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White spots on face due to saliva. Irritation on skin behind lips, chin. Suggest a solution.

Hello sir., i have white spots on my face and i noticed that it is because of my saliva.. When i sleep, saliva flows n in morning it causes problem.this is since last 2 years n the skin beside lip and chin becomes red n irritable and a very light irritation takes. This red spot (after rubbing that white thing) makes my face very bad looking. Please suggest some solution. Thank you
Asked On : Thu, 11 Apr 2013
Answers:  2 Views:  337
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Diseases and Conditions
Dermatologist 's  Response

Hi,you are having sialorrhea causing irritatant contact dermatitis on your face below the lip.Remember,
Sialorrhea (drooling or excessive salivation) is a common problem in neurologically impaired children (i.e., those with mental retardation or cerebral palsy) and in adults who have Parkinson's disease or have had a stroke. It is most commonly caused by poor oral and facial muscle control. Contributing factors may include hypersecretion of saliva, dental malocclusion, postural problems etc.Sialorrhea causes a range of physical and psychosocial complications, including perioral chapping, dehydration, odor, and social stigmatization. Treatment of sialorrhea is best managed by a clinical team that includes primary health care providers, speech pathologists, occupational therapists, dentists, orthodontists, neurologists, and otolaryngologists. Treatment options range from conservative (i.e., observation, postural changes, biofeedback) to more aggressive measures such as medication, radiation, and surgical therapy. Anticholinergic medications, such as glycopyrrolate and scopolamine, are effective in reducing drooling, but their use may be limited by side effects. The injection of botulinum toxin type A into the parotid and submandibular glands is safe and effective in controlling drooling, but the effects fade in several months, and repeat injections are necessary. Surgical intervention, including salivary gland excision, salivary duct ligation, and duct rerouting, provides the most effective and permanent treatment of significant sialorrhea and can greatly improve the quality of life ... Apply mild mild steroid twice a day to improve local irritation and discoloration.Take steroid tab. in tappering doses with antihistaminics till the recovery . Avoid soap on face. .. Ok Still, you consult dermatologist and oral surgeon for perfect result. ..

Answered: Thu, 11 Apr 2013
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Dermatologist Dr. Kalpana Pathak's  Response
Thanks for writing to us.
It seems due to drooling of saliva you have developed irritant contact dermatitis.
Treatment of the affected areas involved application of a mild steroid cream like hydrocortisone or fluticasone and a bland moisturising lotion like cetaphil.
Hope that helped.
Take care
Answered: Thu, 11 Apr 2013
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