What are the other Names for this Condition? (Also known as/Synonyms)

• Periorbital Dermatitis

What is Periocular Dermatitis? (Definition/Background Information)

• Periocular Dermatitis is a form of periorificial dermatitis, a common skin condition, which is characterized by the presence of inflammatory lesions in the skin around the eyes with involvement of the eyelids. Many cases are observed in young and middle-aged women
• The condition can result in redness of skin, tiny bumps, scaly skin, and itchiness in the affected region. The risk factors identified for Periocular Dermatitis include the use of steroidal medications, hormonal factors, and use of certain cosmetics
• The treatment for Periocular Dermatitis may include the use of topical creams and antibiotics. The prognosis is excellent in most individuals with appropriate therapy. However, the condition is known to recur even after a few years following the completion of treatment

Who gets Periocular Dermatitis? (Age and Sex Distribution)

• Periocular Dermatitis is a common skin condition that is typically seen between the ages of 16 and 45 years. However, the condition may also occur in children
• It can affect both males and females, but there is a predilection for females (typically women)
• The condition can occur worldwide; individuals of all racial and ethnic background may be affected

What are the Risk Factors for Periocular Dermatitis? (Predisposing Factors)

The risk factors for Periocular Dermatitis may include:

• Use of certain medications, such as high-potency topical corticosteroids
• Inhaled/nasal steroids
• Use of cosmetics, including sunscreen lotions and moisturizing creams
• Certain hormonal factors including the use of oral contraceptives
• Emotional stress
• Exposure to sunlight, cold temperatures, and wind
• Toothpastes containing fluorides
• Dental cavity fillings made of amalgam (silver or mercury)
• Individuals with atopic eczema, asthma, or hay fever may have a higher risk

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Periocular Dermatitis? (Etiology)

The cause of development of Periocular Dermatitis is unknown, but it may arise from genetic and environmental factors. Research experts believe that some of the following factors may be involved:

• Dysfunction of the skin barrier (epidermis/stratum corneum)
• Changes in the naturally residing skin microorganisms
• Disturbances in the oil (sebaceous) glands

What are the Signs and Symptoms of Periocular Dermatitis?

The signs and symptoms of Periocular Dermatitis may include:

• The presence of multiple red papules, pustules, and blisters/vesicles
• The lesions may be observed in clusters
• The skin around the eyes and the eyelids are typically affected
• The skin can be dry and scaly
• The papules and pustules may sting, burn, and itch
• The skin symptoms can last for weeks to months

How is Periocular Dermatitis Diagnosed?

The following are the diagnostic methods that may be used for Periocular Dermatitis:

• A thorough physical examination and a complete medical history are important
• Eye examination and assessment of the presenting signs and symptoms
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• A skin tissue biopsy is usually not needed to diagnose Periocular Dermatitis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Periocular Dermatitis?

No significant complications due to Periocular Dermatitis have been reported. If the condition is severe, then the following complications may be observed:

• Emotional stress due to cosmetic concerns
• Chronic itching and scaling of the skin may cause the skin to become thick, discolored, and leathery
• Bacterial and fungal infections: If it causes continuous itching and scaling of the skin, it can result in moist skin, which provides a suitable environment for secondary infections
• Rarely, a sudden stoppage of topical steroid creams may result in flaring up of the condition presenting severe symptoms

Periocular Dermatitis may recur even after complete disappearance of the signs and symptoms.

How is Periocular Dermatitis Treated?

Treatment strategies that may be adopted in the management of Periocular Dermatitis include:

• The healthcare provider will recommend a slow stoppage of steroidal topical applications and nasal inhalations (if being previously used by the patient)
• For mild skin conditions, self-care measures, such as washing with mild (antibacterial) soap and applying warm compress, are recommended
• Topical creams, such as metronidazole, erythromycin, clindamycin, azelaic acid, and pimecrolimus, may be used
• Administration of tetracycline class oral antibiotics is known to be effective
• Follow-up care with regular screening and checkups are important

If any of the prescribed treatment medication or methods cause new stinging or burning symptoms, then it is important to discontinue the medication/method and immediately inform the healthcare provider.

A few self-care tips and home remedies for Periocular Dermatitis may include:

• Completely avoid scratching the affected areas
• Avoid excessive washing and scrubbing of the skin
• Use only mild perfumes and soaps
• Keeping the skin moist can help in reducing the signs and symptoms

How can Periocular Dermatitis be Prevented?

Currently, it may be difficult to prevent the onset of Periocular Dermatitis in some cases. In others, the following may be considered:

• Avoiding the use of non-prescription topical steroids and high potency topical steroids prescribed for other conditions
• In case topical steroids are prescribed by the physician, then closely following instructions for using the medication/application. And, using the medication only for the duration of the prescription period
• Avoiding face/eye cosmetics and sunscreens that block the sweat glands (occlusive creams)
• Minimize exposure to harsh weather such as bright sun and cold temperatures

Individuals with Periocular Dermatitis may aggravate the existing condition by continuing to use nasal/topical steroids and cosmetic make-ups and creams.

What is the Prognosis of Periocular Dermatitis? (Outcomes/Resolutions)

• The prognosis of Periocular Dermatitis is excellent with appropriate treatment as the condition is known to respond well to suitable therapy. But, it may take a few months to completely recede and clear
• Nevertheless, the condition may recur after complete resolution of symptoms following treatment, sometimes months/years after it ceased

Additional and Relevant Useful Information for Periocular Dermatitis:

• Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition

The presence of dirt on the body is not a causative factor for Periocular Dermatitis. However, it helps to be clean and hygienic, which will help the condition from getting worse