What Is Perioral Dermatitis? Causes & Treatments

You might not know perioral dermatitis by name, but chances are, you’ve either experienced the scaly red rash yourself or you know someone who has. In fact, Hailey Bieber shared that she struggles with the skin condition, stating that some products irritate her skin, giving her an itchy rash around her mouth and eyes. 


But perioral dermatitis causes can sometimes be linked to more than just the wrong skincare routine.


Interested in learning more? Read on to learn everything you need to know about perioral dermatitis, including what it is, what causes it, and how it’s treated. 


What Exactly is Perioral Dermatitis?

If you have a red rash around your mouth, you may have perioral dermatitis. This rash often looks like small, red, acne-like breakouts in those with light-colored skin and skin-colored breakouts in those who have dark-colored skin. 

But regardless of the color, this rash can be extremely itchy, and sometimes it can also cause a burning sensation. It’s also possible that you won’t experience any itching or burning -- you’ll likely have dry and flaky skin where you have the rash, though. 

While this rash is notorious for developing around the mouth, it can also appear around your nose and eyes. Some people even get it around their genitals. If you happen to have perioral dermatitis in any of these areas, your dermatologist may say you have periorificial dermatitis.

Periorificial dermatitis is actually a much more accurate name for this rash. “Peri” means “around,” and “orifical” refers to “an opening.” No matter where this rash appears, though, people often refer to it as perioral dermatitis, which literally means “around the mouth.”


Causes Perioral Dermatitis

To be honest, doctors don’t know exactly what causes perioral dermatitis. It affects women far more than men, but experts say there are a ton of unanswered questions about potential triggers as they tend to vary from person to person. Ugh, right?

One of the most common causes is steroid cream (including OTC hydrocortisone creams and prescription meds). Many individuals make the mistake of using these creams on their rash because they think it’ll help clear it up, but it can actually make it much worse. Other factors that may trigger perioral dermatitis include:

Depleting The Skin Barrier

Ok so boom.Your skin barrier is essentially a combo of lipids (a fancy word for fats) and skin cells that keep your skin functioning and healthy to protect your insides. Sabotaging your skin barrier allows moisture from your skin to evaporate easier and lets irritants enter your body. Basically, it ain’t good!

Lack of intact barrier function results in a loss of your skin being able to protect itself. The skin gets chronically irritated, inflammation sets in -- and perioral dermatitis is one of the manifestations. 

There are plenty of ways you might damage your skin barrier, including environmental exposure, not drinking enough H2O, and going too hamon harsh cosmetic products.. Misusing physical and chemical exfoliators is a major culprit too. 


Hormonal changes from pregnancy can sometimes trigger perioral dermatitis. There is also evidence that hormonal birth control can play a role. 

Other Possibilities

Other possibilities that may contribute to perioral dermatitis include:

  • Toothpaste containing fluoride (not a proven cause, but it’s associated with perioral dermatitis)

  • Some sunscreens

  • Nasal or inhaled corticosteroid meds that accidentally get on the skin

  • Infections

There are also some theories that dairy may be a contributing factor in perioral dermatitis, but there isn’t sufficient research to back this. 

Additionally, other conditions can sometimes look very similar to perioral dermatitis. For instance, allergic contact dermatitis, an allergy to certain ingredients in skincare products or even certain foods, can trigger a similar red, flaky rash. Sometimes, foods like tomatoes or cinnamon can trigger this kind of allergic rash, which can easily be mistaken for perioral dermatitis if it shows up around the lips and mouth.  


How to Treat Perioral Dermatitis

At this time, there is no cure for perioral dermatitis, but there are many options to manage the condition. Prevention, natural remedies, and avoiding triggers, along with medicines, can help you to heal faster. So don’t stress about it. 

Here are some of the best tips and tricks to prevent flare-ups and manage perioral dermatitis. 

Assess Your Skincare Routine

First things first, stop all potentially irritating products! No scrubbing or foaming cleansers and no active ingredients either. 

Yep, stay away from the AHAs and take it back to basics. Instead, replace them with gentle cleansing and  moisturizing, morning and night, as you aim to reduce any further irritation. 

Not sure where to look? We’ve got you. Check out our hydrating mask LIKE BUTTER here at Topicals -- it’s a thick, whipped mask packed with powerful botanicals for skin so smooth, it’s like butter. Not only does LIKE BUTTER restore and soothe dry, flaky skin, but it will also help to fortify your skin’s damaged moisture barrier. 

Also check out FADED -- it’s our gel serum that gently fades the look of your most stubborn scars, marks, and spots so that you can kick back and let your worries fade away. Made with science-backed ingredients and herbals, this powerful ,yet gentle,brightening and clearing gel will do wonders.

Stop Using Steroid Cream

Experts recommend stopping the use of steroid creams, especially if they are the suspected trigger. You are likely to see a rebound or flare-up of perioral dermatitis after you stop using the cream, but this is just your skin adjusting, so don’t be tempted to start using it again. Go easy on yourself. 

Prescribed Meds

The gold standard prescription is oral anti-inflammatory antibiotics, specifically in the tetracycline family. The ones commonly prescribed are doxycycline and Minomycin. A topical anti-inflammatory, non-steroid cream can also help. 

Diet And Lifestyle Modifications

As we mentioned, it’s not totally certain as to what causes perioral dermatitis, but gluten intolerance is a known cause of flare-ups. 

To control and prevent recurrences, your diet needs more of:

  • Broccoli

  • Spinach, kale, and fenugreek

  • Quinoa and millets

And this is what you should eliminate from your diet to help improve the condition:

  • Dairy products

  • Alcohol

  • Spices such as cinnamon

  • Processed foods

  • Sugar

  • Caffeinated beverages

  • Excessively spicy and salty foods

We know it might suck, but your skin will appreciate you even more than it already does. 

Protect Your Skin From The Sun

A lot of folks dealing with perioral dermatitis  find their flare ups increase when exposed to sunlight. But, believe it or not, the same proportion finds that their skin actually improves from the sun. It’s a little complicated.

This is really similar to how different people living with different skin conditions react to sunshine -- for example, some people with eczema can soak up the warm summer rays and find the sunny season is when their skin is at its best, while others find being out in the sun makes everything more intense, making them itchy, hot and inflamed. You can only go by your own experience. 

It’s also important to realize that  many people with the condition find that sunscreen makes their skin worse, rather than the sunshine itself. Medical advice is to avoid sunburn, so if you’re one of those whose skin flares up when you’re in the sun, you’ll either need to find a hypoallergenic sunscreen that your skin tolerates well or simply avoid the sun by wearing wide-brimmed hats or staying in the shade. 


Bottom Line

Perioral dermatitis can definitely be tough, not to mention painful in some cases, but the good news is that you can get through it. 

In the long-term outlook, most people will get better with treatment and then do well for a period of time -- but it’s fairly common to have a recurrence of the rash or a flare-up at a later time. Even if you’re doing everything right, you may still experience perioral dermatitis. It’s life.

To keep your skin feeling extra loved, head on over to Topicals to be there when flare-ups slide through. We got you!