Perioral dermatitis can appear as a bumpy rash around the mouth. Doctors may recommend topical and oral medications to treat your symptoms.

Perioral dermatitis is an inflammatory rash involving the skin around your mouth. The rash may spread up to your nose or even your eyes, in which case it’s referred to as “periorificial dermatitis.”

Perioral dermatitis usually appears on light skin as a scaly or red bumpy rash. On skin of color, the lesions may be hyperpigmented or brown.

The bumps may contain fluid (pustules), so there may be a clear fluid discharge from the bumps. Slight itching and burning can also occur.

The condition is most common in females between the ages of 20 and 45 years, but it can occur in all ages, races, and ethnicities. Perioral dermatitis can occur in children of any age.

Episodes of perioral dermatitis can last weeks or even months. Perioral dermatitis is often chronic and relapsing, but it may resolve after the triggers are removed.

Language matters

You’ll notice that the language used to share stats and other data points is pretty binary, using the term “female” in the discussion of research.

Although we typically avoid language like this, specificity is key when reporting on research participants and clinical findings.

Unfortunately, the studies and surveys referenced in this article didn’t report data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

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Perioral dermatitis is a rash around the mouth, nose, and eyes. It presents as papules that can be itchy. Burning or tenderness may also occur. Nau Nau/Shutterstock
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Most cases resolve on their own, but topical or oral antibiotics can treat perioral dermatitis if needed. Photography by DermNet New Zealand

Perioral dermatitis usually appears as a rash of pus-filled bumps around the mouth and in the folds around the nose.

The bumps may be scaly in appearance. They can also appear in the area under the eyes, on the forehead, or on the chin.

These small bumps can contain pus or fluid, and they may resemble acne.

You may also experience symptoms, such as burning or itching, especially as the rash worsens.

Is perioral dermatitis contagious?

Perioral dermatitis isn’t contagious. It can’t spread from person to person.

The cause of perioral dermatitis is unknown.

Several common triggers can result in a perioral dermatitis outbreak. You may want to avoid these triggers as much as possible.

These triggers can include:

Perioral dermatitis vs. rosacea

Some experts believe that perioral dermatitis is a type of rosacea, another condition that’s related to skin redness or discoloration. Other experts believe that they’re two distinct conditions.

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Treatment for perioral dermatitis can vary depending on how severe it is and how often it reoccurs.

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 may be responsible for the symptoms in the first place.

But it’s important to talk with a doctor before discontinuing any medications. Sometimes stopping the use of steroid creams abruptly can cause a rebound effect. In these cases, doctors may suggest slowly weaning off the steroid.

A doctor or dermatologist will decide your treatment based on the severity of your condition. For some people, using mild soaps and avoiding heavy skin creams and fluorinated toothpaste may help.

Prescription medications

A doctor may prescribe topical or oral medications. These medications can include:

  • immunosuppressive creams and ointments, such as pimecrolimus (Elidel) or tacrolimus (Protopic)
  • topical ivermectin
  • topical antibiotics, such as metronidazole (Metrogel, Noritate) or erythromycin (Erygel)
  • oral antibiotics, such as:
  • oral vitamin A medications, such as isotretinoin (Amnesteen, Claravis, Myorisan), but only in certain cases

A doctor may prescribe oral antibiotics for more severe cases or if topical therapy doesn’t help.

Diet and routine changes

Some routine changes can help prevent perioral dermatitis from returning. These changes may include:

  • Avoid harsh face scrubs or perfumed cleansers. During flare-ups wash your face with warm water, and once healed, use mild soap and avoid scrubbing.
  • Avoid steroid creams, even nonprescription hydrocortisone.
  • Avoid cosmetics.
  • Frequently wash your pillowcases and towels in hot water.
  • Limit overly salty or spicy foods, which may irritate the skin around the mouth.

How long will it take to get rid of perioral dermatitis?

It may take a few weeks to months for perioral dermatitis to clear up. Treatment by a dermatologist and avoidance of triggers — whether corticosteroids, inhaled steroids, or other personal care products — can help.

