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Perioral dermatitis

  • Definition
    • Perioral dermatitis is a skin disorder in which tiny red bumps form around the mouth and lower half of the face. It can look like acne or rosacea.

  • Alternative Names
    • Periorificial dermatitis

  • Causes
    • The exact cause of perioral dermatitis is unknown. It may occur after using face creams containing steroids for another condition.

      Young women are most likely to get this condition. This condition is also common in children.

      Periorificial dermatitis may be brought on by:

      • Topical steroids, either when they are applied to the face on purpose or by accident
      • Nasal steroids, steroid inhalers, and oral steroids
      • Cosmetic creams, make-ups and sunscreens
      • Fluorinated toothpaste
      • Failing to wash the face
      • Hormonal changes or oral contraceptives
  • Symptoms
    • Symptoms may include:

      • Burning feeling around the mouth
      • Bumps around the mouth that may be filled with fluid or pus
      • A similar rash may appear around the eyes, nose, or forehead

      The rash may be mistaken for acne. Itching is not common.

  • Exams and Tests
    • Your health care provider will examine your skin to diagnose the condition. You may need to have other tests to find out if it is due to a bacterial infection.

  • Treatment
    • Self-care you may want to try include:

      • Stop using all face creams, cosmetics, and sunscreen.
      • Wash your face with warm water only.
      • After the rash has cleared, ask your provider to recommend a non-soap bar or a liquid cleanser.

      DO NOT use any over-the-counter steroid creams to treat this condition. If you were taking steroid creams, your provider may tell you to stop the cream. They may also prescribe a less potent steroid cream and then slowly withdraw it.

      Treatment may include medicines placed on the skin such as:

      • Metronidazole
      • Erythromycin
      • Benzoyl peroxide
      • Tacrolimus
      • Clindamycin
      • Pimecrolimus
      • Sodium sulfacetamide with sulfur

      You may need to take antibiotic pills if the condition is severe. Antibiotics used to treat this condition include tetracycline, doxycycline, minocycline, or erythromycin.

      At times, treatment may be needed for up to 6 to 12 weeks.

  • Outlook (Prognosis)
    • Perioral dermatitis requires several months of treatment.

      Bumps often return. The rash is more likely to return if you apply skin creams that contain steroids.

  • When to Contact a Medical Professional
    • Call your provider if you notice red bumps around your mouth that do not go away.

  • Prevention
    • Avoid using skin creams containing steroids on your face, unless directed by your provider.

  • References
    • Habif TP. Acne, rosacea, and related disorders. In: Habif TP, ed. Clinical Dermatology. 6th ed. St Louis, MO: Elsevier Saunders; 2016:chap 7.

      James WD, Berger TG, Elston DM. Acne. In: James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 12th ed. Philadelphia, PA: Elsevier; 2016:chap 13.