Perioral dermatitis

What is perioral dermatitis?

Perioral dermatitis is a common skin rash affecting the skin around the mouth and sometimes the eyes. It occurs most commonly in women aged between 15 and 45 years. While perioral means 'around the mouth' the condition is inaccurately named, as dermatitis refers to eczema, which it is not.

What does perioral dermatitis look and feel like?

Many similar looking small red spots, some with a white head. Spots mainly occur around the mouth (perioral dermatitis), but sometimes they can affect around the eyes (periocular dermatitis). The spots can occasionally affect several areas of the face (periorofacial dermatitis), but not the cheeks or forehead. The skin around the bottom of the nose can be pink-red (erythematous).

Perioral dermatitis can be itchy. 

What causes perioral dermatitis?

The exact cause is unknown.

What else can contribute to perioral dermatitis?

Certain topical treatments (creams, gels, or ointments applied to the skin) can make perioral dermatitis worse:

• Topical steroids, whether applied deliberately to facial skin or inadvertently
• Emollient creams (moisturisers)
• Cosmetic creams and sunscreens

Nasal steroids (sprays used in the nose), steroid inhalers (for conditions such as asthma), and steroid tablets may also make perioral dermatitis worse.

Things you can do to help yourself

• Stop applying any topical steroids, emollients, and cosmetics to the affected skin. If you have been using a topical steroid and suddenly stop, the spots may become worse for a few days before they settle. Once things improve you made be able to start thinly applying a light oil-free moisturiser if the skin becomes too dry

• If you use a topical steroid to treat a skin condition elsewhere on your body, make sure you wash your hands after you have applied the steroid so that you don’t accidently transfer any to your face

• Avoid washing your face with soap or any product that makes a lather 

• Sunscreen - use a liquid or gel, which are less greasy, and wash off once you are out of the sun

Make an appointment at your GP surgery

If your skin is not improving despite the recommendations above, then make an appointment to see a health professional.

Treatment options may include antibiotic tablets, often for an initial period of 6 weeks, or topical treatments (applied directly to the skin) if the spots are less troublesome.

Referral to a specialist

The main reason for referring to a specialist is if the diagnosis is unclear. You will be referred to a specialist, who will be either a Dermatologist or a GPwER/GPwSI (a GP who has been trained in relevant areas of dermatology).

What will happen when you are referred?

The appointment may be face-to-face (the person attends the clinic), or a video call (teledermatology).

Helping with other skin conditions

If you, a family member, or friend have an undiagnosed skin condition; or you want to learn more about how to treat skin conditions, please view our short video on how to get the best from this website.