Perioral Dermatitis

Do you have a scaly or red, bumpy rash around your mouth?

If this is the case, you may have perioral dermatitis. Approximately 0.5 to 1 percent of people in developed countries are affected (source). Episodes of perioral dermatitis can last for several weeks and even months, and relapse is common. Fortunately, if you suffer from this skin condition, there are several options available to help alleviate your symptoms.

Read on to discover

What is perioral dermatitis?
Symptoms of perioral dermatitis?
Main causes and triggers of perioral dermatitis?
How does perioral dermatitis differ from other skin conditions?
How is perioral dermatitis diagnosed?
Is perioral dermatitis contagious?
What is the best perioral dermatitis treatment?
Living with perioral dermatitis?
Conclusion
Perioral dermatitis FAQs

What is perioral dermatitis?

Perioral dermatitis is a skin condition characterised by an inflammatory rash predominantly occurring around the mouth. While it can be experienced by anyone, it’s most commonly seen in women aged between 15 and 45. Sometimes, this rash may extend to the nose or even the skin surrounding the eyes, referred to as periorificial dermatitis. With the right care and attention, episodes of perioral dermatitis can be managed.

Just as with other forms of dermatitis, flare-ups can persist for several weeks or even longer, but understanding the condition and seeking timely treatment can lead to more comfortable and clearer skin.

Remember, you’re not alone in this, and relapses, while not uncommon, can be navigated with professional guidance.

Symptoms of perioral dermatitis?

Understanding the symptoms of perioral dermatitis is the first step towards addressing and managing the condition. Here’s what to look out for:

Red bumps or rash around the mouth: Individuals with perioral dermatitis often exhibit red, inflamed spots or red tiny bumps on skin surrounding the mouth.
Burning or itching sensation: Affected areas might give itchy skin or give off a mild burning sensation, causing discomfort.
Rash in the nose folds and around eyes: Another common region impacted by perioral dermatitis is the skin around the nose and eyes, where reddish bumps may appear with a slight itch — a presentation that can sometimes resemble eczema.
Fluid or pus-filled bumps: In some instances, the bumps may contain clear fluid or pus, indicating inflammation.
Extension to forehead or under the chin: While less common, symptoms can also appear on the forehead or beneath the chin, where they appear as similar red spots or rashes on the face.

It’s important to remember that these symptoms can vary from person to person. With the right care and timely intervention, many find relief and see improvements in their skin. If you recognize any of these signs, seeking guidance from a healthcare professional can help pave the way to healthier, more comfortable skin.

Source: American Academy of Dermatology Association

Main causes and triggers of perioral dermatitis

Although the exact cause of perioral dermatitis is unclear, there are certain factors that increase the risk of developing this skin condition. These are:

The use of steroid medication: People who use topical steroid creams on their face or inhaled steroids can be more likely to develop perioral dermatitis.
Harsh cleansers and cosmetics: Make-up, facial cleansers, and skincare with strong perfumes or chemicals may irritate the skin.
Environmental factors: Cold, windy weather and strong sunlight (UV light) can make you more prone to developing perioral dermatitis.
Fluoridated products: Toothpaste and chewing gum containing fluoride can sometimes set off perioral dermatitis. (Source)
Bacteria and fungus: Bacteria and yeast that live on the skin and in the hair are a potential cause of perioral dermatitis.
Contraceptive pills: Oral contraceptive pills, known more commonly as birth control pills, can be responsible for outbreaks of perioral dermatitis in some women.

How does perioral dermatitis differ from other skin conditions?

Perioral dermatitis is often confused with other skin conditions such as acne, rosacea and seborrhoeic dermatitis. Here are some differences:

Acne: usually includes blackheads or whiteheads, which perioral dermatitis does not. Acne can appear anywhere on the face, chest, or back, whereas perioral dermatitis mainly affects the mouth and nose.
Rosacea: often involves flushing, visible blood vessels, and redness across the cheeks and nose. Perioral dermatitis tends to cause more clustered bumps.
Seborrhoeic dermatitis: causes flaky, greasy patches, often around the eyebrows, scalp, or sides of the nose. Perioral dermatitis usually looks bumpier and is less greasy.

This distinction can help explain why treatments for acne or rosacea do not always improve perioral dermatitis, and may even make it worse.

Diagnosing perioral dermatitis:

Proper diagnosis of problematic skin conditions is key for effective treatment. If you suspect you have perioral dermatitis, your diagnosis journey might look like this:

Skin examination by a healthcare professional: Your primary healthcare provider or a dermatologist will initiate a thorough examination of the affected skin areas.

Discussion of medical history: Delving into your medical history provides insights that can help in diagnosing the condition accurately.

Skin culture test: In instances where clarity is needed, your GP might opt for a skin culture test. This pain-free procedure involves swabbing a small section of the impacted skin, which is then sent to a lab for detailed analysis.

Possible skin biopsy: If your skin remains unresponsive to typical perioral dermatitis treatments, a skin biopsy might be recommended to get a clearer picture.

Seeking early professional guidance ensures the best approach to manage and alleviate symptoms.

Is perioral dermatitis contagious?

