Understanding Perioral Dermatitis

What Is Perioral Dermatitis?

Many of our patients in Florida experience perioral dermatitis, a common inflammatory skin condition that causes small pink or red bumps around the mouth, nose, and sometimes the eyes. The rash typically appears around the mouth but leaves a narrow clear zone of normal skin right next to the lips.

While it can affect anyone, perioral dermatitis most commonly occurs in women between the ages of 20 and 45, though children can develop this condition as well.

What Causes It?

The exact cause of perioral dermatitis is not fully understood, but several factors are known to trigger or worsen the condition.

One of the most common triggers is the use of topical steroid creams on the face, even low-strength steroid creams available over the counter. These medications may temporarily improve the rash, but the condition often worsens once they are stopped.

Other possible triggers include:

Heavy facial moisturizers or occlusive creams
Certain cosmetics or skincare products
Fluorinated toothpaste
Irritation from multiple or harsh skincare products

Some research suggests that changes in the skin barrier and natural skin microbiome may also contribute to the development of this condition.

What Does It Look Like?

Perioral dermatitis appears as small pink or red bumps, sometimes with tiny pustules (small pus-filled bumps) clustered around the mouth. The rash often affects the folds beside the nose and the chin.

The skin may appear slightly dry, scaly, or irritated, and some people experience mild burning or itching. The bumps may fluctuate, improving and worsening over weeks to months.

A key feature that helps doctors recognize perioral dermatitis is the clear strip of normal skin immediately around the lip border. In some patients, the rash may also appear around the nose or eyes.

How Is It Treated?

Treatment typically begins by stopping topical steroid creams on the face. When steroids are discontinued, the rash may temporarily worsen before it begins to improve.

Your doctor may prescribe topical medications such as:

Metronidazole
Erythromycin
Azelaic acid

For more persistent cases, oral antibiotics such as doxycycline or tetracycline may be recommended to reduce inflammation.

Although the rash can be frustrating, perioral dermatitis is very treatable, and most patients improve significantly once triggers are removed and appropriate treatment is started. Improvement usually occurs gradually, and treatment may take several weeks to a few months to fully clear the rash.

How Can You Prevent It?

To help prevent perioral dermatitis:

Avoid using steroid creams on the face unless specifically directed by your physician
Use gentle, fragrance-free cleansers and moisturizers
Avoid heavy or occlusive facial products
Introduce new skincare products one at a time

When Should You See a Dermatologist?

Consider seeing a dermatologist if:

The rash around your mouth or eyes persists for more than a few weeks
The bumps are spreading or becoming more irritated
Acne treatments are not helping
You have been using steroid creams on the face and the rash keeps returning

Early evaluation can help confirm the diagnosis and start treatment sooner, which often shortens the course of the condition.

Think you might have perioral dermatitis? Contact Florida’s Skin Wellness Physicians to get an evaluation. Call us at (239) 732-0044 or send a message to book an appointment.