Overview
Perioral dermatitis is a skin problem that primarily affects the area around the mouth or rash around mouth but can also involve the nose and eyes. The disease is characterized by red, raised bumps or pimple-like lesions and, in some cases, itchy or burning sensations. It can be frustrating and uncomfortable, but it can usually be effectively treated with proper care and medication.
What Causes Perioral Dermatitis(rash around the mouth)?
Perioral dermatitis is most common in women between the ages of 16 and 45 but can affect people of all ages and genders. The exact cause of the condition has yet to be fully understood. Still, it is believed to be related to several factors, including topical steroids, hormonal imbalances, and a compromised skin barrier.
Topical steroids
Topical steroids are usually used to treat skin inflammation and irritation. However, prolonged or frequent use of these creams, especially around the mouth, can disrupt the natural balance of bacteria on the skin, leading to an overgrowth of harmful bacteria and yeast. This can trigger an inflammatory response and contribute to the development of perioral dermatitis.
Skincare and cosmetic products
Certain cosmetics, moisturizers, or sunscreens that contain fragrances, dyes, or harsh ingredients can irritate the skin and contribute to the development of perioral dermatitis.
Hormonal changes
The hormonal imbalances that occur during pregnancy or while taking oral contraceptives can trigger the development of perioral dermatitis.
Infections
In some cases, perioral dermatitis can be caused by an underlying skin infection, such as a fungal or bacterial infection.
Skin barrier damage
Any damage or disruption to the skin barrier, such as excessive exfoliation or harsh cleansing, can make the skin more susceptible to perioral dermatitis.
Weather conditions
Exposure to extreme temperatures or dry air can damage the skin’s natural protective barrier and increase sensitivity and inflammation. This can make the skin more susceptible to perioral dermatitis, especially in those predisposed to the condition. Therefore, protecting the skin from harsh weather conditions and using moisturizers can help prevent or manage perioral dermatitis.
Genetic predisposition
Some patients may be genetically predisposed to develop perioral dermatitis. Certain genetic factors may increase an individual’s susceptibility to developing perioral dermatitis, although environmental factors also play a role.
Oral antibiotics
Long-term use of oral antibiotics can disrupt the natural balance of bacteria on the skin, leading to an overgrowth of harmful bacteria and yeast. This, in turn, can trigger an inflammatory response and contribute to the development of perioral dermatitis.
The exact relationship between diet and perioral dermatitis has yet to be fully understood. However, some people may be sensitive to certain foods or dietary habits that can trigger the condition. Common triggers include spicy or acidic foods, alcohol, dairy products, and refined carbohydrates. Maintaining a balanced diet and keeping track of potential triggers can help manage the symptoms of perioral dermatitis.
Stress
Stress can trigger the release of stress hormones like cortisol, suppressing the immune system’s response to infection and inflammation. This weakened immune response can make the skin more vulnerable to bacterial and fungal overgrowth, increasing the risk of developing perioral dermatitis. Additionally, stress can lead to changes in skin barrier function, causing dryness and irritation, which can further exacerbate the condition. Managing stress through relaxation techniques and self-care can help reduce the risk of developing perioral dermatitis.
Diet
The exact relationship between diet and perioral dermatitis has yet to be fully understood. However, some people may be sensitive to certain foods or dietary habits that can trigger the condition. Common triggers include spicy or acidic foods, alcohol, dairy products, and refined carbohydrates. Maintaining a balanced diet and keeping track of potential triggers can help manage the symptoms of perioral dermatitis.
Vitamin deficiencies
While there is no direct evidence linking perioral dermatitis to vitamin deficiency, some studies suggest that certain vitamin deficiencies may contribute to skin problems in general. For example, lacking vitamins A, C, D, and E may result in skin dryness, irritation, and inflammation, potentially worsening perioral dermatitis symptoms. However, it’s important to note that perioral dermatitis is a complex condition with multiple contributing factors, and vitamin deficiencies are unlikely to be the sole cause.
It’s important to remember that perioral dermatitis can have multiple causes and vary from person to person.
How is Perioral Dermatitis Diagnosed?
A diagnosis of perioral dermatitis is usually made through a detailed medical history, physical examination of the affected area, and rarely investigations. The diagnosis is based on the appearance and location of the rash. Sometimes a skin biopsy is done to rule out other conditions that mimic perioral dermatitides, such as rosacea or eczema.
Medical History
For better treatment and management, you may be asked the following questions to understand your perioral dermatitis condition better.
- When did you first notice the symptoms of perioral dermatitis?
- Have you ever experienced this type of skin condition before?
- Have you recently started using any new skincare products or cosmetics?
- Have you been exposed to any new chemicals or allergens recently?
- Any other medical conditions or allergies?
- Currently, taking any medications or supplements?
- Have you experienced any itching, burning, or pain in the affected area?
