Perioral Dermatitis Symptoms and Treatments

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Perioral Dermatitis Symptoms and Treatments

Contrary to popular belief, perioral dermatitis can be cured and at the very least the symptoms vastly reduced.  Please always seek advice from your doctor before undertaking any new treatment.

What are the treatment options for perioral dermatitis?

Your doctor or dermatologist will determine your treatment based on the severity of your condition. In some cases, using mild soaps and discontinuing the use of heavy skin creams and fluorinated toothpaste may ease symptoms. Medication may also speed healing.

Your doctor or dermatologist may prescribe and/or recommend the following;

Prescription medications

  • topical antibiotic medications, such as metronidazole (Metrogel) and oral antibiotics such as erythromycin
  • immunosuppressive creams, such as pimecrolimus cream
  • topical acne medications, such as adapalene or azelaic acid
  • oral antibiotics, such as doxycycline, tetracycline, minocycline, or isotretinoin, for more severe cases

Some patients prefer to try natural remedies in addition to or in place of prescription medications which are not working.

There are countless scientific studies showing the efficacy of natural ingredients.

Natural Topically Applied Treatments

  • Natural topically applied creams such as ProSkin Eczema are proving more popular as they provide a safe, natural approach that is also extremely effective.
  • Pure aloe vera is also widely used in the treatment of inflammatory skin conditions like perioral dermatitis. Aloe will help to restore the pH balance of your skin and relieve the itching sensation as well as skin irritation.
  • Vitamin E oil is a natural product that promotes quicker skin healing and also provides significant relief from itching and inflammation. This product can be rub/massaged directly onto the PD rash, once or twice per day.
  • apple cider vinegar (watch this may sting and is drying!!! probably better diluting it with water)
  • green tea
  • Other effective natural remedies include coconut oil, lavender oil, tea tree oil and calendula.

Natural and alternative remedies

These include:

  • taking vitamins A, E, C
  • taking zinc supplements
  • blue light treatment
  • TCM (Traditional Chinese Medicine)

Diet and lifestyle

Part of treating perioral dermatitis is diet and lifestyle changes that can help prevent it. Some possible actions include:

  • Get rid of harsh face scrubs or artificially perfumed cleansers. Instead, use only warm water during flare-ups. Once healed, only use mild soap and don’t scrub at the skin.
  • Avoid steroid creams, even non-prescription hydrocortisone.
  • Stop using or reduce use of makeup, cosmetics, and sunscreen.
  • Wash your pillow cases and towels in hot water frequently.
  • Limit overly salty or spicy foods.

How can I prevent perioral dermatitis?

Since the causes of perioral dermatitis vary and the cause is not completely understood, there isn’t a foolproof way to avoid getting it. However, there are some things you can do to help alleviate it or to keep it from getting worse:

  • Avoid steroid creams and ointments unless specifically directed by your doctor. If another medical practitioner prescribes a topical steroid, make sure to let them know that you have perioral dermatitis. In general, it is more likely to occur with stronger topical steroids than weaker ones, so use the weakest possible one to treat the disease.
  • Avoid using heavy cosmetics or skin creams. Ask your doctor which moisturizers are acceptable to use. Try switching brands if you decide to continue to use cosmetics.
  • Switch to gentle cleansers and moisturizers. Ask your dermatologist for recommendations that would best suit your skin.
  • Limit the amount of time your skin comes into contact with the elements. UV rays, heat, and wind can aggravate perioral dermatitis. Some medications used to treat perioral dermatitis will also make your skin sensitive to the sun. Be sure to protect your skin if you’ll be in the sun for prolonged periods. 

Common triggers

There are several common triggers that can result in a perioral dermatitis outbreak. These should be avoided as much as possible.

