What is the first treatment for perioral dermatitis?

Perioral dermatitis causes small red bumps, dryness or burning around the mouth; it can also affect the nose or eyes. Heavy creams, fragranced products and topical corticosteroids may aggravate the eruption, although stopping a steroid can cause a temporary flare.

A clinician may recommend topical antibiotic therapy for a localised eruption. Oral antibiotics for acne may be used for more persistent or widespread inflammation, but the choice depends on pregnancy status, medicines, allergies and the appearance of the rash.

Use a simple, fragrance-free cleanser and moisturiser, avoid picking the bumps and pause new cosmetics or thick occlusive products. Do not restart a topical steroid on the face without advice. If you have been using one regularly, ask how to taper or replace it safely rather than stopping without a plan.

Follow the prescribed course consistently and allow time for the skin barrier to settle. Ask whether topical antibiotic therapy or oral antibiotics for acne is the better fit, and report irritation or worsening soon after starting treatment.

Arrange a review if the rash reaches the eyelids, symptoms persist despite removing triggers or the skin becomes cracked and painful. Seek urgent care for eye pain, vision change, marked facial swelling, fever or rapidly spreading redness.

Could a steroid, toothpaste, cosmetic or skin-care product be contributing? Should I taper anything used on my face? Would topical antibiotic therapy be enough, or are oral antibiotics for acne appropriate? How should I care for the skin during a flare?