- Have you noticed any changes in the appearance or texture of your skin?
- Have you been exposed to extreme temperatures or environmental factors recently?
- Have you noticed any improvement or worsening symptoms with certain activities or behaviors (such as sun exposure, stress, or diet)?
Physical Examination
During a physical examination for perioral dermatitis following is done
Examination of the affected area
The healthcare provider will visually inspect the skin around the mouth, nose, and chin for signs of a rash or inflammation. They may also use a magnifying glass or dermatoscopy to look closer.
Check for other skin conditions.
Perioral dermatitis can sometimes be mistaken for other skin conditions, such as rosacea or acne.
Investigations for perioral dermatitis
Perioral dermatitis is usually diagnosed through a physical examination. However, in some cases, additional investigations may be recommended to confirm the diagnosis and identify any underlying causes or triggers. These investigations may include the following.
Skin biopsy
A skin biopsy involves taking a small skin sample from the affected area and examining it under a microscope. This can help confirm the diagnosis of perioral dermatitis and rule out other skin conditions.
Patch testing
It involves applying small amounts of potential allergens to the skin to see if they cause an allergic reaction. This can help identify any underlying allergies or sensitivities that may trigger perioral dermatitis.
Culture test
A culture test involves taking a swab or scraping of the affected skin and sending it to a laboratory for analysis. This can help identify bacterial or fungal infections that may be causing or exacerbating the condition.
Blood tests
In rare cases, tests may be recommended to rule out other conditions that can cause a rash, such as autoimmune diseases or hormonal imbalances.
How to Cure Perioral Dermatitis Fast?
Perioral dermatitis treatment usually involves avoiding any irritants or triggers contributing to the condition, such as cosmetics or skincare products that contain fragrances or harsh ingredients. Topical medicines, such as topical antibiotics or azelaic acid, can also be prescribed by a dermatologist to reduce inflammation and speed healing. In addition to topical treatments, oral antibiotics may be prescribed to treat perioral dermatitis. These medications are usually taken for several weeks to help control the condition and prevent future outbreaks.
While there is no known cure for perioral dermatitis, several ways exist to manage the symptoms and help the rash heal faster. Here are some tips that may help:
Stop using all topical steroids
Topical steroids and other skin irritants such as makeup, lotions, and creams often trigger perioral dermatitis. Therefore, it’s essential to identify and stop using products that may exacerbate your condition. This will allow your skin to heal and reduce inflammation.
Avoid strong or abrasive cleansers.
Using strong or abrasive cleansers on the face can further irritate the skin and worsen perioral dermatitis. It’s best to use a gentle, non-irritating cleanser to avoid aggravating the affected area. Consider using a non-soap or a cleanser specifically designed for sensitive skin.
Cold compresses
Applying a cool compress can help reduce inflammation and soothe the skin. A clean cloth soaked in cold water can be used on the affected area for 10-15 minutes, two to three times daily. Be sure to use a clean cloth each time to avoid introducing bacteria or other irritants to the skin.
Use a gentle, fragrance-free moisturizer.
Perioral dermatitis can make the skin dry and itchy, so using a gentle, fragrance-free moisturizer is essential to keep the skin hydrated. Look for a non-comedogenic product that won’t clog pores and is free of fragrance and other potential irritants.
Over-the-counter topical antibiotic cream
Over-the-counter topical antibiotic creams can help reduce inflammation and fight infection in cases of perioral dermatitis. These creams contain ingredients such as metronidazole or erythromycin and are applied directly to the affected area.
Oral antibiotics
Occasionally, oral antibiotics may be prescribed to help clear the rash and reduce inflammation. Commonly prescribed antibiotics for perioral dermatitis include tetracycline, doxycycline, and minocycline.
Topical immunomodulators
In cases where topical antibiotics are ineffective, your dermatologist may recommend a topical immunomodulator such as pimecrolimus or tacrolimus. These medications work by modulating the immune system response to reduce inflammation.
Light therapy
Photodynamic therapy (PDT) or other light therapies may be recommended for more severe cases of perioral dermatitis. This involves using light to kill bacteria and reduce inflammation.
Lifestyle changes
Besides medication and other therapies, your dermatologist may recommend lifestyle changes to help manage your perioral dermatitis. This may include avoiding certain foods or beverages triggering your symptoms, reducing stress, and getting enough rest.
It’s important to note that perioral dermatitis can take several weeks to clear up completely. It’s also important to avoid picking or scratching at the affected area, as this can worsen the rash and lead to scarring. Be patient and consistent with your treatment.
What’s the Best Way to Prevent Perioral Dermatitis from Coming Back?
Preventing perioral dermatitis from coming back can be a challenge, but there are several steps you can take to minimize the risk of recurrence. Here are some tips to help prevent perioral dermatitis from coming back.
Practice good skincare habits.
