perioral dermatitis at nose and mouth

Perioral Dermatitis

Perioral Dermatitis

Perioral Dermatitis

Perioral Dermatitis (PD) is inflammation of the skin, primarily around the mouth, but can be found around the eyes, in the folds of the nose, and forehead.  Most often it looks like a red, slightly scaly or bumpy rash that may burn or itch, but those sensations aren’t common.  In some cases there are small bumps that can appear to be acne because they are filled with pus.  While 90% of people suffering from perioral dermatitis are mostly women between 20-45, it can affect men too!

The exact cause isn’t known but it may appear after:

  1. Topical steroid creams that are applied to treat other conditions and inhaled prescription steroid sprays used in the nose and mouth.

    perioral dermatitis from steroid inhalants.

    Perioral Dermatitis from using a Steroid inhalant.

  2. Applying heavy creams that contain petrolatum or paraffin base, which actually  worsen perioral dermatitis.
  3. Read the labels of your cosmetics (face washes, toothpastes, moisturizers, basically anything that touches your  face and hair) because a few ingredients may be the nasty culprit causing your rash! Be on the look out for these haters: Sodium Lauryl Sulfate (SLS), Parabins, and Whiteners!
  4. Heavy makeup.
  5. Rosacea.
  6. Bacterial  and fungal infections.
  7. Florinated toothpasts.
  8. Oral contraceptives.
  9. Sunscreen.

Perioral Dermatitis is difficult to treat and, sadly, can last for months or be chronic. According to the American Osteopathic College of Dermatology, even after weeks of treatment symptoms can worsen before they improve.  Naturally the next question is, what are my treatment  options? Well it all depends on the severity of your symptoms. For some, using mildo soaps and discontinuing the use of heavy creams and florinated toothpaste may calm PD. Medications can also expedite healing.  Your dermatologist may prescribe:

  • Topical/oral antibiotic medications, such as Metronidazole and Erythromycin.
  • Pimecrolimus  cream which is an immuno suppressive cream.
  • Topical anti-acne med school such as Adapalene  or Azelaic Acid.
  • Oral antibiotics may be required if your case is more severe. Doxycycline, Tetracycline, Minocycline, or Isotrentinoin.
perioral dermatitis around eye

Perioral dermatitis around eye.

You should also discontinue non-prescription hydrocortisone.  Think of your skin as a creme junkie that needs to go cold turkey!  No more creams and heavy makeup.  No scrubs or exfoliants.  Cleanse with gentle facial cleansers like PCA Creamy Cleanser, and make sure that you are keeping your skin moisturized and protected from UV rays because some of the medications  used to treat PD make your skin more sensitive  to the sun!  We don’t want to be a sunburned, hyperpigmented, Perioral Dermatitis hybrid! What a hot mess that would be! Note that heat and wind can aggravate PD symptoms  too.

perioral dermatitis at nose and mouth

Perioral Dermatitis at folds of nose and mouth.

Not all cases are this inflammed.  In fact three of my clients were diagnosed  by a dermatologist  and their rash was nowhere near this red. So it’s best to see your dermatologist  to determine your condition and best course of treatment.

Best wishes,


Pictures: pinterest

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