What is Perioral Dermatitis? Symptoms, Causes and Treatments

Understanding Perioral Dermatitis

Perioral dermatitis refers to a facial rash occurring around the mouth, chin, and nasal regions. The flaky, bumpy red skin eruption often symmetrically surrounds the lip and nose areas in a sharp border.

Common Signs and Symptoms

Hallmark perioral dermatitis symptoms include:

• Red, raised rash around the mouth and nostrils
• Small red bumps or pus-filled pimples
• Pink, flaky, scaly, itchy skin
• A distinct border marking where the rash stops
• Mild burning or stinging sensations

Symptoms range from mild to severe based on the outbreak severity. Flare ups may come and go over time.

Who Gets Perioral Dermatitis?

While anyone can develop perioral rashes, they most often affect:

• Women from ages 16 to 45
• People with past atopic dermatitis or rosacea
• Individuals with oily skin or frequent acne
• Those using strong topical steroids on the face

Common Triggers and Causes

Doctors dont know exactly what causes perioral dermatitis rashes, but potential contributing factors include:

• Use of topical corticosteroids on the face
• Heavy cosmetics, moisturizers, or skin care products
• Fluoridated toothpastes near the mouth
• Saliva or drool irritating skin near mouth
• Sun exposure which damages facial skin
• Hormonal changes
• Stress
• Poor diet

Diagnosing Perioral Dermatitis

Doctors can often recognize perioral dermatitis just by the characteristic rash appearance and location around the mouth and nasal folds. However, they may perform additional tests to confirm the diagnosis and rule out conditions like:

• Allergic contact dermatitis
• Rosacea
• Seborrheic dermatitis
• Psoriasis
• Impetigo

Skin patch testing identifies potential allergies triggering rashes. Examining skin scrapings under a microscope checks for other issues like fungal infections.

Treating Perioral Dermatitis Effectively

With the right treatment plan, perioral dermatitis often clears up within a few weeks to months.

Topical Treatments

Mild cases may respond to over-the-counter hydrocortisone creams applied sparingly around the mouth temporarily to relieve itching and redness.

For moderate or severe rashes, doctors may prescribe topical antibiotics like metronidazole cream. Azelaic acid, sulfur preparations, and pimecrolimus also combat inflammation.

Oral Antibiotics

For widespread facial involvement, oral erythromycin or doxycycline often successfully treat perioral dermatitis and prevent recurrence.

Oral antibiotics treat underlying bacterial overgrowth while reducing overall facial inflammation. Normally a 4-8 week course clears most cases.

Lifestyle Measures

Making certain lifestyle adjustments also aids perioral dermatitis healing and stops repeated flares:

• Avoid skin irritants - Discontinue use of fluoride toothpastes or heavy face creams.
• Gentle skin care - Use only mild cleansers and non-comedogenic moisturizers for sensitive skin.
• Watch toothpaste - Rinse mouth thoroughly after brushing and avoid toothpaste contact with skin.
• Sun protection - Wear broad-spectrum SPF 30+ sunscreen on face whenever outside.
• Stress reduction - Make time for relaxing activities to lower stress aggravating rashes.
• Healthy diet - Eat a balanced anti-inflammatory diet with lots of plants and omega-3s.

Treatment Considerations

During perioral dermatitis treatment, patients should:

• Avoid reusing old corticosteroid creams which can worsen rashes
• Expect possible initial flare up from antibiotic creams before improvement
• Not pick at scabs or crusts which slows healing
• Follow prescription directions closely for optimal results

With the right dermatologist monitored regimen, most achieve full clearance within 1-3 months.

Preventing Recurrent Perioral Rashes

Even after successful treatment, perioral dermatitis carries a high risk of recurrence. Preventative measures help stop repeated flare ups.

Avoid Triggers

Eliminating potential periorial dermatitis triggers reduces risks of repeat episodes. This may mean:

• Switching to SLS-free toothpaste
• Not using corticosteroid cream on the face
• Minimizing greasy ointments or makeup near mouth
• Opting for oil-free, fragrance-free skincare
• Wearing face sunscreen whenever outside

Gentle Daily Cleansing

Gently wash the face just once or twice daily using lukewarm water and a mild, sulfate-free cleanser. Rinse soap away thoroughly and pat skin dry before applying moisturizer.

Watch for Early Signs

Check facial skin near the mouth regularly for early symptoms like redness, flaking, bumps or pimples. Starting treatment promptly often limits severity and duration of perioral dermatitis outbreaks.

Keep Follow-Up Appointments

See your dermatologist as recommended to monitor skin condition even after rash resolution. They can provide prescription-strength preventatives before visible symptoms start if needed.

With diligent avoidance of triggers and irritation, many successfully control recurrent perioral dermatitis through simple lifestyle measures and early intervention when necessary.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.