Navigating Perioral and Seborrheic Dermatitis: A Case Study
By Dr. Ashley Baldree, Village Dermatology, Katy and Memorial Houston
At Village Dermatology, we often encounter patients dealing with challenging skin conditions that affect their confidence and comfort. Recently, a 35-year-old female visited our clinic with a two-month history of a painful, dry, and flaking rash on her face. After trying and failing treatments, including doxycycline, ketoconazole, and hydrocortisone, she sought a solution to regain control over her skin health.
Understanding the Diagnosis
Upon examination, the patient displayed signs of two conditions: perioral dermatitis and seborrheic dermatitis.
Perioral Dermatitis: This chronic rash, characterized by inflamed areas around the mouth and nose, was identified on her chin, cheek, and upper lip. Common triggers for this condition include cosmetics, topical steroids, fluorinated toothpaste, and environmental factors like wind or sun exposure.
Seborrheic Dermatitis: Additionally, the patient exhibited pink/orange scaly plaques on the glabella, consistent with seborrheic dermatitis—a chronic condition prone to flares triggered by stress.
Seborrheic Dermatitis
Tailored Treatment Plan
To address these concerns, we devised a comprehensive treatment strategy:
Perioral Dermatitis:
Prescribed Soolantra 1% cream (or Metrocream as an alternative) for daily application.
Provided Rhofade sample for temporary redness management before events.
Recommended gentle cleansing with La Roche-Posay Toleriane and daily use of Tizo tinted sunscreen to prevent UV-induced flares.
Counseling on minimizing cosmetic use and avoiding triggers.
Seborrheic Dermatitis:
Suggested moisturizers like Cetaphil, CeraVe, and La Roche-Posay Toleriane for gentle care.
Emphasized using shampoos with tar, selenium, or zinc pyrithione to improve scalp health.
Patient Education and Follow-Up
Patients with chronic skin conditions like these require education on long-term management. We counseled her on expectations, including the potential for periodic flares and the importance of regular sunscreen application. A follow-up was scheduled within 2-4 weeks to evaluate progress and fine-tune the regimen.
Empowering Skin Health
At Village Dermatology, we prioritize individualized care to help patients feel confident in their skin. If you're managing perioral or seborrheic dermatitis, visit our dedicated page on seborrheic dermatitis or contact us for an appointment. Let us guide you toward healthier skin today!