Perioral dermatitis is a type of rash that can develop on your face, particularly around your mouth. Like eczema, this inflammatory skin disease may be long-term, or chronic. It also tends to recur without treatment.
The key to treating and preventing this red, bumpy, and sometimes painful rash is to use the right treatments. Prescription medications are the foundation of fast perioral dermatitis treatment. A dermatologist may also recommend stopping other medications and adopting a new skin care routine.
Keep in mind that this rash is treated gradually, with complete resolution expected between a few weeks and a few months.
Talk with a doctor or dermatologist about which of the following treatment methods may work best for your perioral dermatitis.
Oral antibiotics are considered the most reliable treatment for perioral dermatitis. These help to clear up any underlying infections that may be contributing to this rash.
To avoid antibiotic resistance, your dermatologist will likely recommend decreasing doses as part of your treatment plan.
An alternative to oral antibiotics for perioral dermatitis are topical versions. These take several months to clear up your rash but may reduce the possible risks and side effects associated with taking antibiotics by mouth.
Topical antibiotics may be prescribed in either cream or lotion form.
Unlike eczema (atopic dermatitis), steroids aren’tused to treat perioral dermatitis. In fact, both prescription and over-the-counter (OTC) topical steroids are considered one of the most common causes of this condition. Nasal and inhaled steroids may also contribute.
For this reason, your dermatologist may recommend that you stop using such products. They may direct you to taper you off topical steroids over the course of 1 to 2 weeks before discontinuing them entirely.
Still, it’s important to know that your symptoms may look or feel worse for days and weeks before improving. Avoid using steroid creams again — including hydrocortisone — without talking with your doctor first, as this could make the cycle worse.
Washing your face is an important way to remove dirt and oil, even if you have perioral dermatitis.
The key is to use a gentle cleanser designed for sensitive skin. Brand-name options include Dove, CeraVe, and Cetaphil cleansers. These products don’t have fragrances or synthetic ingredients likely to irritate skin rashes.
Along with these mild cleansers, you may consider other complementing products within the same brands, such as a gentle moisturizer that’s water-based and noncomedogenic. Avoid scrubs and other harsh products that may irritate your skin rash.
When washing your face, use cool or lukewarm water to lessen skin irritation. Pat your skin dry and follow up with a fragrance-free moisturizer.
Even with the right treatment, perioral dermatitis may recur over the course of several months — or even years.
There’s no clear reason or cause for perioral dermatitis, so most triggers are unknown. We do know that it’s more common in women, and researchers think that hormones may play a big role.
To keep perioral dermatitis from coming back, you can try the following strategies to see whether they work for you.
Avoid lifestyle triggers
You can start by avoiding the substances and lifestyle habits that have been known to trigger perioral dermatitis, such as:
- sun exposure
- fluoride-containing toothpastes
- heavy facial moisturizers
- noncomedogenic makeup
- chemical sunscreens
- cosmetics that contain fragrances
Avoid medication triggers
You may also need to avoid certain medications that may also trigger perioral dermatitis, including:
- long-term use of prescription topical steroids
- OTC steroid creams, such as hydrocortisone
- inhaled steroids
- nasal steroids
- birth control pills
Treat and manage rosacea (if you have it)
Perioral dermatitis is sometimes associated with another inflammatory skin condition called rosacea. By treating and managing your rosacea, you may be able to reduce the number of perioral dermatitis flare-ups.
However, be aware that it’s also possible for recurring perioral dermatitis to become rosacea.
Before changing your skin care routine, it’s important to get a proper diagnosis of your facial skin rash.
A dermatologist can identify perioral dermatitis with a physical exam and provide treatment advice. Don’t stop taking prescribed topical or oral medications unless your doctor tells you to.
Once you start treatment for perioral dermatitis, it’s important to stick with your treatment plan, even if you don’t see results right away. However, if you see new or worsening symptoms after several weeks, call your dermatologist. Examples include:
- acne-like pustules
- rash that spreads to other parts of your face, such as your eyes
- burning or stinging
- plaque-like or scaly lesions
Perioral dermatitis can be a frustrating condition, and recurrence is likely without proper treatment.
The good news is there are proven treatments and remedies to help cure this rash, including prescription antibiotics and lifestyle changes. In fact, most people with this rash find relief once they implement the right treatments.
It can take weeks or months for perioral dermatitis to go away. Once your rash does clear up, it’s important to prevent it from coming back. Talk with your doctor about which medications and substances trigger your perioral dermatitis so you can avoid them.
If your symptoms don’t improve after several weeks of treatment, see your doctor regarding next steps.