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Perioral dermatitis

Definition

Perioral dermatitis is a skin disorder characterized by tiny red bumps (papules) around the mouth.

Causes, incidence, and risk factors

Perioral dermatitis most commonly affects young women. However, it sometimes affects men, too. While its exact cause is unknown, it may appear after skin creams containing steroids are applied to the face to treat other conditions.

Symptoms

Perioral dermatitis is usually characterized by an uncomfortable burning sensation around the mouth. Itching is not a common symptom.

In most cases, bumps (papules) and fluid- or pus-filled bumps (vesicopustules) are seen around the mouth. Rarely, a similar rash may appear around the eyes, nose, or forehead. The rash appears very similar to acne.

Usually, patients are most concerned with the cosmetic appearance of the bumps.

Signs and tests

Your health care provider will likely diagnose perioral dermatitis based upon the appearance of your skin. A test for bacteria may sometimes be needed to eliminate the possibility of infection.

Treatment

Generally, skin creams containing steroids should not be used to treat perioral dermatitis. Your health care provider may choose to treat the bumps with other topical (applied directly to the skin) medications, such as metronidazole, erythromycin, benzoyl peroxide, tacrolimus, clindamycin, or pimecrolimus.

In more severe cases, oral antibiotics (such as tetracycline, doxycycline, minocycline, or erythromycin) may be required.

Expectations (prognosis)

Perioral dermatitis is a difficult condition to treat effectively. It often requires several months of treatment.

It is not unusual for the bumps to return, particularly if skin creams containing steroids are reapplied to the face.

Calling your health care provider

Call your health care provider if you notice persistent red bumps around your mouth.

Prevention

Avoid using skin creams containing steroids on your face, unless specifically directed by your dermatologist.
Dermatitis, perioral
Dermatitis around the mouth (perioral) is most common in young to middle age women. Frequently, no specific cause is found. However, there appears to be an association with fluorinated steroids. In children, dermatitis around the mouth may be associated with irritation from specific foods or other materials carried to the face on the hands.
Review Date: 12/11/2009
Reviewed By: Michael Lehrer, MD, Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network; Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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