Toothpaste and Oral Care Tips for Perioral Dermatitis

What is Perioral Dermatitis?

Perioral dermatitis is a common facial skin condition that causes a red, bumpy rash to develop around the mouth. The rash typically occurs around the nasolabial folds, eyes, and chin, though other facial areas can also be affected in some people.

Symptoms of Perioral Dermatitis

The signature symptom of perioral dermatitis is a red or pink bumpy facial rash occurring in the regions around the mouth. Additional symptoms may include:

• Itchy, scaly, dry skin patches
• Burning or stinging sensations
• Peeling skin
• Pimple-like papules or pustules

In most cases, symptoms come on gradually over days to weeks. Flare ups are common, with periods of symptomatic skin interspersed by periods of clear skin.

Causes and Risk Factors for Perioral Dermatitis

While doctors don’t know the exact cause of perioral dermatitis, various triggers likely interact to spur its development, such as:

• Usage of topical steroid creams on the face
• Heavy face creams and ointments
• Fluoridated toothpastes
• Makeup products
• Moisturizers with harsh chemicals
• Weather extremes
• Stress
• Hormonal changes

Women ages 16 to 45 make up around half of perioral dermatitis cases. Individuals with other rash-producing conditions like eczema or rosacea also have a heightened risk.

Getting a Perioral Dermatitis Diagnosis

Seeing a Dermatologist

Only a dermatologist can provide an official clinical diagnosis of perioral dermatitis. During an initial appointment, the dermatologist will:

• Review your full medical history
• Examine your current facial skin condition
• Ask follow up questions about specific symptoms
• Rule out other potential causes like contact dermatitis or fungal infections

From there, they can definitively diagnose perioral dermatitis and outline an appropriate treatment plan.

When to See a Doctor

Schedule an appointment with a dermatologist promptly if you have any sort of persistent red, bumpy facial rash. Key times to seek medical care include:

• Facial rash lasts longer than 2 weeks
• Over-the-counter treatments haven’t improved the rash
• Symptoms are widespread or getting rapidly worse
• Facial skin is cracked, bleeding or excessively painful
• Rash is accompanied by fever or flu-like symptoms

Catching perioral dermatitis early makes it easier to treat and helps prevent complications like skin infections from scratching. So don’t delay on making a dermatology appointment.

Medical Tests and Procedures

Sometimes a skin biopsy or culture may be performed to confirm perioral dermatitis or rule out other problems like fungal infections. These tests involve:

• Skin biopsy: Extracting a small skin sample to examine under a microscope
• Skin culture: Taking a skin swab to identify any abnormal bacteria or fungi

Outside of clinical exam and questioning, most patients won’t require invasive tests for an accurate perioral dermatitis diagnosis.

Perioral Dermatitis Treatment Guidelines

The Main Treatment Steps

Resolving perioral dermatitis requires working with your dermatologist on tailored therapies while also removing triggers from your daily personal care and lifestyle habits.

The gold standard perioral dermatitis treatment guidelines focus on:

1. Discontinuing usage of fluoridated toothpastes or potential irritant skin/hair products
2. Avoiding heavy creams or ointments on the face
3. Initiating antibiotic therapy, typically oral minocycline or doxycycline for 2-3 months
4. Applying only gentle, non-comedogenic moisturizers and cleansers
5. Using mild topical steroid creams on occasion for symptom flares
6. Continuing antibiotics even once symptoms resolve to prevent recurrence

Lifestyle Changes to Aid Healing

You can also take proactive at-home steps to help clear perioral dermatitis faster and prevent future flare ups:

• Wash with gentle, fragrance-free cleansers only 1-2 times per day
• Avoid wearing heavy makeup or using fragranced skin products
• Use toothpaste for perioral dermatitis instead of regular toothpastes
• Apply protective sunscreens when spending time outdoors
• Take measures to reduce stress levels where possible

Supplemental and Natural Treatment Options

For people hesitant about taking oral antibiotics long term, some alternative therapies to discuss with your doctor include:

• Probiotics to counteract gut microbiome disruption from antibiotics
• Zinc, nicotinamide (vitamin B3), and other nutritional supplements
• Photodynamic light therapy applied directly to affected areas
• Azelaic acid cream, metronidazole cream, or other topical treatments

Special Considerations for Toothpaste and Oral Care

The Impact of Toothpaste on Perioral Dermatitis

Most regular toothpastes contain fluoride added for cavity prevention and sodium lauryl sulfate (SLS) as a foaming agent. However, evidence suggests fluoride and SLS may provoke or worsen perioral dermatitis for some people when applied directly onto lips or facial skin repeatedly over time.

Choosing a Perioral Dermatitis Friendly Toothpaste

To minimize triggers, opt for specialized toothpaste for perioral dermatitis that leaves out known irritants. When shopping for toothpaste, look for ones clearly labeled as:

• Fluoride-free
• SLS-free
• Allergen-free
• Fragrance-free

These types of specially formulated toothpastes are gentle for use in conditions like perioral dermatitis, rosacea, eczema, or general sensitive skin. Common brands to try include Tom's of Maine Perioral Dermatitis Toothpaste, Hello Sensitivity Relief Toothpaste, and Squigle Enamel Saver Toothpaste.

Other Oral Health Considerations

In addition to swapping out regular toothpaste, also avoid alcohol-containing mouthwashes during a perioral dermatitis flare up. Use extra caution when removing your toothbrush across facial areas to limit irritation.

And never attempt to pop, drain or pick at papules around the mouth. Doing so will impede healing and raise infection risks.

Outlook for Perioral Dermatitis Treatment and Healing

When addressed early with topical steroid withdrawal and oral antibiotics, perioral dermatitis often resolves within several weeks to months for most patients.

However, without proper treatment, flare ups tend to persist long term and may progress in severity. Relapse after an initial round of treatment also remains relatively common.

Following your full dermatologist-directed treatment plan including lifestyle adjustments gives you the highest odds of clearing symptoms more quickly while working to prevent recurrence down the road.

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.