Perioral Dermatitis

Perioral dermatitis is a common facial rash consisting of small inflamed papules (bumps) and sometimes tiny vesicles (water filled blisters) or pus spots, which are often clustered around your mouth, base of your nose and your chin. Although perioral dermatitis has similar symptoms to other inflammatory conditions, you won’t see comedones (whiteheads and blackheads), cysts (boil-like lesions), or scarring as you would if you have acne, nor will you see the typical flushing of rosacea. There may be some background redness on your chin and upper lip, especially if you have used steroid creams. You may sometimes feel an itchy or stinging sensation. People can get this any time between their mid-teens and menopause, but it occurs most often to women in their 20s. Occasionally men will get it, most often on their eyelids. Although not always recognized, it is seen quite frequently in children. It usually lasts for months, if not years (up to 2-3 years) and may recur.

Common symptoms of perioral dermatitis include:

  • Burning sensation around the mouth
  • Small red pustules around the mouth, occasionally on the eyelids

The cause is not known. Steroid creams can certainly produce, as well as aggravate this condition. There have been reports about toothpastes causing this, especially the anti-tartar and fluorinated types. No infectious agents have been found to be responsible. Hormones may play a role. Cosmetics and moisturizers may worsen the rash. Some experts believe perioral dermatitis may be related to rosacea.

When caring for skin affected by perioral dermatitis, it’s important to use gentle skin-care products to avoid irritation. Use oil-free cleansers and cosmetics. Do not use moisturizing products as these can make the rash worse.

Avoid using steroid creams or lotions on the face. These can cause the condition to worsen or recur.

Prescription
A doctor may prescribe topical medications, such as metronidazole gels or creams to treat perioral dermatitis. In more severe or unresponsive cases, oral antibiotics such as tetracycline, doxycycline, minocycline, or erythromycin may be needed.

  • Oral Antibiotics
  • Topical Metronidazole