What is perioral dermatitis and how to remove the rash around the mouth

If pimples appear around your nose and lips, they cannot always be dealt with by changing your foundation or adding a new acne treatment to your routine. When the cause of the rash is perioral dermatitis, such products can only do harm. We tell you why this disease develops and how to keep it under control.

What is perioral dermatitis

This is a chronic skin disease that manifests itself as multiple small rashes in the form of red bumps with a diameter of 1-2 mm, sometimes with redness and scaling. In addition to the rash, other symptoms may occur:

• Itching or burning sensation develops. The folds between the nose and mouth are most affected.
• The skin around the rash becomes dry and flaky.
• The rash may appear around the eyes, nose and genitals.

Misa Lukic / Shutterstock

PhM2019 / Shutterstock

PhM2019 / Shutterstock

You cannot become infected with perioral dermatitis or pass it on to someone else . The presumable reason why it occurs is a skin reaction to certain components in facial care products or even to fluoridated toothpaste.

This disease affects 0.5–1% of people in developed countries each year, 90% of whom are women aged 16 to 45 years. But sometimes perioral dermatitis occurs in children and the elderly.

Why does perioral dermatitis occur?

The exact reason is unknown . Perioral dermatitis may occur after using steroid face creams that are used to treat another condition, such as atopic dermatitis or psoriasis. Risk factors also include hormonal changes – for example, during pregnancy, before the onset of menstruation or while taking oral contraceptives.

The occurrence of perioral dermatitis can be triggered by the use of the following products :

• Topical steroids, such as hydrocortisone cream.
• Medicines with corticosteroids, regardless of the form of release: inhalers for asthma, sprays for allergic rhinitis, tablets.
• Skin care creams and sunscreens. The likelihood of developing dermatitis increaseswhen using night and day moisturizer in combination with foundation.
• Toothpaste with fluoride.
• Oral contraceptives.

What diseases can perioral dermatitis be confused with?

Rash, redness, and sometimes itching are not unique symptoms of dermatitis. Other diseases can manifest themselves in a similar way. It will not be difficult for a doctor to distinguish them from each other: each disease has a characteristic feature that helps to distinguish it from other similar ones.

Rosacea

This is a chronic skin disease characterized by pimples and redness. It differs from perioral dermatitis in telangiectasias, or, as they are also called, spider veins, which is an expansion of small blood vessels in the skin.

Rosacea can also affect the eyes, causing itching, dryness, and vision problems.

Atopic dermatitis

In this disease, inflammation of the skin develops from early childhood, often between the ages of 2 months and 5 years. It is accompanied by redness and severe itching, which is not as pronounced with perioral dermatitis.

The localization also differs: with atopic dermatitis, not only the facial skin is most often affected, but also the neck with the folds of the arms.

Acne

This is a disease that is primarily accompanied by various rashes: pimples, blackheads, cysts or painful red nodules. They can occur on the face, upper back, chest and arms, and not just around the mouth as with perioral dermatitis.

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Seborrheic dermatitis

This chronic skin disease occurs due to impaired sebum production. Seborrheic dermatitis, unlike perioral dermatitis, affects men more often. And the rashes are usually localized in places where sebaceous glands are most concentrated: in the hair, eyebrows, eyelashes, nasolabial folds and on the skin of the ears. Red spots with yellow scales appear there , and the affected areas are very itchy.

How to help skin with rashes around the mouth

If your doctor determines that the cause of the rash is perioral dermatitis, he may advise the following:

• stop using all types of face creams, including decorative cosmetics and sunscreens;
• wash only with warm, not cold or hot water;
• change your skin care routine – switch to a gentle, fragrance-free cleanser and don’t rub your face when washing;
• Avoid steroid creams and ointments.

An important nuance: if you discontinue medications that contain corticosteroids and hydrocortisone, the rash may worsen . You need to endure this period, even if you are tempted to start using steroid creams or ointments again. In Russia, this approach to treatment with the abolition of trigger drugs is called zero therapy. Sometimes it is quite enough, and the rash goes away within two weeks.

But if there is no noticeable effect, the doctor may supplement the treatmentantibacterial drugs – such as metronidazole, erythromycin, clindamycin or benzoyl peroxide. Each of them is selected individually depending on the condition of the skin and the severity of the disease. On average, such products are recommended to be used for 6 to 12 weeks.

In most cases, the rash does not return after treatment . But there is a risk that the rash will recur if you continue to use corticosteroid creams. Therefore, it is better to avoid such drugs without special recommendations and instructions from the attending physician.