Perioral Dermatitis

Perioral Dermatitis is a condition where an inflammatory rash occurs on the skin around the mouth.


Perioral dermatitis is a facial rash that is often seem among women between the ages of 16 to 45 years. Occurring around the mouth, the rash is red and slightly bumpy or scaly. The rash could be itchy and can sometimes also cause a burning sensation. A common facial problem characterized by groups of tender and itchy small red papules, perioral dermatitis is usually confined to the skin around the lower half of the face, especially around the mouth.

What are the different types of Perioral Dermatitis?

Apart from the typical perioral dermatitis, there is also granulomatous perioral dermatitis. Whilst granulomatous is not a type of perioral dermatitis, it is considered as an irregular version of the same. In granulomatous dermatitis, one would notice yellowish bumps instead of the usual red ones. Children are more prone to having granulomatous dermatitis than adults.

What are the symptoms of perioral dermatitis?

One of the first symptoms of perioral dermatitis is a red rash appearing around the mouth. This rash may be dry or flaky or scaly. More often than not, there are also inflamed bumps present called papules. While it is most common around the mouth, perioral dermatitis can also spread to the eyelids, around the eyes, and nose. It can also appear on the scalp, ears, neck, trunk, and genitals. The rash can cause a burning or itching sensation.

Which other skin conditions can mimic Perioral Dermatitis signs and symptoms?

Perioral dermatitis treatment is typically based on the nature and characteristics of the rash. Clinicians will often suggest a skin biopsy to rule out other skin diseases that are similar or resemble perioral dermatitis. These include the likes of Rosacea, Acne vulgaris, Seborrheic dermatitis, allergic contact dermatitis, irritant contact dermatitis, angular cheilitis.

What are the causes of Perioral Dermatitis?

A clear cause for perioral dermatitis has not yet been identified. However, doctors and experts have seen a connection between perioral dermatitis and the use of topical corticosteroids as well as bacterial and viral infections. Other aggravating factors include the use of occlusive topical cosmetic products (paraffin, foundation creams, or sunscreens), microbiologic factors, contact allergens, or tartar-control products. Other hormonal factors can lead to the worsening of perioral dermatitis in women, especially during pregnancy, the premenstrual period, or when they are taking oral contraceptives.

How is Perioral Dermatitis diagnosed?

One of the first steps in perioral dermatitis treatment is diagnosing it. Doctors or experts diagnose perioral dermatitis primarily based on the appearance of the skin. At other times, doctors may do a skin culture test to check for bacterial and to ensure that there is no infection. In other rare cases, doctors may opt for a skin biopsy where they take a little bit of the affected skin for testing. This is a part of the perioral dermatitis treatment that is usually carried out when other forms of treatment have not been effective.

How can Perioral Dermatitis be prevented?

Whilst there have been advancements in perioral dermatitis treatment(s), the most burning question is around how it can be prevented in the first place. One must avoid face creams and topical steroids. It is also advised to visit a healthcare provider as soon as the symptoms are noticed.

Once treated, individuals must only use a fragrance-free mild soap or a soap substitute to wash and must avoid using products that were used before the rash.

Though there are no known foods or medicines that can prevent the occurrence of perioral dermatitis, one must at any cost avoid topical steroids as they are one of the most likely causes of the rash.

How can Perioral Dermatitis be treated?

One of the first steps of perioral dermatitis treatment is to stop using nasal sprays containing steroids or topical steroid creams. These products can aggravate the symptoms making the condition even worse. For individuals witnessing the symptoms, it is of paramount importance to visit a doctor or to undertake the perioral dermatitis treatment online.

More than often the severity of the condition dictates the perioral dermatitis treatment that is recommended. In the earlier stages of the condition, patients would be advised to discontinue using their earlier skin creams and fluorinated toothpaste to ease the symptoms.

Other treatments could include the likes of variations in diet and lifestyle. Patients suffering from the condition can consider:

  • Avoid using perfumed cleansers and harsh face scrubs
  • At all costs, do not use steroid creams, even the non-prescriptive hydrocortisone
  • Reduce the usage of makeup, cosmetics, and sunscreens.
  • Wash pillow covers and towels with hot water regularly
  • Limit the intake of salty and spicy food items

Apart from dietary and lifestyle changes, patients can also be prescribed medicines to treat the condition. These include:

  • Erythromycin or Metronidazole or other topical antibiotic medications
  • Tacrolimus cream or other immunosuppressive creams
  • Azelaic acid or adapalene or other topical acne medications
  • Isotretinoin, minocycline or doxycycline, or other oral antibiotics for more severe cases

When to see a dermatologist?

More than often, individuals having perioral dermatitis do not consult with the dermatologist until the condition has progressed. Visiting a dermatologist early can help identify the underlying cause of the perioral dermatitis and initiate proper treatment. Normally you should expect the dermatologists to treat the condition within 6-weeks to 12-weeks.

The recurrence of perioral dermatitis is not uncommon, especially if the time frame of systemic therapy is not sufficient. With adequate perioral dermatitis treatment, patients should have an excellent prognosis, but if left untreated, the disease can linger on for months or years. If left untreated, perioral dermatitis can be burdensome of the patient’s mental health and permanent scarring.

How can an online dermatologist help treat Perioral Dermatitis?

Treatment of perioral dermatitis with oral or topical antibiotics together with eliminating any underlying causes such as topical steroid use is often sufficient to heal the condition. It is also worth to mention that perioral dermatitis treatment online is an efficient and effective alternative to a physical consultation. During online perioral dermatitis treatment, the patient will upload pictures of their condition and list down information around the symptoms and irritations they are experiencing. A dermatologist will review the picture and text information for the condition and respond with a diagnosis and available treatment options for the patient.

How to prepare for your Perioral Dermatitis appointment?

An appointment with a dermatologist is the first step towards perioral dermatitis treatment. It is advised that the patient consults with a dermatologist as soon as he/she notices any symptoms for early diagnosis and treatment. The patient should be vocal about any medication or other substance use and the use of cosmetics such as creams and makeup. The dermatologist could have follow up questions such as materials one uses to wipe their face and other substances that could have come in contact with the skin. This will help the dermatologist analyze and eliminate the root cause for perioral dermatitis and initiate proper treatment.


  • Is Perioral Dermatitis contagious?

Perioral dermatitis is a common form of a rash that is not contagious.

  • What do you need to eliminate from your diet to improve the condition?

Intolerance of gluten or an undiagnosed allergy can be one of the main triggers for perioral dermatitis. Moving to a low-carb gluten-free diet can help stop the condition from getting worse. Additionally, one should look at avoiding salty and spicy meals while suffering from the condition.

  • Does the sun make Perioral Dermatitis worse?

While there is no concrete evidence, some people have noted that their perioral dermatitis condition gets worse when exposed to sunlight.

  • Can perioral dermatitis be caused by hormones?

While perioral dermatitis is not caused by hormones, numerous hormonal factors could contribute to the worsening of the condition, especially during pregnancy, during their premenstrual period and/or due to use of contraceptives.

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