These triggers include:

  • using a steroid cream on the face
  • makeup and harsh cleansers that are applied to the affected or irritated area, which can make flare-ups worse
  • exposure to ultraviolet light
  • exposure to strong winds
  • birth control pills
  • fluorinated toothpaste

Risk factors

Some people will be more prone to or at risk of developing perioral dermatitis than others. Risk factors include:

  • gender (women are more likely to develop this condition than men)
  • use of steroid creams or ointments on the face
  • age (teenagers, young adults, and middle-aged adults are most likely to be affected)
  • presence of an autoimmune disorder
  • a history of allergies
  • hormonal imbalances
  • environment (those who are more frequently exposed to strong winds are more likely to develop this condition)

What is perioral dermatitis?

Perioral dermatitis is an inflammatory rash involving the skin around the mouth. The rash may spread up to the nose or even the eyes. It usually appears as a scaly or red bumpy rash around the lips. There may be a clear fluid discharge. Redness and slight itching and burning can also occur.

Perioral dermatitis is more common in women between the ages of 16 to 45 years, but can be seen in all ages, races, and ethnicities. When it occurs in children, it tends to affect younger children with an average age of 6 years. Without the right treatment, cases of perioral dermatitis go away but may reappear later. Episodes of perioral dermatitis can last weeks, months and sometimes even years.

What causes perioral dermatitis?

The cause of perioral dermatitis is unknown. However, research suggests that it can occur after the use of strong topical steroids on the skin, which may be prescribed to treat another condition. Nasal sprays containing corticosteroids can cause perioral dermatitis as well.

There is also evidence that certain ingredients in cosmetics can cause perioral dermatitis. Heavy skin creams that contain petrolatum or a paraffin base may cause or worsen this condition.

Other factors that may trigger this condition include:

  • bacterial or fungal infections
  • constant drooling
  • fluorinated toothpaste
  • sunscreen
  • rosacea
  • hormonal changes due to the oral contraceptive pill
  • hormonal changes due to the menopause
  • hormonal changes due to monthly cycles

How is perioral dermatitis diagnosed?

Your doctor or dermatologist can often diagnose perioral dermatitis with just a visual examination of your skin, along with your medical history.

Your doctor may also perform a skin culture test to rule out a possible infection. During this test, your doctor will swab a small patch of skin in the affected area. They will send the sample to a laboratory to test the skin cells for bacteria or fungi. Your doctor may perform a skin biopsy, especially if the rash doesn’t respond to standard treatments.

The video below shows how Blue Light Treatment can be effective for PD. 

Disclaimer :

The information above is for educational purposes only. We do not advocate the use of any products recommended in this article except our own and we are firmly against products containing artificial ingredients, those which are tested on animals, and those produced by companies who still carry out animal testing outside of the EU. 

6 responses to “Perioral Dermatitis Symptoms and Treatments”

  1. Emma K says:

    I disagree! I have never used steroids either internally or externally yet I’ve suffered with several awful outbreaks of PD over several years. I do not find this easy to get rid of, no matter what I do. Heals on its own eventually, as long as I put NOTHING on my face at all. Can’t be hormonal cos I’m fifty and finished with all that! I finally concluded my foundation was to blame… full of ‘nanoates’ as are most foundations, creams and sun screens. Just look up that word and you’ll see it’s an horrendous technology they’re using in our cosmetics. The body reacts to these little microscopic nanoates as if it is attacking a virus. Hence the length of time it takes to get rid of and the fact only antibiotics speed up healing. :-/ One for the conspiracy theorists to chew over, I think!

  2. Stella kerrod says:

    I have recently developed this perioral dem, it started soon after i took the miny pill!
    (Stopped pill straight away )
    I am 52, Rrrrrrr, don’t need rashes etc at this age.
    Doctor prescribed hydrocortisone, then fucidin H both making it much worse.
    I worked out the perioral dem myself after 10 months!
    Also the less you put on it, the better. It has almost cleared up once.
    I have a 4 week wait to re visit the doctor.
    Antibiotics cream i hope

