Learning About Perioral Dermatitis

Perioral dermatitis is an itchy rash that appears around the mouth. It may also spread to the nose and eyes. Anyone can get it, but it's most common in young women. Talk to your doctor if you have questions about your risk.

Experts aren't sure what causes perioral dermatitis. It may be triggered by something that irritates your skin. Or you may be allergic to something that has touched your skin.

It's often caused by applying corticosteroid medicine to the skin around the mouth for too long.

Other possible causes include:

• Inhaled or nasal corticosteroids.
• Toothpaste with fluoride.
• Chewing gum.
• Dental materials, such as those used in fillings, for treating tooth problems.
• Cosmetics.
• Sunscreens.
• Face mask use.
• A poorly fitted continuous positive airway pressure (CPAP) mask.

Your body's hormones may also play a role.

Perioral dermatitis appears on the skin around the mouth. Symptoms include:

• Red spots on light skin or dark spots on skin of color.
• Itching or burning in the affected areas.
• Tiny inflamed bumps (papules).
• Pus-filled bumps (pustules) that may look like acne.
• Colored, scaly patches.
• Dry, flaky skin.

Your doctor can usually diagnose perioral dermatitis just by asking about your symptoms and looking at your skin. In some cases, your doctor may do a biopsy. This is taking a small sample of the affected skin and sending it to a lab for a closer look.

Since perioral dermatitis is usually caused by overusing corticosteroids, such as hydrocortisone cream, you'll have to stop using them. But stopping too quickly can make the rash flare up again. This is called rebound flaring. It can be tempting to go back to using corticosteroids to deal with the flareup, but this will only make the rash worse. So your doctor may tell you to stop using them little by little over time. If the medicine was prescribed by a doctor, check with that doctor before you change how you use it.

You may be asked to stop using other products that have triggered your rash. These may include toothpaste with fluoride, makeup, and other skincare products.

Your doctor may prescribe medicine to apply to the rash. Options include:

• Clindamycin lotion or gel.
• Erythromycin gel.
• Topical sulfur preparations.
• Azelaic acid gel.

If your rash is severe or hard to treat, your doctor may also prescribe antibiotics. These will be taken by mouth at the same times every day. If your doctor prescribes antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Even with medicine, the rash will clear slowly. It may take from a few weeks to a few months to recover completely.