The Role of the Skin Barrier in Periorificial Dermatitis

Periorificial dermatitis, mostly known as perioral dermatitis, is a benign inflammatory facial dermatosis which can be a severe burden and even disfiguring and psychologically disturbing. The disease still presents a challenge for physicians when it comes to etiology and appropriate therapy. Although a variety of extrinsic and intrinsic factors have been proposed as etiopathogenetic factors, none of these fully explain complex pathogenesis of the disease. There is more evidence that supports beliefs that the epidermal barrier dysfunction is an underlying main pathogenic factor that contributes to persistent cutaneous inflammation in typical facial localizations. Patients with periorificial dermatitis are considered hyper-reactors who have impaired essential function of the skin barrier, especially the skin barrier of the perioral region, characterized by thin permeable stratum corneum and imbalance of intercellular lipids, which makes them more susceptible to various internal and external irritants that contribute to the development of the disease. The verification of this connection reinforces the need for clinicians to address this issue when approaching their patients and formulating the best treatment plan. Treatment should emphasize repairing the impaired skin barrier function to minimize associated skin inflammation and sensitivity, which results in resolution of the objective and subjective symptoms.