PERIORAL DERMATITIS

What Is Perioral Dermatitis?
Who Gets Perioral Dermatitis?
Perioral Dermatitis Symptoms
Perioral Dermatitis Causes
Is Perioral Dermatitis Contagious?
Perioral Dermatitis Treatment
Perioral Dermatitis Prevention

What Is Perioral Dermatitis?

Perioral dermatitis is a rash that closely resembles acne and typically forms around the mouth. In people who have light-colored skin, the rash is red. In people with darker complexions, it is skin colored. The skin may also turn scaly.

Who Gets Perioral Dermatitis?

Women between ages 20 and 45 are most at risk for perioral dermatitis, which occurs less often in men. Kids, both girls and boys, can develop this rash, too.

Perioral Dermatitis Symptoms

Perioral dermatitis triggers an eruption of small bumps, usually on the chin and upper lip, but sometimes around the nose and eyes. The rash may appear on both sides of the face or just one side.

Some people develop the rash around their genitals. This type of perioral dermatitis is more accurately called periorificial, or “around an opening,” dermatitis.

In addition to developing bumps, the skin may be dry and flaky, and you may feel a burning sensation.

Perioral Dermatitis Causes

No one is sure what causes this skin condition, but some prime suspects include:

Topical steroids

People who use a steroid cream or ointment on their face for an extended period of time may be vulnerable to developing perioral dermatitis. Nasal steroid sprays and inhaled steroids have been linked to the condition, too.

Cosmetics and other personal hygiene products

It’s possible that certain cosmetics promote perioral dermatitis in some people. One study found that women who used foundation makeup, moisturizer and night cream had a 13-fold increased risk for perioral dermatitis. Authors of the study suspect these products, in combination, can create a barrier on the skin that allows bacteria to grow, which may promote a mouth rash and breakouts elsewhere on the face. (Using moisturizer alone didn’t seem to cause perioral dermatitis in the study.)

Skin care products containing petroleum jelly and certain other ingredients have also been linked to perioral dermatitis, as have physical sunscreens (as opposed to chemical sunscreens) in children. Even fluoride toothpaste has been cited as a possible culprit.

Face masks

The face masks you wear to guard against getting infected with or spreading airborne illnesses like the virus that causes COVID-19 may increase the risk for perioral dermatitis. During the pandemic, dermatologists saw an increase in mask-related acne, aka maskne, but also other skin rashes, including perioral dermatitis. Masks keep the skin underneath them warm and damp. This may lead to changes in the balance of skin bacteria, triggering skin problems.

Hormones

Since women make up the majority of adult patients with perioral dermatitis, some scientists suspect hormones may play a role. That theory is strengthened by research indicating that using oral contraceptives (which alter hormone levels) improves rashes caused by this condition.

Is Perioral Dermatitis Contagious?

No. If you develop this rash, you can’t spread it to others.

Perioral Dermatitis Treatment

Perioral dermatitis sometimes clears up on its own. If it persists, there are several strategies that can help clear your skin.

Stopping the use of topical steroids

If you use any steroid product on your face, including an over-the-counter hydrocortisone cream or a prescription corticosteroid, stop. Talk with your doctor before you stop using a prescription corticosteroid, however. The doctor may want to wean you off the medicine slowly, which may require stepping down to a weaker steroid. When you stop the steroid, your rash may worsen before it improves on its own or with treatment.

Stopping the use of certain skin care products

Your doctor may recommend that you stop using any cosmetic or other product on your face, even sunscreen, while your skin clears. (When your symptoms improve, talk with your doctor about what type of sun protection you should use.) Switching to fragrance free soap and other skin care products may help, too. Wash your face gently, without scrubbing.

Topical treatments

Various topical medicines may be used to treat perioral dermatitis. Doctors are most likely to recommend them for milder cases. These medicines include azelaic acid, metronidazole, pimecrolimus and praziquantel.

Oral antibiotics

For stubborn or severe cases, your doctor may prescribe an oral antibiotic such as tetracycline, which has anti-inflammatory properties that may speed healing.

Perioral Dermatitis Prevention

Following a few rules may help keep perioral dermatitis at bay.

Use topical steroids only as directed

If you need to use an over-the-counter or prescription topical steroid on your face, follow the label instructions to the letter. If your doctor prescribes a topical steroid, ask for the lowest effective potency, and stop using it as soon as possible.

Avoid other perioral dermatitis triggers

If you identify a cosmetic or other product that you think may cause your face to break out, stop using it.

Practice good mask hygiene

When you wear a face mask for protection against airborne illnesses, you can reduce your risk for perioral dermatitis and maskne with these tips:

Choose a mask that is comfortable (so you don’t need to constantly adjust it) and fits snugly but isn’t too tight. If the layer that touches your face is made of a soft, breathable fabric such as cotton, that’s a bonus for your skin.
Don’t wear makeup under your mask.
Wash your face daily with fragrance free soap and apply a light moisturizer at least a half hour before putting on your mask.
Every few hours, go outdoors or to a private place where you can remove the mask for a while to reduce pressure and moisture.
Replace or wash your masks (for washable masks) often.