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 that case, it’s referred to as periorificial dermatitis.

Perioral dermatitis usually appears as a scaly or red bumpy rash. In darker skin, the lesions may be hyperpigmented or brown.

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

The condition is most common in women between 20 and 45 years old, but it can be seen in all ages, races, and ethnicities. It can occur in children of any age.

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

perioral dermatitis on a young boy with lighter skinShare on Pinterest
Perioral dermatitis is a rash around the mouth, nose, and eyes. It presents as papules that can be itchy and accompanied by burning or tenderness. Photo by DermNet New Zealand
perioral dermatitis on a man with darker skinShare on Pinterest
Most cases resolve on their own, but topical or oral antibiotics can treat perioral dermatitis if needed. Photo by DermNet New Zealand

Perioral dermatitis usually appears as a rash of red 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. They may resemble acne.

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

Perioral dermatitis vs. rosacea

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

Periorial dermatitis is not contagious. It can be caused by long-term use of:

  • topical steroid creams
  • some inhaled asthma medications
  • heavy moisturizers or sunscreens

It cannot be spread from person to person.

How to cure

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 are likely responsible for the symptoms in the first place.

But it is 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.

However, it’s important to speak with a doctor before discontinuing any medications. If you’re concerned about your condition and don’t already have a dermatologist, you can view dermatologists in your area through the Healthline FindCare tool.

A doctor or dermatologist will determine your treatment based 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 speed healing.

Prescription medications

Medications a doctor or dermatologist may prescribe to treat your condition include:

  • immunosuppressive creams and ointments, such as pimecrolimus (Elidel) or tacrolimus (Protopic)
  • topical ivermectin
  • topical antibiotics, such as metronidazole (Metrogel, Noritate) and erythromycin (Erygel)
  • oral antibiotics, such as:
    • doxycycline (Monodox, Vibramycin)
    • tetracycline (Achromycin V)
    • minocycline (Minocin, Dynacin)
    • isotretinoin (Amnesteen, Claravis, Myorisan)

Oral antibiotics are prescribed for more severe cases.

Diet and lifestyle changes

Part of treating perioral dermatitis is incorporating lifestyle changes that can help prevent it from returning. Consider the following:

  • Get rid of harsh face scrubs or perfumed cleansers. Instead, use only warm water during flare-ups. Once healed, only use mild soap and don’t scrub your skin.
  • Avoid steroid creams, even nonprescription hydrocortisone.
  • Stop using or reduce your use of makeup and cosmetics.
  • Frequently wash your pillowcases and towels in hot water.
  • Limit overly salty or spicy foods. They can irritate 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 avoiding the triggers — whether corticosteroids, inhaled steroids, or other personal care products — can help.

The cause of perioral dermatitis is unknown. However, experts suggest it can occur after the use of strong topical steroids, which may be prescribed to treat another condition.

Nasal sprays containing corticosteroids may also cause perioral dermatitis, as can inhaled steroids.

Certain ingredients in cosmetics or personal care products may cause perioral dermatitis, too. Heavy skin creams that contain petroleum jelly or a paraffin base may cause or worsen this condition.

Other common culprits include fluoride and sodium lauryl sulfate (SLS).

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

Risk factors include:

  • sex assigned at birth, as women are more likely to develop this condition than men
  • age, with young and middle-aged adults most likely to be affected
  • using steroid creams or ointments on the face
  • having a history of allergies
  • having hormonal imbalances

A doctor or dermatologist will often diagnose perioral dermatitis with just a visual examination of your skin, along with your medical history.

The doctor or dermatologist 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. They’ll send the sample to a laboratory to test the skin cells for bacteria or fungi.

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

There are several common triggers that can result in a perioral dermatitis outbreak. These should be avoided as much as possible.

These triggers can include:

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 your 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 the doctor or dermatologist which moisturizers are acceptable to use. Try switching brands if you decide to continue using cosmetics.

Switch to gentle cleansers and moisturizers. Ask your doctor or dermatologist for recommendations that would best suit your skin.

Protect your skin

Limit the amount of time your skin comes into contact with the elements. The sun’s ultraviolet (UV) 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.

What flares up perioral dermatitis?

Flare-ups of perioral dermatitis can be caused by topical and inhaled steroids, cosmetics, and heavy moisturizers. 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.

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 periorial dermatitis and rosacea can involve small acne-like pustules and redness. 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. Periorial dermatitis is an inflammatory rash brought on by a specific cause that can be cured through treatment.

However, sometimes perioral dermatitis can recur and develop into a chronic condition.