What is perioral dermatitis and how is it treated?
Dermatitis is a term referring to an inflammation of the skin, and perioral means around the mouth. The skin condition is sometimes called periorificial dermatitis. When perioral dermatitis affects children, it is called childhood perioral dermatitis.
Perioral dermatitis is most common in females between the ages of 16 and 45 years. Older people, males, and children can also have the condition, but this happens less frequently.
What are the symptoms?
Perioral dermatitis is a rash that most often affects the skin around the mouth.
Perioral dermatitis is a rash that develops around the mouth and tends to be bumpy or scaly.
The bumps generally do not affect the skin right next to the mouth but appear a short distance away from the lips. They may form a ring around the mouth.
Sometimes the rash can appear around the nose or eyes. It can occasionally appear around the genitals too, but this is rare.
What does it look like?
Some people with perioral dermatitis may only get a few bumps, and their rash may not be very discernible. Others may have many lumps forming a noticeable rash.
It is possible that the rash will look inflamed, with the underlying and surrounding skin appearing red or pink.
What does it feel like?
The rash may be itchy or non-itchy, but it does not usually hurt. Some people with perioral dermatitis may feel tightness or mild burning in the affected skin, which may be dry or flaky.
The use of steroid ointments, creams, or gels can cause perioral dermatitis.
There is no underlying condition that causes perioral dermatitis, and it is not contagious.
Although the exact cause is unknown, researchers think it may relate to the use of topical corticosteroids.
Topical corticosteroids are steroid ointments, creams, or gels that people use to treat skin conditions. People should only ever use these products as a short-term treatment, and most of them are not suitable for application on the face.
Sometimes people use corticosteroids for longer than they should or use them on their face. This can result in skin damage.
A 2017 study explores the effects of the misuse of topical corticosteroids on facial skin. Researchers found that perioral dermatitis was one of the adverse effects.
Additional possible causes of perioral dermatitis include:
- a problem with the skin's protective barrier
- a change in the bacteria on the skin
- bacteria getting into the hair follicles
- an allergic reaction
- irritation resulting from a skin care product or toothpaste
- hormonal changes
- taking a birth control pill
- strong winds
- UV light
More research is necessary to understand the exact causes of perioral dermatitis.
What are the treatment options?
As topical corticosteroids seem to be a primary risk factor for perioral dermatitis, it is essential to stop using them on the skin. This includes hydrocortisone.
If a doctor has prescribed corticosteroids, it is best to ask them for an alternative. The continued use of corticosteroids could cause the rash to worsen.
When a person stops using corticosteroids, the rash may get worse before it improves. It is vital that they are not tempted to use the corticosteroids again.
It is important to see a dermatologist if the rash does not get better on its own. The dermatologist may prescribe an oral or topical antibiotic or a cream that suppresses the immune response.
The following home remedies and lifestyle changes may help to manage the symptoms:
- avoiding topical steroids
- washing the face with warm water alone
- using fragrance-free skin care products
- avoiding the sun
- reducing inflammation
- fighting bacteria
- promoting wound healing
- repairing the skin barrier
Due to these properties, coconut oil may help perioral dermatitis. However, researchers need to carry out more studies into its effectiveness as a treatment for this skin condition.
Risk factors and triggers
Birth control pills may be a trigger for perioral dermatitis.
Females are more likely to get perioral dermatitis, especially between the ages of 16 and 45.
Those with a hormonal imbalance or history of allergies are more at risk of getting the skin condition, and the use of topical steroids can also increase the risk.
In addition, the following may trigger the condition:
- using heavily scented toiletries and skin care products
- wearing heavy makeup
- taking birth control pills
How to prevent perioral dermatitis
To prevent perioral dermatitis, people should only use topical steroids as a doctor advises.
Following a skin care routine consisting of fragrance-free products may also help to keep skin healthy. It is a good idea to avoid heavy makeup too.
Avoiding the sun and strong winds may also promote skin health.
When to see a doctor
If someone has perioral dermatitis that does not go away when they stop using topical steroids, they should speak to their doctor.
The doctor can recommend the best course of treatment.
Perioral dermatitis usually clears up on its own a few weeks after a person stops using topical steroids. Using fragrance-free products helps to avoid irritating the skin while it heals.
This skin condition may flare up if a person starts using topical steroids again, so it is best to discuss alternative options with a doctor.