Good skincare habits can help reduce the risk of perioral dermatitis. This includes using a gentle, fragrance-free cleanser and moisturizer, avoiding over-exfoliating, and removing makeup before bed.
Limit exposure to environmental irritants.
Environmental irritants, such as pollution and harsh weather conditions, can exacerbate perioral dermatitis. Therefore, it’s essential to limit exposure to these irritants by wearing protective clothing and using skincare products that provide a barrier against environmental pollutants.
Manage stress
It can weaken the immune system and trigger skin conditions like perioral dermatitis. Therefore, managing stress through yoga, meditation, or other stress-reducing techniques is essential.
Follow up with your dermatologist.
Regular appointments with your dermatologist can help you monitor your skin and address any underlying conditions contributing to perioral dermatitis. Your dermatologist can also help you adjust your treatment plan to prevent a recurrence.
Signs Perioral Dermatitis is Healing
Perioral dermatitis can take several weeks or even months to heal fully, and the timeline for healing can vary from person to person. However, several signs indicate that the condition is healing.
Decreased redness
As the skin begins to heal, you may notice a decrease in redness and inflammation around the affected area.
Reduced itchiness or discomfort
You may experience less itching or pain in the affected area as the inflammation subsides.
Smoother skin texture
As the rash begins to heal, the texture of your skin may begin to smooth out, with fewer bumps or pustules.
Fewer new breakouts
Over time, you may notice fewer new breakouts or flare-ups, indicating that the condition is under control.
Gradual fading of discoloration
If your perioral dermatitis causes discoloration, such as hyperpigmentation or scarring, it begins to fade over time.
It’s important to note that healing can take time, and it’s normal for some symptoms to persist even as the condition improves.
What Triggers Perioral Dermatitis?
The exact reason for perioral dermatitis is not well understood, but several factors are thought to trigger or contribute to the development of the condition. These include:
Topical steroids
Topical steroids are frequently used to treat various skin disorders, such as psoriasis and eczema. But repeated use of these drugs on the face, especially close to the lips and chin, can damage the skin’s protective layer and cause perioral dermatitis. This is because steroids may thin the skin, increasing its sensitivity to irritants and infections.
Moisturizers and cosmetics
Certain moisturizers, cosmetics, and other skincare products can also irritate the skin and trigger a flare-up of perioral dermatitis. This is particularly true of products that contain fragrances, dyes, or other harsh ingredients. These products can disrupt the skin’s natural barrier, making it more susceptible to inflammation and infection.
Oral contraceptives
Some women may develop perioral dermatitis as a side effect of oral contraceptives. This is because hormonal changes associated with these medications can disrupt the skin’s balance of bacteria and yeast, leading to perioral dermatitis.
Infections
A bacterial or fungal skin infection may trigger perioral dermatitis. This can occur when the skin’s natural barrier is disrupted, allowing harmful bacteria or fungi to enter and infect the skin.
Hormonal changes
Hormonal fluctuations, particularly in women, may also contribute to the development of perioral dermatitis. This is because changes in hormone levels can affect the balance of bacteria and yeast on the skin, leading to inflammation and infection.
Weather changes
Extreme weather variations may worsen the condition, including exposure to cold, dry, or windy circumstances. These circumstances can cause the skin to dry and break its protective natural barrier, making it more prone to irritation and infection. In certain persons, exposure to heat or sunshine can also cause a flare-up of perioral dermatitis.
It’s important to note that what triggers perioral dermatitis can vary from person to person, and some people may have multiple triggers. Suppose you’re experiencing symptoms of perioral dermatitis. In that case, keeping a diary of potential triggers, such as skin care products or weather changes, is an excellent idea to help identify what may be exacerbating your symptoms.
Is Perioral Dermatitis Contagious?
Perioral dermatitis is not contagious. It is a skin condition that typically appears as a rash around the mouth, nose, or eyes. It is thought to be caused by hormonal changes, topical corticosteroids, or certain cosmetic products.
An infection does not cause perioral dermatitis and cannot spread from person to person through physical contact. However, multiple people in a household or environment can develop perioral dermatitis if exposed to the same triggers or irritants.
Is Perioral Dermatitis a Fungal Infection?
Perioral dermatitis is not a fungal infection. It is a skin disorder thought to be brought on by several variables, including hormone fluctuations, topical corticosteroid use, and the use of specific cosmetic products. Perioral dermatitis is characterized by small, red, and bumpy rashes that typically appear around the mouth, nose, and eyes. It can sometimes be mistaken for other skin conditions, such as acne or rosacea, but a fungal infection does not cause it.
Can Perioral Dermatitis Become Rosacea?
Perioral dermatitis and rosacea are two distinct skin conditions, although they can share similar symptoms and sometimes be mistaken for one another. While perioral dermatitis can cause redness and bumps around the mouth and nose, rosacea typically causes redness and flushing on the face, as well as visible blood vessels and acne-like bumps.
