Skin Rash #1: Perioral Dermatitis

A guide to solving a pesky problem

Disclaimer: This is meant for general skincare advice and sharing of knowledge. This is not medical advice.

Welcome Back! I have taken some time off through the last few months as I moved into a new home. As you all know that can be extremely time consuming Today will be a different more technical type of post. I get this question a lot on twitter so it is time to address it. Let’s dive in!

What is Perioral Dermatitis?

In short, we can simply break the name down: “perioral = around the mouth” and “dermatitis = inflammation of the skin”. Perioral dermatitis can also affect around the openings of the nose as well. The rash itself is a rather common chronic inflammatory skin eruption with an unknown etiology. Although the cause is unknown, there are still ways to stratify risk factors and common triggers for this particular problem which is what I will accomplish today.

First off, this is a classic picture of what Perioral Dermatitis can and will look like:

As you can see, there is moderate inflammation around the mouth as well as the nasal openings. Sometimes associated with this inflammation can be raised pimple like bumps. These may or may not be present but can cause irritation to be worsened. The below picture is more of an in-depth look of inflammatory pimples that are associated with this condition:

As important as it is to understand how this can present, it is equally important to understand who is more likely to get perioral dermatitis and who is at a higher risk for perioral dermatitis. These are the things that are in your control and things that I want to help you understand in order to leave this condition in 2022.

PD causes and who is likely to get it

The reason I mention this is because there are many rashes that can occur around the mouth and face that can be mistaken for perioral dermatitis. Understanding the demographics of this particular condition can help differentiate between these other rashes.

Now this visual is a simplified version but this tells us a lot. Perioral dermatitis most likely affects younger females with lighter skin complexions. 20-45 year old females and 7months-13 year olds are broad categories but it does tie into the suspected causes.

Exogenous irritants basically cover anything that can penetrate the stratum corneum, the top layer of skin, and cause irritation. Most commonly these include:

1. Various forms of corticosteroid use such as topical creams, oral, and inhaled versions.

2. Fluoride in toothpaste is thought to possibly be an irritant and trigger for PD

3. Excessive dryness or sunburn of the lips and the surrounding (Keep Your Lips Healthy)

4. Any excessive use of harsh products or exfoliators on the face can trigger the irritation of perioral dermatitis

Other than dryness and certain exogenous irritants, some of perioral dermatitis is completely idiopathic (of unknown cause) and can be frustrating to understand. It can frequently be mistaken for other diagnoses and can at times be a catch all for a vague, generic rash around the mouth. Either way, I can help you with some general measures to take if you suspect that this may be happening to you.

Perioral Dermatitis DOs and DONTs

Perioral Dermatitis DOs:

1. Look at your skincare routine and pause any new products that might have been recently added

2. If your skin is inflamed and irritated then pause any harsh acne ingredient cleansers such as salicylic acid, retinol or benzoyl peroxide

3. Trial different gentle soaps and cleanser to find one that does not cause further irritation

Perioral Dermatitis DONTs:

1. Do not use topical steroid creams such as Hydrocortisone cream if you think you have PD. These creams typically make things more severe.

2. Do not pick or pop any pimple like bumps that may occur. This can lead to more scarring. Read this for more info Why You Should Not Pop Pimples?.

3. Do not over worry as stress can tend to make things like this worse. I know that having a condition like this can be cosmetically displeasing but I assure you that we can get this fixed. Trust your friendly online skincare provider.

Perioral Dermatitis is self-limiting which means that it will go away with no long term consequences but don’t worry there are ways to speed up this process.

General Measure to Fix PD

1. Stop all cosmetic products as they can be the likely culprit. As the rash goes away then start to introduce one at a time which will eliminate any confusion as to whaat could be causing this.

2. Switch to a bland moisturizer such as Vanicream. Vanicream is great for sensitive skin and typically minimizes common exogenous irritants like fragrances and dyes.

3. As mentioned above, stop using any topical steroids as this will make things worse.

Specific Measures to Fix PD

1. See a Dermatologist for prescription treatment

2. Azelaic Acid topically can help to reduce redness and swelling

3. Prosacea will also help reduce redness and irritation

Overall, if this is something that you experience then I hope that this article shed some light. Either way, stay tuned for more common skin rash posts as we continue this series. If you enjoyed this post then hit the subscribe button below and stay tuned!