Perioral Dermatitis

Written by Tricia Kinman | Published on September 4, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What Is Perioral Dermatitis?

Perioral dermatitis is inflammation of the skin around the mouth. It usually appears as a rash around the lips that may be scaly or bumpy.

According to Medscape, perioral dermatitis can happen to anyone, but it occurs most often in women ages 20 to 45. In fact, 90 percent of cases reported are in young women. It is also common in children. (Medscape, 2012)

What Are the Symptoms of Perioral Dermatitis?

Perioral dermatitis is characterized by a rash of red bumps around the mouth and in the folds around the nose. The bumps can also appear in the area under the eyes, on the forehead, and on the chin. These small bumps can be filled with pus or fluids and may resemble acne.

Symptoms such as burning or itching may occur, but this is uncommon.

What Causes Perioral Dermatitis?

The cause of perioral dermatitis is unknown. However, research suggests that it can occur after the use of topical steroids on the skin, which may be prescribed to treat another condition.

There 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. (Medscape, 2012)

Other factors that may trigger this condition include:

  • bacterial or fungal infections
  • using fluorinated toothpaste
  • taking oral contraceptives
  • using sunscreen

How Is Perioral Dermatitis Diagnosed?

Your doctor or dermatologist can often diagnose perioral dermatitis with just a visual examination of your skin.

Your 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. The sample will then be sent to a laboratory to test the skin cells for bacteria or fungi.

How Is Perioral Dermatitis Treated?

How you are treated will depend 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 be used to speed healing.

Medications your doctor may prescribe include (Medscape):

  • topical or oral antibiotic medications, such as metronidazole and erythromycin
  • immunosuppressive creams, such as pimecrolimus cream
  • topical anti-acne medications, such as adapalene or azelaic acid
  • oral antibiotics used in more severe cases , such as doxycycline, tetracycline, minocycline, or isotretinoin

It is important to avoid topical or nasal steroids, as they can make symptoms worse.

What Can I Expect in the Long-Term?

Perioral dermatitis is difficult to treat and can last for months. According to the American Osteopathic College of Dermatology (AOCD), even after a few weeks of treatment, the condition can get worse before it improves. In some people, perioral dermatitis becomes chronic. (AOCD)

How Can I Prevent Perioral Dermatitis?

Since the causes of perioral dermatitis vary, 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 him or her know that you have perioral dermatitis.
  • Avoid using heavy cosmetics or skin creams. Ask your doctor about which moisturizers are acceptable to use. If you decide to continue to use cosmetics, try switching brands.
  • Limit the amount of time your skin is exposed to the elements. UV rays, heat, and wind can aggravate perioral dermatitis. In addition, some medications used to treat perioral dermatitis will make your skin sensitive to the sun, so be sure to protect your skin if you’ll be in the sun for prolonged periods.
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