Perioral dermatitis is not contagious. This means it cannot be spread from one person to another through touch, sharing personal items, or close contact. The red bumps and rashes associated with this condition are a result of inflammation and not due to any infectious agent that can be transmitted.

What is the best perioral dermatitis treatment?

There are several treatments available for perioral dermatitis depending on the severity of your symptoms, which areas of the body are affected and how often you experience relapses.

Here are some examples:

Over-the-counter treatments

Ask your pharmacist about over-the-counter treatments that you can try to reduce your symptoms and lessen the number of perioral dermatitis outbreaks.

Gentle skincare products

To help your skin heal from perioral dermatitis, choose products for sensitive skin. You can read our guide on skincare for sensitive skin here. Try the Itch Relief Gel to soothe itching or the Dermatitis Cream to calm your skin.

If you wear makeup, it can be a good idea to look for fragrance-free, light products that are less likely to irritate the skin. Avoid any makeup products that contain harsh chemicals or strong scents.

Lifestyle changes

As well as medications, lifestyle and diet changes can be highly effective in the management of perioral dermatitis.

Some of the most effective diet and lifestyle changes for treating mild perioral dermatitis include:

Limiting spicy and salty foods: These foods can irritate the skin around the mouth.
Gentle cleansing: Over-washing or scrubbing the face can irritate the skin. Stick to mild cleansers such as Face Foaming Cleanser and lukewarm water.
Cosmetic care: Avoid heavy makeup, especially products that are oil-based and always remove makeup before bed.
Sun protection: Wear sunscreen daily. Sun exposure can exacerbate skin conditions, including perioral dermatitis.
Reducing stress: Chronic stress can be a trigger for many skin conditions. Try incorporating relaxation techniques like meditation, yoga, or deep breathing exercises into your routine.
Dietary awareness: Some people find that certain foods exacerbate their symptoms. Maintaining a balanced diet and being aware of any potential food triggers can be beneficial.
Avoiding fluoridated toothpaste: In some cases, toothpaste containing fluoride might exacerbate perioral dermatitis. Ask your pharmacist or dentist for advice on alternative options if you think this is a potential trigger for you.
Maintaining good hygiene: Regularly clean items that come into contact with your face, like phone screens, pillowcases, and makeup brushes.
Hydration: Drinking plenty of water can help maintain skin health and reduce the risk of flare-ups.
Limit hormonal medications: If possible and in consultation with your doctor, consider limiting the use of oral contraceptives or hormone therapies that might trigger the condition.

Prescription medications

If you have severe perioral dermatitis or you have not had success using a perioral dermatitis over the counter treatment, then you can ask your GP about prescription medications.

Living with perioral dermatitis

Living with perioral dermatitis presents both emotional and physical challenges. Physically, the itching and occasional burning sensations are not just surface-level disturbances; they can impact everyday tasks, making routines like face-washing or makeup application tricky

Emotionally, the prominence of red, inflamed bumps, especially on the face, can weigh on one’s self-esteem. This, combined with the trial-and-error nature of finding effective treatments, can lead to feelings of frustration. If you are struggling with your self-esteem due to perioral dermatitis, it can be helpful to join an online forum created for people living with this condition or read blogs written by people with perioral dermatitis.

Conclusion

Perioral dermatitis, while challenging, is a condition that many face. By understanding its symptoms, causes, and triggers, you can take proactive measures to manage flare-ups and improve your quality of life. By seeking professional guidance, making informed lifestyle changes, and connecting with a supportive community, living with perioral dermatitis becomes more manageable.

Perioral dermatitis FAQs

What triggers perioral dermatitis?

Perioral dermatitis is often triggered by both topical and inhaled steroids. Flare-ups can also occur due to the application of make-up or the use of heavy moisturisers. Other triggers can be fluoride, sun creams and the use of hormonal birth control.

How do you get rid of perioral dermatitis?

There are several treatments for perioral dermatitis, including topical creams, antibiotics and lifestyle changes, such as not wearing make-up during flare-ups and using gentle skincare products.

What is the fastest way to cure perioral dermatitis?

The fastest way to treat perioral dermatitis is usually with antibiotics. Consult with a dermatologist or doctor for further advice.

What foods trigger perioral dermatitis?

Although there are no foods that trigger perioral dermatitis outbreaks, there are certain types of foods and drinks that can exacerbate your symptoms, including spicy foods, salty foods, hot drinks, alcohol, dairy products, tomatoes and citrus fruits.

Does perioral dermatitis go away by itself?

Perioral dermatitis can sometimes go away on its own, especially if the cause of your flare-up is the use of steroid creams and you stop using these.

How long does a perioral dermatitis flare-up last?

The length of an episode of perioral dermatitis can vary from person to person. Some people notice that their symptoms go away in as little as a week, whereas others can be affected for several months.

To reduce the duration of perioral dermatitis flare-ups, it is often a case of trial and error to see which treatment works best for you. See your GP to create a bespoke treatment plan.

Does moisturiser help perioral dermatitis?

Moisturisers can help to treat perioral dermatitis as long as you pick the right ones. Look for a perioral dermatitis cream that is gentle on the skin. Avoid moisturisers that contain harsh chemicals and ones that are scented. You should not use steroid creams as these can make the symptoms of perioral dermatitis worse.