  3. Marcie A says:

    I recently developed perioral dermatitis that looks just like this picture. I was initially confused, but after reading how other people with this condition had allergies and digestive issues, it made total sense to me. I decided that the cause was the same as when I had psoriasis, which I basically cured with an alkaline diet, i.e., eating lots of leafy greens. I’m sure everyone is different, but I suspect that the microbiomes in my body are just really imbalanced from too much acidity in my body (or maybe from tons of antibiotics as a child) — and of course from allergies and digestive issues. Bad skin can actually show bad digestion according to traditional Chinese medicine. So I’ve been taking probiotics, using massive amounts of coconut oil, occasionally rubbing my chin with bleach and ingesting baking soda dissolved in water (because they’re bases, but maybe ignore those things), paying more attention to my food allergies, and eating a lot more leafy greens, pineapple, and watermelon. And I’ve been doing some acupuncture/acupressure points related to digestion. I’m still having some sugar and coffee (though I’m sure cutting it out would help), but in the past week, the perioral dermatitis has been improving a lot. I just thought I’d share this in case this helps someone whose root cause might be similar to mine.

  4. jaynie says:

    I have had Perioral Dermatitis for over 6 months now, its only almost gone on a couple of occasions and i dont know why, but for the most its flared up covering most of my face, itchy and burning, so bad ive not been able to go out and even had to have time off work. Ive been seen by dermatologist – Topical steroids, can be a main cause, i have been using ointment for eczema on my hands which ‘might’ apparently have been the initial cause, my gp had also given me a milder steroid ointment for the facial rash (before diagnoisis by the dermatologist) which ive been told added to the problem. Although it helps for a few days, it is also the cause of it remaining and not healing.
    I now have to go cold turkey on the use of the ointments which can and will cause a bad flare up for possibly 2 weeks or so, i did run out of ointment once and it did flare up really bad, but unknowing at the time got more ointment, it has at no time done anything more than stop some of the burning/itch it only eliviates some symptoms intitally as i have flare ups even when using it and now it seems its actually prolonging the rash rather than healing.
    The best thing to happen so far was washing my face very mild soap and rinsing lots without rubbing my face, each time it itched or burned, i then took an antihistamine and the ointment. So far its the best my face has been and im not washing my face adding ointment nor taking antihistamines so often for the first few weeks i can now see ‘normal’ coloured skin around my mouth and just look spotty rather than a burns victim. The dermatologist has put me back on antibiotics, ive had 3 courses of different ones from the gp and they seem to do little, however this time im to take them for 3 months. I was put on Prednisone for 7 days reluctantly by the gp because i had a wedding to attend it did reduce the rash right down but i was left with a small amount after the 7 days of which i put the ointment on ( knowing as i do now , it might have got rid of it had i not used the ointment) the gp didnt want to give me predisone in the first place and only gave it me as it was so bad (the worst it had ever been) and i was so distressed she will not give me any more and yet i have read others have had it for longer and it has cleared theirs. I must add i dont want to be using steroids, even in the creams let alone orally, but needs must with my face as it was it became a necessity. I have had smaller flare ups still nasty but i seem to be controlling it better and since the frequent rinsing of my face definitely and improvement. However, im just about to stop using the ointment… and on to the antibiotics. I will be continuing to wash my face with the itch or burning im trying to keep my face as clean as possible, i do have to wear make up at work 2 days a week as im at front desk job, i cant not wear make up with this on my face , i just cant, i feel like a leper as it its 🙁 what ive done is i now take my make up and refresh it during my breaks. I have also tried to cut down on sugar milk and salt im eating healthier REF : the post above i think it helps to cleanse the body certainly i believe what we eat effects our skin hair etc , its by no means easy. I think as from here its watch this space i will do a catch up post in a few weeks let you know how its gone with my routine,

  5. Gillian says:

    I thank my lucky stars I read this article. I had been battling with perioral for some time and the doctor and dermatologist between them could not find an answer for me. The antiobitics and metrogel did nothing and one of the creams (that I have forgotten the name of) even made it worse. I tried the pro skin excema mentioned and within a fortnight my perioral was completely gone. I have had no recurrance of this which is great as I had perioral for five years.

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