Several options are available for periorbital dermatitis treatment, including topical creams and oral medications. The severity of the rash will determine the treatment option used. For a mild rash, the method of treatment usually involves gently washing the affected area with warm water. More severe forms require the use of oral or topical antibiotics.
Antibiotics primarily work as an anti-inflammatory agent in periorbital dermatitis. The anti-inflammatory effects of antibiotics are mostly due to the inhibition of an enzyme called nitric oxide synthase. This enzyme is responsible for many biological cellular processes, including the induction of inflammatory responses. Inflammation is one of the main characteristics of dermatitis. By reducing the incidence of inflammation in the affected area, the skin condition will gradually improve.
Inflammation in periorbital dermatitis is accompanied by small itchy bumps that usually form large skin plaques. Due to the overwhelming urge to scratch the affected area, harmful microorganisms such as bacteria are allowed to proliferate and cause infection. Not only do antibiotics treat inflammation, they also address the secondary issue of infection that sometimes accompanies periorbital rashes.
Some researchers have suggested yeasts and bacteria that live in hair follicles may be the primary trigger for periorifical disorders, hence the reason antibiotics work so well. Regardless of the exact cause, it has been shown antibiotics remain the primary treatment option for severe dermatitis. An example of an anti-inflammatory antibiotic is tetracycline. This antibiotic is one of the most prescribed medications for periorbital dermatitis treatment.
Topical antibiotics don't always work as well as oral antibiotics, but some creams, such as azelaic acid cream, can be used as a periorbital dermatitis treatment due to its natural antibiotic and anti-inflammatory properties. Post inflammatory pigmentation, which is sometimes present in dermatitis suffers, can be treated with this medication. Azelaic acid is usually tolerated by most people; however people with sensitive skin might experience excessive irritation. The facial cream should be discontinued if severe scaling, itching or burning is present.
It is important to note that fluorinated or topical steroids such as hydrocortisone should not be used as a periorbital dermatitis treatment. Despite having anti-inflammatory properties, fluorinated hydrocortisone creams and ointments tend to worsen the condition. Typically, when topical steroids are discontinued, the rash gets worse for a few days before improving. Facial creams, moisturizers and soap-based cleansers also tend to worsen the condition. Reapplying hydrocortisone or other facial creams will most likely cause the condition to return in a more aggressive form.