One of the frequent questions we get here on My Skin Care Connection is from women who find that they have red bumps or a rash around their mouth and want to know what this can be. Some of you report that the cause of such symptoms has been diagnosed by your doctor as something called Perioral dermatitis.
Perioral dermatitis or as it is sometimes called, periorificial dermatitis, is a skin condition characterized by a red bumpy rash around the mouth area. Some people mistake the bumps for acne.
Symptoms may include:
• An uncomfortable burning sensation around the mouth. Mild itching is a less common symptom.
• The predominant feature of this skin disorder is many red bumps around the mouth and some of these bumps may be pus filled.
• There can be redness and peeling of the skin affected.
• The red bumpy rash is usually confined between the nose and lips, to the sides of the lips and from the lower lip to the chin. There is frequently a small perimeter of skin which borders the lips which will not have the rash.
• It is rare but sometimes the rash can appear around the eyes, nose, and forehead.
What does perioral dermatitis look like?
Here is an image of perioral dermatitis with rash and red bumpy appearance as shown on The National Institutes of Health web site.
Who gets this skin disorder?
This is a skin condition most commonly seen in young women of childbearing age. Women who are from 15-45 years of age are most affected. It is less common but perioral dermatitis can also affect men and children.
What causes perioral dermatitis?
Most sources say that the exact cause is yet unknown but there can be some things which may be associated with the development of this skin disorder and they include:
• The use of topical corticosteroid creams applied to the face to treat other skin conditions. Ironically the individual may use a steroid cream to try to get rid of this rash only to have the symptoms come back even worse when the treatment is stopped.
• The use of fluoridated toothpaste may also be a culprit in developing perioral dermatitis.
• You may want to check to see if your moisturizers, face creams, and make-up including foundation is contributing to the problem.
• Skin exposure to sunlight, heat, and wind may exacerbate the symptoms of perioral dermatitis.
• On some forums patients who have perioral dermatitis report that alcohol, spicy foods, and caffeine can aggravate their condition.
What can I do if I think I have perioral dermatitis?
If you suspect that you may have perioral dermatitis you need to do three things right away.
1. Call your doctor or dermatologist and schedule an appointment. If left untreated this skin disorder can for months to years. You need a doctor to properly diagnose and treat you.
2. Stop using all facial products including make-up, lip balms, lotions, or topical cortisone creams on the affected skin areas to see if this makes a difference. It is suggested that you wash with warm water alone and see if the rash improves.
3. Stop using fluoridated toothpaste or ones which contain anti-tartar ingredients to see if this helps your condition.
The main thing is to consult with your doctor to make sure you get a proper diagnosis.
How is perioral dermatitis treated and how long will treatment take?
There seem to be a variety of opinions on how to best treat this skin condition. Most skin experts advise not use skin creams containing steroids as this can make the problem worse.
Topical creams such as metronidazole, clindamycin or pimecrolimus may be prescribed. If the case is severe oral antibiotics may be required such as doxycycline or tetracycline.
It seems that there is no clear consensus among doctors or dermatologists about how to best treat perioral dermatitis as judged by this on-line discussion of doctors on the Dermatology Online Journal.
You can read what our Dr. Hema Sundaram recommends for treating this skin disorder as she answers a member question about the best topical treatments for perioral dermatitis.
One quality patients who have this skin disorder will need to have is patience. It is said that this can be a difficult condition to treat. It can take months to cure it and during this time the rash and symptoms can reoccur. If you have been diagnosed with perioral dermatitis please do share your experience here. We would love to know which treatments have worked for you to clear up your condition.
The American Academy of Dermatology
The Merck Manuals Online Medical Library