Perioral Dermatitis

What is perioral dermatitis?
Perioral dermatitis is a common skin problem that mostly affects young women. Occasionally men or children are affected. Perioral refers to the area around the mouth, and dermatitis indicates redness of the skin. In addition to redness, there are usually small red bumps or pus bumps, and mild peeling. Sometimes the bumps are the most obvious feature, and the disease can look a lot like acne. The areas most affected are within the borders of the lines from the nose, to the sides of the lips, and the chin. There is frequent sparing of a small band of skin that borders the lips. Occasionally, the areas around the nose, eyes, and cheeks can be affected. Sometimes there is mild itching or burning.

How long does it last?
If not treated, perioral dermatitis may last for months to years. Even if treated, the condition may recur several times, but usually the disorder does not return after successful treatment.

What causes perioral dermatitis?
The cause of perioral dermatitis is unknown. But some dermatologists believe it is a form of rosacea or sunlight-worsened seborrheic dermatitis. Strong corticosteroid creams applied to the face can cause perioral dermatitis. Once perioral dermatitis develops, corticosteroid creams seem to help, but the disorder reappears when treatment is stopped. In fact perioral dermatitis usually comes back even worse than it was before use of steroid creams. Some types of makeup, moisturizers, and dental products may be partially responsible.

Can it be prevented?
There is no guaranteed way to prevent perioral dermatitis. Do not use strong prescription strength corticosteroid creams on the face. Your dermatologist may have suggestions about the use of moisturizers, cosmetics, and sunscreens, and may advise against using toothpaste with fluoride, tartar control ingredients, or cinnamon flavoring 

Are laboratory tests needed to diagnose the problem?
Most of the time, no tests are necessary. A dermatologist can usually make an accurate diagnosis by just examining the skin. Sometimes, scraping or a biopsy of the skin is done. Occasionally, blood tests are ordered to eliminate other conditions that can look similar.

How is this condition treated?
An oral antibiotic, like tetracycline, is the most common treatment for perioral dermatitis. Treatment may be needed for several months to prevent recurrence. For milder cases or pregnant women, topical antibiotic creams may be used. Occasionally, your dermatologist may recommend a specific corticosteroid cream, just for a short time to help your appearance while the antibiotics are working.

What can be expected with treatment?
Most patients improve with two months of oral antibiotics. If corticosteroid creams were used for treatment, there may be a brief flare-up when the creams are stopped. If antibiotic treatment is stopped too early however, the problem can come back.