Peri-Oral Dermatitis

What is Perioral Dermatitis?

You can find the definition of perioral dermatitis in its name - a skin rash or irritation (dermatitis) that appears around (peri) the mouth (oral). It's not contagious, and it doesn't usually cause serious adverse health effects. With proper care, most people start feeling better, but it can take a while for the condition to clear up completely. Even with treatment, it can take weeks for perioral dermatitis to clear up, so it's essential to start treating as soon as you see the first warning signs.

What are the Symptoms of Perioral Dermatitis?

Perioral dermatitis produces a rash around the mouth. Usually, it is confined to just around the mouth, but it can spread around the nose and even the eyes. When caused by mask wear, the irritation is in the mask's shape - around the mouth, nose, chin, and sometimes ears. The lips, nostrils, and skin immediately surrounding these areas will typically not be affected by perioral dermatitis - this leaves these areas looking paler than the rest of the face. Even when caused by mask wear, perioral dermatitis will rarely develop on the cheeks.

The appearance of perioral dermatitis rashes will vary based on skin tone. The rash is usually red or pink-coloured in people with light skin tones and may look like acne. People with darker skin tones may see bumps close to their skin tone or slightly lighter or darker.

In addition to these noticeable bumps, symptoms of perioral dermatitis include:

• Itching, burning, and skin irritation and inflammation
• The affected area may feel numb or tingly.
• The skin around the rash may be dry or flaky.
• Bumps may develop into pustules containing fluid and resemble acne or small blisters.

What Causes Perioral Dermatitis?

There's no single underlying cause of perioral dermatitis. Factors like emotional stress, lack of sleep, and a diet high in inflammatory foods such as sugar, trans fats, and refined carbohydrates worsen the condition. Some other common factors that are related to the development of this condition include:

• Irritation – wearing a face mask that rubs your skin all day and traps moisture against your face.
• Medications – topical corticosteroids and steroid inhalers, mainly used frequently or for an extended time, can lead to a face rash. Other topical and oral drugs (prescription and over-the-counter) have also been linked to perioral dermatitis, including oral contraceptives, so pay attention whenever you begin taking a new medication.
• Chemicals – new skincare, cosmetic, or cleaning products can trigger a response. Using a new toothpaste is a common cause of perioral dermatitis, so don't forget your oral hygiene products.
• Allergens – whether it's from food, the environment (pollen), or other sources (your pets), an allergic reaction may result in a facial rash.
• Poor hygiene – failure to keep skin clean and moisturized can lead to the development of perioral dermatitis.
• Weather – very hot or cold, dry or humid, or other extreme weather conditions can cause a perioral dermatitis eruption.
• Systemic changes – hormonal shifts, immune system strain, and other changes in the body's function can lead to a facial rash.

How do I treat Perioral Dermatitis?

Even if you do your best to prevent it, you may still develop perioral dermatitis from frequent mask wear. When that happens, your doctor can help you get the symptoms under control and work toward healing your skin. People often get frustrated by how long the rash can linger, but it will clear up with consistent treatment. Some of the recommended treatments include:

• Stop using topical corticosteroids, including over-the-counter hydrocortisone cream, on your skin. If another physician has prescribed corticosteroids, you may need to work with your doctor to find an alternative. When you first stop using your steroid cream, the itch and discomfort will likely worsen, but don't resume corticosteroid use as this will only lead to further long-term discomfort.
• We will prescribe an antibiotic in some cases, especially if pimples or pustules develop. Additionally, topical antibacterial creams may be recommended for faster relief from itch and discomfort.
• Review all skincare, hygiene, cosmetic, and cleaning products you're using with your doctor. Create a good skincare routine that will minimize irritation. We may also ask that you change your oral hygiene routine as certain kinds of toothpaste can contribute to perioral dermatitis.
• Immunosuppressive creams or topical rosacea medications are prescribed in some cases.

When Should I Visit a Doctor?

It can take a few weeks, but if your condition does not begin to clear up on its own when you discontinue corticosteroid use and switch to gentler hygiene practices, you may want to call your doctor. In some cases, this condition can develop into more serious skin health issues without proper care. Granulomatous perioral dermatitis and steroid-induced rosacea are two examples of developing this condition. Granulomatous perioral dermatitis often occurs in kids, almost always caused by corticosteroid use. Steroid-induced rosacea can occur when perioral dermatitis develops into the pus-filled papules. These bumps make patients much more likely to create a response on their cheeks and forehead, which is characteristic of rosacea. Whether your condition isn't clearing, it develops into a more severe case, or you're just very uncomfortable, a trip to the doctor can help.