The doctor may suggest hospitalization simply because it may be necessary to break the cycle of chronic inflammation, or other problems that are exacerbating the illness. Frequently, five or six days of vigorous in-hospital treatment care can result in a dramatic clearing of the eczema. Food tests, allergy skin testing, and the development of an outpatient therapy plan can all be done during the hospitalization. Unfortunately, getting approval from insurers is often difficult. During an acute flare the number of 15-20 minute baths must be increased to three or four per day. Besides hydrating the skin, baths also increase the penetration of topical medication up to ten-fold if the medicine is applied immediately after the bath. Wet wraps after baths may also help hydration and medicinal penetration. Bedtime wet wraps are most practical, and can be done with elasticized gauze followed by ace bandages or double pajamas. (The first pair of pajamas is worn damp but not soaking wet, and a second pair of dry pajamas is worn over them. For a tighter fit, sometimes a plastic sauna suit is used instead of the dry pajamas.) For feet and hands, socks can be used. Additional blankets or increased room heat may be necessary during this three to seven days to prevent chilling.
Generally, this skin rash will not disappear on its own without an effective treatment and it can last for years. Treatment of this face skin problem is required to eliminate it. The first treatment step is to eliminate the use of products that are suspected triggers (as listed above) of the rash around the mouth. Oral or topical antibiotics are used and sometimes in combination with mild corticosteroid cream application to reduce redness and inflammation of the skin. Care must be taken with close monitoring when using the steroidal creams because they may make the mouth rash worse. The antibiotic treatment may have to be continued for up to three months in order to completely eliminate this skin care problem. Like antibiotic treatments for other health problems, the complete treatment needs to be followed through until the end to eliminate the risk of perioral dermatitis reoccurring. Treatment should not stop simply because the symptoms have decreased or disappeared.