Perioral Dermatitis is an inflammatory skin condition characterized by multiple red/pink bumps around the mouth. It can also spread to the nose and eyes – called periorificial dermatitis).
Perioral dermatitis can cause dry, flaky skin surface, acneiform eruption that can be red bumps or pustules. These lesions can itch and burn.
Perioral Dermatitis is still not fully understood. The most frequent cause is typically chronic steroid exposure on facial skin. This includes topical steroids, often used to treat facial eczema, as well as steroid inhalers or nose sprays. Other causes include fluorinated toothpaste, mint or cinnamon flavoring, hormonal fluctuations, bacteria, and cosmetic creams/sunscreens.
The first step in treating perioral dermatitis is withdrawal of the offending agent. This is typically topical steroid cessation. For patients who use steroid inhalers or nasal sprays, we suggest washing your face after use to ensure no residual steroid is on your skin. All other topical cosmetic creams and soaps should be discontinued until the skin is healed. Topical antibiotics including metronidazole, clindamycin or erythromycin cream have been shown to be effective. For more severe cases, low dose oral antibiotics can be used to help calm inflammation. Topical immunomodulating creams such as tacrolimus (Protopic®) or pimecrolimus (Elidel®) may also be used.
As with most skin conditions, resolution of perioral dermatitis often takes weeks. Consistent medication use and avoidance of triggers is required for a full resolution. The condition may relapse with subsequent exposure to triggers.