Last reviewed by Editorial Team on August 13th, 2018.
What is Perioral Dermatitis?
Breaking down this word perioral means “around your mouth” and dermatitis means “inflammation of your skin”. Putting them together means inflammation around your mouth but occasionally you will see a similar rash around your nose and eyes and on your forehead. In ninety percent of the cases of perioral dermatitis it affects women between the ages of twenty and forty-five but men can also get it. It is also common in children. Many times once you have this medical condition you will have it again. Some dermatologists feel that perioral dermatitis is a form of seborrheic dermatitis, adult acne, or rosacea and is not contagious.
Symptoms of Perioral Dermatitis
Perioral dermatitis can be asymptomatic, which means having no symptoms, or they can have the following symptoms:
- Most who have it will have a rash of red bumps around your mouth. You may also have these red bumps in the folds around your nose. They can also appear on your forehead, your chin, and the area under your eyes.
- These small bumps will usually be filled with fluids or pus and can resemble a combination of acne and eczema.
- The small bumps are usually no larger than one to two millimeters in size
- Although it is uncommon you can also have a burning feeling and itching.
- These bumps can also make your skin feel stretched or tight around your mouth.
- Your skin can also look dry, scaly, and rough
In chronic cases there is a chance that it can scar your skin.
The precise cause of perioral dermatitis is not known but there are several triggers that may cause it to occur. Some of these triggers include:
- Overusing topical corticosteroids – this medication is often prescribed to treat eczema, rashes, or dermatitis. In some cases when you stop using topical corticosteroids it will become worse and will establish a cycle of overuse and then having an outbreak of perioral dermatitis. Even if you are using a topical steroid elsewhere on your body it is possible to transfer it to the delicate skin around your mouth if you forget to wash your hands and touch this area with your fingers after putting on topical steroid.
- Using dental products that contain fluoride especially if you are sensitive to fluoride.
- The type of makeup and moisturizers you are using could irritate the delicate skin around your mouth, nose, and eyes. Dermatologist feels that the main culprit is using skincare products that have a paraffin or petrolatum base.
- Hormonal fluctuation
- Oral contraceptives
- Fungal or bacterial infections
- Using sunscreen
- Using face creams that contain steroids
- Inhaled steroids that you were given to treat respiratory illnesses
Which is the best treatment for your outbreak of perioral dermatitis will depend on what is causing the outbreak and how severe your condition is. If the condition is caused by using fluoride toothpaste, certain makeup and moisturizers, or using topical steroid creams, you should discontinue using them. You should also care of your skin by washing it correctly. Avoid factors that seem to worsen the issue like stress, heat, or wind.
When treating perioral dermatitis you may need to use the treatments for several months in order to completely clear up the rash and small red bumps. It is not uncommon for perioral dermatitis to come back after treatment making it necessary to take another course of antibiotics. Some of the common treatments for perioral dermatitis can include:
- Using oral antibiotics like minocycline, doxycycline or tetracycline when it is a severe breakout. It can take a month and half to three months for these oral antibiotics to reduce the inflammation.
- For mild cases you may be prescribed an antibiotic cream to use on the skin around your mouth or wherever else the outbreak is occurring
- You may be told to also use anti-acne creams
- Using non-topical steroid creams such as erythromycin, tacrolimus, pimecrolimus, or metronidazole. These creams will give relief to your skin but they have to be applied regularly for many months in order to prevent it from coming back.
You should always make sure that the area is kept clean by washing the area with plain warm water when you have the red bumps. Once you see the breakout starting to clear up you can start to use a cleanser on your face that is soap-free. In some of the worse cases it can cause disfigurement and you may need to have laser or surgical treatment to help make the scars less noticeable.
When a person has perioral dermatitis sometimes eating spicy or hot foods can make it worse because this type of foods dilate your blood vessels and increase the inflammation in your skin. This can make the inflamed red pimples worse. Other foods that may also cause this same reaction are yogurt, citrus fruits, sour cream, cinnamon, spices, hot sauce, and vinegar. You should also make sure that you are following a diet that is rich in vitamins B12, A, and E. Vitamin B12 helps to strengthen your skin’s protective barrier to help prevent further irritation and damage. Vitamin A helps with the regeneration of new skin cells. Vitamin E will help to reduce the inflammation in your skin and helps to protect your skin cells from further damage.
You should also try to follow a diet that is free of additives and low in amines, artificial ingredients, and salicylates. These compounds can start an eruption of these small red bumps of perioral dermatitis or make them worse if you already have this medical condition. If you follow this type of diet for two to four weeks it will help to reduce these small red bumps. To boost your immune system you should make sure that you are getting enough vitamin C and Probiotics.