goodtoknow says: Perioral dermatitis is a rash of small red spots you can get around your mouth from your chin up to your cheeks. It normally affects women from their 20s to 40s and looks a bit like acne. It's not normally painful, but can be itchy. You can have just a few spots or a mass of them. The skin in between the spots may be red too, whereas the skin just outside your lips isn't normally affected. Cosmetics, steroid creams, fluorinated toothpaste, sunlight, wind, hormonal changes and the contraceptive pill can all be triggers. Antibiotics can help clear it.
For a full medical explanation of the causes, symptoms and treatments of perioral dematitis from patient.co.uk, read on.
Perioral dermatitis is a rash that develops around the mouth. The word perioral means 'around the mouth'. Dermatitis means 'inflammation of the skin'.
Typically, small red or pink lumpy spots develop on the skin anywhere around the outside of the mouth. That is, it may appear on the chin, cheeks, and the skin next to and below the nose. They look a little like acne spots, but it is not acne. The skin under and next to each lump is often red or pink. It there are a lot of lumps next to each other, then the area of affected skin can just look red and lumpy.
Typically, the skin just next to the lips is not affected, or is affected much less than the skin just a little further away from the lips. So, in some cases, it looks like the rash forms almost a 'ring' around the mouth, but sparing a small border of skin next to the lips. Occasionally, the skin around the eyes is also affected.
The severity of the rash can vary from a few minor spots that are barely noticeable, to a definite and obvious unsightly lumpy rash that is around the mouth. The rash is not usually painful or itchy. However, some people report a mild burning or itchy feeling. The rash is not serious and is not associated with any underlying disease. However, it can be unsightly.
Almost all cases occur in young women, most commonly between the ages of 20 and 45 years. It is thought to affect up to 1 in 100 women at some point in their life. It is uncommon in men and children.
The cause is not clear. However, in many cases the rash seems to be triggered by one or more of the following:
Topical steroids can also temporarily clear a mild patch of perioral dermatitis. Some people will have tried a steroid cream that you can buy at pharmacies to treat what they think is mild eczema. However, as soon as the rash clears, and you stop the steroid, the rash re-appears, only even worse. This can get into a vicious circle as you may then put more steroid cream on to clear the reappearance of the rash, which may clear. Again, you may then stop the treatment, but then the rash comes back again even worse. Etc.
Without treatment, the condition may last months or years. Treatment can usually help.
Firstly, your doctor is likely to advise that you stop using any cream, ointment, cosmetics, etc, on your face, In particular, to stop using any topical steroid. If you have been using a topical steroid, the rash will get worse for several days before it gets any better. You may have to anticipate and accept this. Just wash your face with water only whilst the rash is present. Some doctors advise not to use toothpaste that contains fluoride.
Even when the rash has gone, it is best to not use any cosmetics or creams on the affected area as the rash may re-appear. And use only a bland liquid face cleaner to wash your face rather than bar soap.
Your doctor may prescribe an antibiotic tablet in the tetracycline group. Topical antibiotics are sometimes used in milder cases. The course of treatment is usually 6-12 weeks and you may not notice any improvement for the first few weeks whilst taking treatment. However, there is an improvement in most cases within two months after starting antibiotic treatment. So, do persevere if an antibiotic is prescribed. The way antibiotics work in this condition is not clear. It is not a simple skin infection. However, tetracyclines and some other antibiotics have an action to reduce inflammation in addition to killing bacteria, and this may be why they work.
See www.patient.co.uk/showdoc/1097/ for links to websites showing pictures of skin conditions.
© EMIS and PIP 2007 Updated: February 2007