September 2, 2020 –
Perioral dermatitis is an inflammatory condition which can occur around the mouth or nose and appears as pink or red bumps or pustules that can then coalesce together to form more of a rash. Sometimes it is mistaken for acne, but when treated with acne topicals, it often worsens. When treated with topical corticosteroids, it often improves, but this is never an appropriate therapy because the withdrawal of the steroid causes the inflammatory condition to return with a vengeance. Also, topical steroids are never appropriate for chronic or long-term use, and perioral dermatitis is a chronic condition which can recur over time with stressors or illness. Appropriate treatment includes non-steroidal immune modulators such as calcineurin inhibitors such as pimecrolimus and tacrolimus, as well as low dose antimicrobials which only act as anti-inflammatory agents (and not as antimicrobials) such as are used in chronic inflammatory conditions as rosacea.
With the onset of the Covid-19 pandemic, dermatologists have seen a surge in perioral and perinasal dermatitis due to intermittent mask application. Even 5-10 per day of mask usage can initiate or exacerbate this inflammatory condition. Treatment is the same as for typical perioral dermatitis. Patients are also recommended to wear masks which are 100% cotton and allow breathability, instead of the N95 or KN95 masks which are composed of synthetic fibers which worsen the condition.