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Q: Rash around mouth
asked by: Sarah35 on May 5th, 2009
New User
Hello,

Since early February, I've had a rash around my mouth that seems to get better and worse. It started when I woke up one morning and my lips were bright red, swollen, with blisters, and a ring around my mouth. I literally looked like a clown. It subsided in about 2-3 days, and settled into a ring that I still have today. I've had a breakout like that twice, but most of the time, they are red, itchy and swollen. They are constantly dry if I don't put some vaseline on them. I'm 28, female, and usually very healthy.

They tingle a bit when I exercise. Also, I went out of town for a week and they completely healed, but as soon as I got home it came right back. I've thought of everything it could be and changed what I'm doing - laundry detergent, foods, coffee, toothpaste, lip glosses/sticks - I just can't place it. Sometimes I feel a little light headed around dust, but other than that, I have no allergies.

I've been to 2 doctors - the first, a GP, said it was angioedema, and gave me an epipen to use if my tongue swelled up. The second, a derm, said it wasn't angioedema and to only use vaseline, (I was only using aquaphor) and it's no better, maybe even a little worse. There was a little less swelling when I put some benedryl cream on them, but the derm said not to use it. I tried anti-fungal cream, and that didn't work either.

I have a feeling it's something in my apartment - mold? Dust? I'm running out of ideas of what this could be. I have an appt with an allergist in a couple weeks - the first available appointment they had! It's just frustrating to see two professionals that don't even really listen to your symptoms, they just tell you what they think it is and send you along your way - and nothing gets any better.

Any advise is helpful. I'm so frustrated...

Thanks
Sarah
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MandMs
replied on May 6th, 2009
Extremely eHealthy
You are probably experiencing a condition known as dermatitis (an inflammation that usually involves swollen, reddened and itchy skin).
Sometimes, it is called ezcema.
There are different forms of dermatitis,like irritant and allergy contact dermatitis, but, when the itching is very prominent, the affected area is largely swollen and blisters are more common, the diagnosis is more suggestive for an allergic contact dermatitis.
Possible factors for triggering this condition are lip balms, lipstick, toothpaste, mouthwash, bubble gum (ie, rosin, cinnamates), nickel in musical instrument mouthpiece, rubber in snorkeling mouthpiece, cane reed in a clarinet, food (eg, mango skin).
The ring around the mouth is an inflammation, too, and is called perioral dermatitis.
The same triggers for lip dermatitis, may triggered the perioral dermatitis, too.
This condition is harmless, but, the ring will be present for months or years if it isn't treated.
Usually, an antibiotic therapy is prescribed for a period of 12 weeks.
Avoid make up foundation, since it is considered a strong provoking factor for perioral dermatitis.


Best wishes!
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Sarah35
replied on May 6th, 2009
New User
Thank you
That is the most thorough, thoughtful response I've received - thank you for taking the time to explain the problem. I've noticed it definitely flares up a bit after I put on make up.

Do you know the name of the antibiotic that would be prescribed?

The other hitch is my husband and I are trying for a baby, so I don't want to do anything that could harm that process.

Thank you again for taking the time to respond.
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MandMs
replied on May 11th, 2009
Extremely eHealthy
You are welcome!
I feel like I haven't written enough information about how the perioral dermatitis looks.
Usually, it is a rash of small red or pink lumpy spots, with red or pink skin between and around the spots.
They look like pimples, and may cause burning sensation.
It looks like the rash forms almost a 'ring' around the mouth, but sparing a small border of skin next to the lips (that appears in contrast very white).
In milder cases or when the woman is pregnant or trying to concieve, the systemic oral therapy with antibiotic tetracycline, is often switched with locally appllied (topical)antibiotic (erythromycin) in different forms, lotion, creme, gel.
The course of antibiotic therapy is prolonged and often lasts for several months (6-12 weeks) to avoid recurrences.
First few weeks are usually without noticible changes.
It is a general rule that administration of erythromycin during pregnancy is a safe treatment for the fetus.
Also, when applied topically is less systemically available than medicines taken orally, ultimately meaning that the fetus is exposed to less of the medication.

Please, before taking any therapy consult your physician for the right diagnosis and treatment!

Best wishes!
Marija
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Sarah35
replied on May 13th, 2009
New User
Thanks again!
After you suggested perioral dermatitis, I did some research and immediately stopped using my toothpaste that has SLS in it, and in days the redness has cleared up. Very strange - I did change to a new bottle of toothpaste around the time the irritation began, but the exact same brand... maybe the formula changed? Anyway, it's improved immensely, but is not completely healed. There's still redness, and I still have a little bit of tingling, but no where near as bad as before.

I've also ordered facial cleansers, sunscreens, and other toiletries that people with the condition use, so I'm looking forward to getting started with those. I've also stopped using listerine, as it has alcohol, which is also very irritating. I'm nervous about discontinuing Proactiv, which I use for my acne, but it's just too drying. Not excited about the acne coming back, but I'm going to try a natural product by Kiss My Face. We'll see.

I have an appointment with an allergist on Friday, and I'll mention our discussion and see if they can prescribe me erythromycin.

Again, thanks for your thoughtful responses - I'm seeing the light at the end of the tunnel!

Sarah
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