Medically reviewed by Dr. A.M. van Coevorden, dermatologist
Perioral dermatitisBumps around the mouth with a surprising culprit.
Perioral dermatitis is a rash of small red bumps and light scaling around the mouth, with a narrow border directly along the lips staying clear. The condition mainly affects young women. The main trigger is, surprisingly, the use of corticosteroid cream on the face; rich cosmetics can also play a role. Treatment starts with stopping, and applying nothing for a number of weeks.
What is perioral dermatitis?
Small, red bumps appear around the mouth, sometimes with light scaling, while a narrow zone directly along the lip margin remains strikingly clear. The rash can extend to the folds beside the nose and sometimes around the eyes. The skin itches mildly and often feels burning and sensitive; soap, water and sunlight can irritate it further. The condition mainly affects young women and sometimes children, and can resemble acne or rosacea.
How does perioral dermatitis develop?
The precise cause is unknown, but the main trigger is clear: corticosteroid cream or ointment on the face. The product temporarily suppresses the rash while keeping it going at the same time, creating a vicious circle: after stopping, the rash first gets worse, which tempts people to start applying again. The stronger the corticosteroid, the higher the risk. Rich cosmetics such as foundation can also play a role, and sometimes there is no clear cause.
Do you use a corticosteroid inhaler for asthma? That too can trigger perioral dermatitis. Rinse your face and mouth with water after inhaling.
What can you do yourself?
Treatment starts with leaving things out: stop corticosteroid cream on the face and set aside make-up and rich creams. Apply nothing at all to the rash for a number of weeks and wash the face only with lukewarm water and, if needed, a mild, soap-free cleanser. This feels counterintuitive, but it is the core of the treatment: after removing the triggers, the rash usually clears by itself.
Please note
After stopping the corticosteroid cream, the rash first gets temporarily worse. That is normal and passes: do not start applying again, because that keeps the condition going.
When to see a dermatologist or doctor?
Have your skin assessed if you are unsure whether it is perioral dermatitis; the condition can resemble acne or rosacea, which need a different approach. An assessment is also wise if the rash does not improve after a few weeks of applying nothing, or if the symptoms are severe. The doctor can then prescribe a cream or gel with an anti-inflammatory antibiotic, or a course of antibiotic tablets for extensive symptoms. After healing, perioral dermatitis usually does not return.
Frequently asked questions
Why shouldn't I apply steroid cream to perioral dermatitis?
Because corticosteroid cream both causes the condition and temporarily suppresses it. As long as you apply it, things look better, but the rash persists and worsens after every attempt to stop. The only way out is stopping for good and sitting out the temporary worsening.
How long does perioral dermatitis last?
After stopping the triggers, the rash first gets worse for one to a few weeks, and then gradually clears. Count on weeks to a few months. With treatment via the doctor, recovery is often faster.
What is the difference with acne or rosacea?
Perioral dermatitis characteristically sits around the mouth, with a clear border directly along the lips, and consists of small, uniform bumps. Acne also causes blackheads and spreads across the face; rosacea sits mainly on the cheeks and nose with flushing. A dermatologist can tell the difference from the picture.
Can I wear make-up with perioral dermatitis?
Preferably not during treatment: rich and covering products such as foundation can trigger and maintain the condition. Keep the face as bare as possible for a number of weeks and then, if you wish, carefully rebuild with light, non-greasy products.
When should you see a dermatologist about perioral dermatitis?
If you are unsure about the diagnosis, if the rash does not improve after a few weeks of applying nothing, or if the symptoms are severe. The dermatologist confirms the picture and can prescribe an anti-inflammatory cream or a course of antibiotics.
Sources and more information
- Dermatitis perioralis (nvdv.nl)