While it is not common for perioral dermatitis to progress into rosacea, the two conditions can sometimes coexist or be mistaken for one another. Additionally, some factors contributing to perioral dermatitides, such as topical corticosteroids or certain skincare products, can trigger rosacea.
Is Perioral Dermatitis Permanent?
Perioral dermatitis is a treatable skin condition that may not necessarily be permanent. With proper treatment and management, many people can clear up their perioral dermatitis and prevent it from recurring.
The duration of perioral dermatitis can vary depending on the individual, the severity of the condition, and the underlying causes. Some cases of perioral dermatitis may clear up within weeks to a few months, while others may persist for extended periods.
It is important to note that while perioral dermatitis can be treated, it may recur in some individuals. To prevent a recurrence, it is essential to identify and avoid any triggers or factors contributing to the condition. This may include avoiding certain skincare products, reducing stress, and making lifestyle changes to manage underlying health conditions.
FAQs About Perioral Dermatitis Answered By Your Doctors Online Tea
Perioral dermatitis is a skin condition that affects the area around the mouth. There are different types of perioral dermatitis, including idiopathic, allergic contact, irritant contact, steroid-induced, and periorificial dermatitis.
Moisturizing can help alleviate dryness and discomfort associated with perioral dermatitis, but choosing the right moisturizer is essential. Look for a fragrance-free, non-comedogenic moisturizer that does not contain ingredients that can aggravate perioral dermatitides, such as petroleum jelly or mineral oil. A moisturizer with ceramides, glycerin, or hyaluronic acid can help repair the skin’s natural barrier and prevent further irritation. It’s also important to avoid using any other skincare products that could irritate the skin, such as exfoliants or acids.
The exact cause of perioral dermatitis is poorly understood, but certain foods may trigger or worsen the condition. Some common trigger foods include spicy and acidic foods, citrus fruits, chocolate, caffeine, dairy products, and foods containing artificial additives and preservatives. These foods may aggravate perioral dermatitis by causing skin irritation and inflammation. Keep a food journal and note any symptoms to identify and stay away from trigger foods.
While drinking plenty of water is vital for overall skin health and hydration, no direct evidence suggests it can improve perioral dermatitis. However, staying hydrated can help improve the skin’s natural barrier function and prevent dryness, which may reduce irritation and help manage symptoms. Additionally, avoiding dehydration can prevent the buildup of bacteria in the mouth that can aggravate the condition.
Tiny red bumps and pustules around the mouth characterize a skin ailment called perioral dermatitis. Although the precise cause of perioral dermatitis is unknown, gastrointestinal health may be a factor. This is due to the intimate connection between the skin and the gut, with the gut microbiota impacting the skin’s health.
Research suggests that imbalances in the gut microbiome, such as dysbiosis or overgrowth of certain bacteria, can lead to systemic inflammation, which may trigger skin conditions like perioral dermatitis. Certain foods or food sensitivities can also trigger perioral dermatitis in some individuals.
Stress has been proposed as a potential trigger for perioral dermatitis, even though the specific causation of this ailment is not entirely established. Stress can compromise the immune system, which can result in inflammation and could cause or exacerbate perioral dermatitis. The equilibrium of the gut microbiota can also be upset by stress, associated with the emergence of perioral dermatitis.
No, it is not recommended to let perioral dermatitis dry out. Perioral dermatitis is a skin condition that is characterized by dryness, redness, and irritation around the mouth area, and it is caused by inflammation. Allowing the affected area to dry out can worsen the condition and cause further irritation.
Instead, it is vital to keep the affected area moisturized and hydrated. Using gentle, non-irritating moisturizers can help to soothe the skin and alleviate symptoms. It is also essential to avoid using harsh skincare products, as these can exacerbate the condition.
Yes, there is a potential hormonal link to perioral dermatitis. Studies suggest hormonal changes can trigger or worsen perioral dermatitis in some individuals. This is because hormonal fluctuations can lead to imbalances in the body, which can impact the skin’s health.
For example, perioral dermatitis is more commonly seen in women than men, and it often occurs during periods of hormonal changes such as pregnancy, menstrual cycles, or menopause. Additionally, hormonal contraceptives may increase the risk of developing perioral dermatitis.
Perioral dermatitis is not contagious, which means that it cannot spread from person to person through contact. However, perioral dermatitis can apply to other areas of the face or body in the same individual if left untreated or if triggers are not addressed. In some cases, perioral dermatitis may appear in other facial areas, such as around the nose, eyes, or forehead. This is because the condition is caused by inflammation and imbalances in the skin’s microbiome, which can impact multiple face areas. Additionally, if triggers such as harsh skincare products or specific foods are not addressed, perioral dermatitis may continue to flare up and spread.
