- Perioral dermatitis is a common skin problem that mostly affects young women.
- Perioral refers to the area around the mouth, and dermatitis indicates redness/inflammation of the skin. In addition to redness, there are usually small red bumps and mild peeling.
- This condition has overlapping features of acne (and similar treatments) however the underlying cause(s) and course of disease differ.
- If not treated, perioral dermatitis may last for months or years. Even if treated, the condition may recur several times if triggers are not identified and avoided.
- Effective treatments include topical and oral antibiotics, topical calcineurin inhibitors, limited ingredient facial cleansers, moisturizers and sunscreen.
Perioral dermatitis is a common skin problem that mostly affects young women. Occasionally men or children are affected too. Perioral refers to the area around the mouth, and dermatitis indicates redness of the skin. In addition to redness, there are usually small red bumps and mild peeling. Sometimes the bumps are the most obvious feature and can look a lot like acne. The area most affected are within the borders of the nasal creases, chin, nasolabial folds but spares the small band of skin the borders the lips. Occasionally, the areas around the nose, eyes, and cheeks can be affected. Mild itching or burning are also symptoms.
The exact cause of perioral dermatitis is unknown. Some dermatologists believe it’s a form of rosacea or worsened seborrheic dermatitis. Overusing strong topical steroids, heavy moisturizers/cold creams, cinnamon flavored toothpaste, mouthwash and whitening toothpastes are all common causes. Food sensitivities (especially to gluten, sugar, dairy, alcohol and highly processed foods) and stress can trigger flares.
If not treated, perioral dermatitis may last for months or years. Even if treated, the condition may recur several times. However, usually the disorder does not return after successful treatment.
There’s no guaranteed way to prevent perioral dermatitis. Avoiding the use of strong prescription strength corticosteroid creams on the face is a good start. Your dermatologist may have suggestions about appropriate moisturizers, cosmetics, and sunscreens, and may advise against using toothpaste with fluoride, whitening ingredients, or cinnamon flavoring.
Most of the time, no tests are necessary. A dermatologist can usually make an accurate diagnosis by just examining the skin. Sometimes, a scraping or biopsy of the skin is done in office to rule out other conditions such as seborrheic dermatitis or a fungal infection
An oral antibiotic, like doxycycline, is the most common treatment for perioral dermatitis and you may need it for several months to prevent recurrence. Topical calcineurin inhibitors are very effective since they have an anti-inflammatory effect on the skin. For milder cases or pregnant women, topical antibiotic creams such as topical dapsone, metronidazole or erythromycin may be used. Occasionally, your dermatologist may recommend a specific mild corticosteroid cream, just for a short time to help your symptoms while the antibiotics are working