Red scaly rash with bumps around the mouth? Sometimes it appears out of nowhere. While there are many things that can cause it, perioral dermatitis is one of the common causes.
It is easily mistaken for acne and eczema. However, the treatment of these differs. In fact, treating perioral dermatitis with acne or eczema medications can make it worse.
Changes in the skincare routine and over-the-counter treatment options can help in improving perioral dermatitis. However, if it worsens one should see a doctor immediately.
What is perioral dermatitis?
Perioral dermatitis is a red scaly rash that appears usually around the mouth. One can also see small red papules and pustules in this region sometimes mimicking acne.
While it is commonly seen around the mouth, it can also occur around the nose and eyes. For that reason, it is often referred to as periorificial dermatitis (in simple words rash around the openings).
It is commonly seen in young adult females (20-45 years of age).
Read more: Is perioral dermatitis contagious? & Perioral dermatitis vs Cold sore
Symptoms
Perioral dermatitis can result in:
- Red scaly rash
- Papules
- Pustules
- Vesicles
- Itching
- Burning
Causes and triggers
Multiple factors are associated with perioral dermatitis. It is often linked to:
- Use of topical steroids
- Oral or inhaled steroids
- Fluorinated toothpaste
- Dental fillings
- Hormonal factors
- Certain cosmetics
- Heavy and thick topical products
- Stress
- Face masks
Read more: Is perioral dermatitis fungal or bacterial?
Diagnosis
In most cases, a doctor can diagnose it clinically by looking at the rash. In some cases, they may take skin scrapings or a skin biopsy to rule out certain skin conditions.
Treatment options
There are certain over-the-counter options that can be effective for perioral dermatitis. In some cases, one will need prescription medications.
The commonly prescribed medications are topical and oral antibiotics depending on the severity of symptoms.
Home remedies
1. Remove the trigger
If your rash coincides with the introduction of any new skincare or makeup product, try to remove that. Sometimes, just removing the trigger can improve the rash.
2. Do not use topical steroids
Whenever we have a rash, we are tempted to use over-the-counter steroids like hydrocortisone cream. It may temporarily reduce the redness of perioral dermatitis only to make it worse later.
As discussed above, topical steroids are actually the main cause of perioral dermatitis.
Many over-the-counter moisturizers meant to relieve itching and redness have steroids like hydrocortisone in them so check the ingredient list of any over-the-counter product you use.
If you’re using a prescription steroid to treat any inflammatory skin condition, make sure to get in touch with your doctor and discuss the appropriate management
3. Stop using strong actives
The red bumps of perioral dermatitis are often mistaken for acne and some people try to treat it by using over-the-counter acne medications like retinol and salicylic acid. These over-the-counter medications will worsen this skin condition.
Vitamin C (ascorbic acid) serums and exfoliants like glycolic acid and lactic acid are usually at an acidic pH. These can cause burning, stinging, and irritation.
4. Check your toothpaste
Fluoride in toothpaste is often associated with perioral dermatitis so take a look at the ingredient list of your toothpaste.
In addition, some people are sensitive to sulfates in toothpaste, especially sodium lauryl sulfate.
5. Use a gentle pH-balanced cleanser
Many cleansers can be harsh which can further worsen perioral dermatitis. If you experience any dryness and tightness from using your face wash, it’s best to switch to a gentle pH-balanced cleanser.
In addition, make sure to remove any makeup or sunscreen at the end of the day to avoid worsening of perioral dermatitis.
6. Use a lightweight moisturizer
Some people develop perioral dermatitis when they use occlusive skin care products or apply multiple layers of skin care products.
It’s best to simplify your routine, stick to the basics, and use a lightweight moisturizer (instead of ointments based on petrolatum or mineral oil).
You can look for products with ceramides and nourishing oils that will help in healing the skin.
Many moisturizers have niacinamide in them which can be great in reducing redness and inflammation. However, some people feel a stinging sensation with it.
So, if it causes any burning or stinging sensation, use a niacinamide-free moisturizer.
7. Sulfur
Sulfur is a great option for treating perioral dermatitis. It has antimicrobial and anti-inflammatory properties.
You can include it in your skincare routine in several ways like as a face mask or as a light moisturizer.
