, and then after a few weeks it should improve.

Antihistamines

At this time it is possible to use antihistamines(Suprastin, etc. see All), sodium thiosulfate, calcium chloride.

Antibiotics

At oral dermatitis Treatment with antibiotics is quite effective. The administration of Metronidazole gel or cream 0.75% or Erythromycin gel 2% stops the progression of the disease. Apply the product 2 times a day until the rash stops.

The doctor may prescribe an oral antibiotic - this is Minocycline or Doxycillin 100 mg 2 times. per day until the rash goes away, then for a month, 100 mg once a day and another month, 50 mg per day. And also taking Metronidazole orally (this is not an antibiotic, but an antiprotozoal drug).

Or Tetracycline according to a similar regimen, only 500 mg/2 times, then 500 mg/1 time and 250 mg/1 time. Worsening may occur after starting antibiotics, but symptoms usually improve markedly after 3 weeks. skin.

Elidel Cream (Pimecrolimus)

Pimecrolimus can be used for oral dermatitis only as prescribed by a doctor when other treatments are ineffective.

Elidel is a cream that has long-term adverse effects; the effect of the drug has not yet been fully studied, but it is believed that pimecrolimus suppresses the secondary immune response and there have been cases of the development of skin tumors and lymphomas after its use. Therefore, the use of this remedy should be treated with caution.

Skin care for perioral dermatitis

For this disease, gentle facial skin care is recommended. After washing, you should not wipe your face with a towel, but only blot it. The doctor can select for you indifferent powders, cooling, moisturizing creams that do not contain substances that aggravate the symptoms of the disease. (cm. , )

Herbal infusions

When acute process to relieve symptoms, you can use cooling lotions from chamomile infusion (if you are not allergic) or 1% boric acid, as well as from infusions of St. John's wort and calendula.

Normalization of the general condition of the body

If foci of infection exist, treatment is necessary concomitant diseases, as well as normalization of the endocrine and nervous systems, the functioning of the gastrointestinal tract. If necessary, general strengthening, immunostimulating drugs are prescribed, medicines normalizing the function of the central nervous system. Monthly courses of vitamin therapy, B vitamins, vitamin C and A, and folic acid are recommended.

Sun protection

During the treatment period, you should protect yourself from direct contact sun rays, because the ultraviolet radiation worsens the symptoms of perioral dermatitis. In summer, you should use sunscreen daily with a protection factor of at least 30.

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The skin around the mouth is much thinner and more delicate than most areas of the body. It also does not have a good moisturizing function. The rash can occur due to physical trauma, dryness and intense sunlight.

Sometimes the rash can spread to the surface of the lips, but there are certain types that only affect the skin and never affect the lips themselves.

For some people, the rash around the mouth is chronic, permanent state, for others it may occur by chance. Here are some of the most common causes of dryness skin rash around the mouth.

Contact dermatitis
Seborrheic dermatitis
Climate change, lip licking and certain medications

Common reasons

Let's discuss in more detail the causes of rashes that can occur in adults and children:

Contact dermatitis

Allergic contact dermatitis as a reaction to mango juice

This is a disease that is characterized by inflammation at the site of skin contact with an allergen or irritant. Therefore, contact dermatitis can be allergic when the immune system reacts to a certain substance, or is irritable - the skin is exposed to some chemical substance. The first appears after a few hours, and the second much earlier.

Looks like red plaques that may be accompanied by itching and pain. Most often, this type of reaction occurs to certain cosmetic products, plants (poison ivy) or certain skin care products.

Atopic dermatitis

Atopic dermatitis around the mouth usually appears in the first 6 months. As he ages, his rash moves mainly to his arms and legs

They also say - atopic eczema. It is also a skin condition that causes irritation and inflammation around the mouth, and may also cause a rash on the legs, face, knees (usually with reverse side) and hands. The rash is characterized by itching, redness, swelling, thickening of the skin and the formation of scales.

There are several factors that cause this rash around the mouth, including extreme temperatures, stress, and some chemical substances. But to the end the nature of appearance atopic dermatitis not known. It usually affects children, but can sometimes persist with age.

Hives

This skin condition is caused by an allergic reaction to food, medications, stress and some other factors. Angioedema (angioedema) is a condition very similar to urticaria, but much more dangerous, with a rash and swelling also appearing on the lips.

This disorder most often affects women and causes groups of small red bumps to appear around the mouth. May extend to upper lip, chin and cheeks, making these areas of skin very dry and flaky.

People with oily skin types, as well as those who use cosmetics containing strong chemicals, are slightly more susceptible to this type of dermatitis.

Associated symptoms

Externally, the rash looks like red bumps. Sometimes it can become scaly and spread to the area under the eyes, forehead and chin. The bumps may be filled with pus or other fluid, causing them to resemble acne.

You may also experience symptoms such as burning or itching, especially as the condition worsens.

Causes in children

Causes of rashes in babies include:

foot and mouth disease

This is a skin problem caused by a virus known as Coxsackie. With this disease, the rash is accompanied by fever.

Impetigo

This bacterial infection, which causes a rash consisting of raised red bumps and a light brown crust around the baby's mouth and nose.

Smearing food around the mouth

Children often get dirty with food while eating. If they are not washed in time, inflammation may appear, which opens the way for bacterial infection.

Pacifiers

Because of the pacifier, the skin around the baby's mouth is constantly smeared with saliva, which is known to be an excellent environment for the growth of bacteria.

Salivation

This problem mainly affects infants. Prolonged skin contact with saliva can cause a rash.

The main causes of rash around the mouth in children

Rash with burning

This condition of the skin around the mouth can be caused by:

Chemical burns

May occur when skin comes into contact with strong chemicals such as acids. Chemical burn may cause redness, pain, or blistering of the skin.

Herpes

Herpes

Although the herpes rash most often appears on the lips (called a cold sore) or on the mucous membranes of the mouth (oral herpes), it can also appear on the skin around the mouth. These are burning, fluid-filled small blisters that eventually burst and crust over.

Other burning rashes

Allergic reaction
Erythema multiforme
Angular cheilitis

Rash before menstruation

This is due to the rare skin disease called autoimmune progesterone dermatitis (APD), which appears cyclically, according to menstrual cycle. It is believed that this is a skin reaction to hormonal changes that occur just before menstruation.

When progesterone levels in the blood rise, an autoimmune response occurs in the form of a rash. As progesterone levels decrease, the rash goes away. This is repeated every cycle.

Itchy rash around the mouth

Perioral dermatitis is characterized by groups of itchy and tender small red papules. The disease is named so based on the area where the rash spreads. The reason for its appearance is unknown. It is described in more detail at the beginning of the article.