Some people will be more prone to or at risk of developing perioral dermatitis.

Risk factors can include:

  • people assigned female at birth, as they’re more likely to develop this condition than people assigned male at birth
  • age, with young and middle-age adults most likely to be affected
  • use of steroid creams or ointments on the face
  • exposure to allergens or irritants
  • hormonal imbalances
  • use of cosmetics

A doctor or dermatologist may diagnose perioral dermatitis by examining your skin and taking your medical history.

They may also perform a skin culture test to rule out a possible infection. During this test, they’ll swab a small patch of skin in the affected area. A laboratory then tests the skin cells for bacteria or fungi.

The doctor may perform a skin biopsy, especially if the rash doesn’t respond to standard treatments.

Perioral dermatitis is difficult to treat and can last for months. According to the AOCD, even after a few weeks of treatment, the condition can get worse before it improves.

In some people, perioral dermatitis may become chronic.

Since the risk factors for perioral dermatitis vary and the cause isn’t completely understood, there isn’t a foolproof way to avoid getting it.

There are some things you can do to help alleviate it or to keep it from getting worse.

Avoid topical steroids

Avoid using steroid creams and ointments, unless specifically directed by a dermatologist. If another medical practitioner prescribes a topical steroid, make sure to let them know you have perioral dermatitis.

In general, perioral dermatitis is more likely to occur with stronger topical steroids than weaker ones. Use the weakest possible one to treat the condition.

Use cosmetics with caution

Avoid using heavy cosmetics or skin creams. Ask a doctor or dermatologist which moisturizers are acceptable to use. Consider switching brands if you decide to continue using cosmetics.

Switch to gentle cleansers and moisturizers. A doctor or dermatologist can give recommendations for your skin.

Protect your skin

Limit the amount of time your skin comes into contact with the elements. The sun’s ultraviolet rays, heat, and wind can aggravate perioral dermatitis. Some medications used to treat perioral dermatitis can also make your skin sensitive to the sun.

Be sure to protect your skin if you’ll be in the sun for prolonged periods.

The following includes frequently asked questions about perioral dermatitis.

What triggers perioral dermatitis?

Topical and inhaled steroids, cosmetics, and heavy moisturizers can cause flare-ups of perioral dermatitis. Other triggers can include certain kinds of toothpaste, sunblock, and birth control pills.

What foods should you avoid if you have perioral dermatitis?

Spicy and salty foods can irritate the skin around the mouth. Chewing gum may also cause perioral dermatitis.

What vitamins are good for perioral dermatitis?

While there aren’t any studies showing the effect of vitamins on perioral dermatitis, vitamins and nutrition can play a role in your skin’s health. Vitamins C, D, and E may benefit the skin’s youthful appearance.

Learn more about vitamins for healthy skin.

Can perioral dermatitis become rosacea?

Both perioral dermatitis and rosacea can involve small acne-like pustules and redness or discoloration. In fact, some experts believe perioral dermatitis may be a variant of rosacea.

Rosacea is a long lasting and recurring inflammatory disorder that can cause face flushing, thickening skin, and acne symptoms. Perioral dermatitis is an inflammatory rash brought on by a specific cause that can be cured through treatment.

Sometimes perioral dermatitis can reoccur and develop into a chronic condition.

Will perioral dermatitis heal on its own?

Perioral dermatitis typically requires treatment from a doctor or dermatologist and doesn’t go away on its own.

What can be mistaken for perioral dermatitis?

Some conditions may cause symptoms similar to perioral dermatitis. These conditions include rosacea, bacterial or fungal infections, and seborrheic dermatitis. A doctor may consult tests to rule out these conditions.

Perioral dermatitis is a skin condition that causes pus-filled bumps around the mouth.

Treatment can include prescription medications, depending on the severity. A doctor may also recommend avoiding common triggers to prevent future reactions.

Treatment may help resolve perioral dermatitis, but in some cases, the condition can become chronic.