What is perioral dermatitis?
dermatitis is an inflammatory rash involving the skin around the mouth. The
rash may spread up to the nose or even the eyes. It usually appears as a scaly or
red bumpy rash around the lips. There may be a clear fluid discharge. Redness
and slight itching and burning can also occur.
dermatitis is more common in women between the ages of 16 to 45 years, but can
be seen in all ages, races, and ethnicities. When it occurs in children, it
tends to affect younger children with an average age of 6 years. Without the
right treatment, cases of perioral dermatitis go away but may reappear later.
Episodes of perioral dermatitis can last weeks and even months.
The cause of perioral
dermatitis is unknown. However, research suggests that it can occur after the
use of strong topical steroids on the skin, which may be prescribed to treat
another condition. Nasal sprays containing corticosteroids can cause perioral
dermatitis as well.
is also evidence that certain ingredients in cosmetics can cause perioral
dermatitis. Heavy skin creams that contain petrolatum or a paraffin base may
cause or worsen this condition.
factors that may trigger this condition include:
- bacterial or fungal
- constant drooling
- oral contraceptives
What are the
symptoms of perioral dermatitis?
dermatitis usually appears as a rash of red bumps around the mouth and in the
folds around the nose. The bumps may be scaly in appearance. The bumps can also
appear in the area under the eyes, on the forehead, and on the chin. These
small bumps can contain pus or fluids and may resemble acne.
may experience symptoms such as burning or itching, especially as the rash
How is perioral
doctor or dermatologist can often diagnose perioral dermatitis with just a
visual examination of your skin, along with your medical history.
doctor may also perform a skin culture test to rule out a possible infection.
During this test, your doctor will swab a small patch of skin in the affected
area. They will send the sample to a laboratory to test the skin cells for
bacteria or fungi. Your doctor may perform a skin biopsy, especially if the
rash doesn’t respond to standard treatments.
What are the
treatment options for perioral dermatitis?
The American Osteopathic College of Dermatology (AOCD) recommends stopping the use of topical steroid
creams or nasal sprays containing steroids, if possible. These products can
make symptoms worse and are likely responsible for the symptoms. However, it’s
important to speak with your doctor before discontinuing any medications.
doctor will determine your treatment based on the severity of your condition.
In some cases, using mild soaps and discontinuing the use of heavy skin creams
and fluorinated toothpaste may ease symptoms. Medications may also speed
your doctor may prescribe to treat your condition include:
- topical antibiotic
medications, such as metronidazole (Metrogel) and erythromycin
creams, such as pimecrolimus cream
- topical acne
medications, such as adapalene or azelaic acid
- oral antibiotics,
such as doxycycline, tetracycline, minocycline, or isotretinoin, for more
Natural and alternative remedies
Some patients prefer to
try natural remedies in addition to or in place of prescription medications.
These are not as effective as medications or over-the-counter treatments, and
do not have the medical research to back it up, but are thought to offer relief
for some patients.
- essential oils
like tea tree or lavender oil, applied topically
vitamins A, E, C
- taking zinc
- apple cider
vinegar, applied topically
- green tea,
Diet and lifestyle
Part of treating perioral
dermatitis is lifestyle changes that can help prevent it. Some possible actions
- Get rid of
harsh face scrubs or perfumed cleansers. Instead, use only warm water during
flare-ups. Once healed, only use mild soap and don’t scrub at the skin.
- Avoid steroid
creams, even nonprescription hydrocortisone.
- Stop using or
reduce use of makeup, cosmetics, and sunscreen.
- Wash your
pillow cases and towels in hot water frequently.
- Limit overly
salty or spicy foods.
Some people will be more
prone to or at risk of developing perioral dermatitis than others. Risk factors
- gender (women
are more likely to develop this condition than men)
- use of steroid
creams or ointments on the face
- age (teenagers,
young adults, and middle-aged adults are most likely to be affected)
- presence of an
- a history of
- environment (those
who are more frequently exposed to strong winds are more likely to develop this
are several common triggers that can result in a perioral dermatitis outbreak.
These should be avoided as much as possible.
- using a
steroid cream on the face
- makeup and
cleansers that are applied to the affected or irritated area, which can make
- exposure to
- exposure to
- birth control
What is the
dermatitis is difficult to treat and can last for months. According to
even after a few weeks of treatment, the condition can get worse before it
improves. In some people, perioral dermatitis becomes chronic.
How can I prevent
the causes of perioral dermatitis vary and the cause is not completely
understood, there isn’t a foolproof way to avoid getting it. However, there are
some things you can do to help alleviate it or to keep it from getting worse:
- Avoid steroid
creams and ointments unless specifically directed by your doctor. If
another medical practitioner prescribes a topical steroid, make sure to
let them know that you have perioral dermatitis. In general, it is more
likely to occur with stronger topical steroids than weaker ones, so use
the weakest possible one to treat the disease.
- Avoid using heavy
cosmetics or skin creams. Ask your doctor about which moisturizers are
acceptable to use. Try switching brands if you decide to continue to use
- Switch to gentle
cleansers and moisturizers. Ask your dermatologist for recommendations
that would best suit your skin.
- Limit the amount of
time your skin comes into contact with the elements. UV rays, heat, and
wind can aggravate perioral dermatitis. Some medications used to treat
perioral dermatitis will also make your skin sensitive to the sun. Be sure
to protect your skin if you’ll be in the sun for prolonged periods.