Perioral dermatitis treatment: what to know

Perioral dermatitis is an inflammatory facial rash that can cause small red bumps, dryness, burning, or tightness around the mouth and sometimes the nose or eyes. It can resemble acne, but acne-focused products may irritate the area. A clinician may review recent steroid creams, cosmetics, toothpaste, moisturisers, and other exposures before choosing treatment.

Depending on the extent and persistence of the rash, treatment may involve a prescribed topical antibiotic or another anti-inflammatory medicine. More widespread or stubborn disease may need an oral antibiotic course. The right choice depends on the examination, pregnancy status, allergies, other medicines, and the exact location of the rash.

Use a gentle, fragrance-free cleanser and lukewarm water, then pat rather than rub. Pause scrubs, exfoliating acids, fragranced products, heavy occlusive creams, and makeup on the affected skin while it settles. Do not start or stop a steroid cream on the face without medical guidance; stopping suddenly after repeated use may make the rash flare.

Follow the prescribed schedule even when the bumps begin to fade, and report marked irritation or new symptoms. Keep a simple record of products and medicines used near the face. Related reading: Perioral Dermatitis and Sensitive Skin.

Arrange a medical assessment if the rash is spreading, recurring, painful, crusted, or not improving after removing likely irritants. Seek prompt care for eye pain, light sensitivity, vision change, marked eyelid swelling, fever, or rapidly worsening redness, because these features may need a different assessment.

Ask whether the rash fits perioral dermatitis rather than acne or contact dermatitis, which products should be paused, how long the treatment trial should run, and what to do if the skin worsens after a steroid is stopped.