Products with sulfur can stain clothing, metals, and light hair.
8. Azelaic acid
Azelaic acid has anti-keratinizing, anti-inflammatory, and antioxidant properties. It also has antimicrobial properties.
Sometimes, it is prescribed for perioral dermatitis mainly due to its anti-inflammatory properties.
The prescription strength uses azelaic acid at a concentration of 15%. However, you can get a lower concentration of it over the counter.
There are several serums and lotions based on azelaic acid. It is best to stick to a product with minimal ingredients to avoid further irritation of the skin.
Related: Best azelaic acid products
9. Manage stress
Stress is often associated with perioral dermatitis. Use relaxation techniques like meditation, exercising, and listening to music to decrease your stress.
10. Don’t use essential oils
Many essential oils have anti-microbial and anti-inflammatory properties. However, these can also irritate the skin. So avoid using them.
11. Sun protection
It Is important to protect your face from the sun to decrease the chances of hyperpigmentation.
Use a lightweight sunscreen that doesn’t burn or sting. Some people prefer to use mineral sunscreen. Make sure the formulation is not too thick or occlusive.
If you cannot use sunscreen, protect your face with sun-protective clothing.
12. Face mask
Due to COVID and flu infections, it becomes important to wear face masks. However, make sure you are washing your face mask every day or using a new disposable one.
Natural treatments
Some people get relief from using raw honey or aloe vera. These have hydrating, antimicrobial, and wound-healing properties which might benefit perioral dermatitis.
However, we don’t have enough research data that shows its effectiveness for treating perioral dermatitis.
One can be allergic to these as well, so make sure to patch-test them before using them.
FAQs
- Should I moisturize perioral dermatitis? Yes, moisturizing can help in healing the skin. However, use a lightweight moisturizer. Do not use occlusive thick ointments or moisturizers.
- Can toothpaste cause perioral dermatitis? Yes, certain ingredients in toothpaste are linked to perioral dermatitis. It includes fluorides, sulfates, and essential oils.
- Can Vaseline cause perioral dermatitis? Thick occlusive skin care products are associated with perioral dermatitis. Since Vaseline is a thick occlusive, it can lead to perioral dermatitis in some cases.
- Will perioral dermatitis heal on its own? Sometimes just removing the trigger factor causing perioral dermatitis can improve and heal the rash.
Summary
Perioral dermatitis is a common skin condition that leads to a red scaly rash and red bumps around the mouth. It is often mistaken for acne or eczema.
The exact cause behind it is not clear. However, it has been linked to the use of topical and oral steroids and certain skin care products.
Simplifying the skincare routine and some over-the-counter treatments can help in clearing this rash. However, if it gets worse it’s important to see a doctor to get a proper diagnosis and treatment.
Read more:
- Best Products for Perioral Dermatitis: Face Wash, Moisturizer, Sunscreen
- The Ordinary Products for Perioral Dermatitis
- Perioral Dermatitis vs Acne: How to Tell the Difference
References
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- Searle T, Ali FR, Al-Niaimi F. Perioral dermatitis: Diagnosis, proposed etiologies, and management. J Cosmet Dermatol. 2021 Dec;20(12):3839-3848. doi: 10.1111/jocd.14060. Epub 2021 Mar 16. PMID: 33751778.
- Malik R, Quirk CJ. Topical applications and perioral dermatitis. Australas J Dermatol. 2000 Feb;41(1):34-8. doi: 10.1046/j.1440-0960.2000.00385.x. PMID: 10715898.
- McLoone P, Oluwadun A, Warnock M, Fyfe L. Honey: A Therapeutic Agent for Disorders of the Skin. Cent Asian J Glob Health. 2016 Aug 4;5(1):241. doi: 10.5195/cajgh.2016.241. PMID: 29138732; PMCID: PMC5661189.
- Olisova OY, Teplyuk NP, Grekova EV, Lepekhova AA. Dermatoses caused by face mask wearing during the COVID-19 pandemic. J Eur Acad Dermatol Venereol. 2021 Nov;35(11):e738-e741. doi: 10.1111/jdv.17546. Epub 2021 Aug 4. PMID: 34310757; PMCID: PMC8447160.
Disclaimer: This blog post is for information purposes only and does not replace medical advice.