Eczema & Dermatitis
Perioral Dermatitis
WHAT IS IT
A bumpy red rash around the mouth
HOW COMMON
Common, especially in young women
CONTAGIOUS?
No — you cannot catch it or spread it
CURABLE?
Yes — usually clears with the right approach
What Is It?
Perioral dermatitis is a rash of small red bumps and scaling around the mouth, and sometimes the nose or eyes. A classic clue is a clear zone of normal skin right around the lip border. It can look like acne but is treated differently.
Signs & Symptoms
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Small red bumps and pustules around the mouth
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Fine scaling or dryness over the bumps
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A clear rim of normal skin next to the lips
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Burning or tenderness more than itching
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May extend to the nose or around the eyes
Why Does It Happen?
The exact cause isn't fully known, but it is strongly linked to topical steroid use on the face (creams or inhaled/nasal steroids). Heavy face creams, fluoridated toothpaste, and some cosmetics can contribute. Stopping facial steroids is often key — though the rash may briefly flare first. It is NOT contagious.
Treatment Options
The cornerstone is stopping facial steroids and simplifying skin care, plus prescription treatment. Warn patients the rash may briefly worsen after stopping steroids before it improves.
STOP FACIAL STEROIDS
Discontinuing topical steroids on the face is essential (expect a brief flare).
TOPICAL ANTIBIOTICS
Metronidazole or similar to calm the rash.
ORAL ANTIBIOTICS
A course of tetracycline-class antibiotics for moderate cases.
SIMPLIFY SKIN CARE
Stop heavy creams and cosmetics; use only gentle products.
Tips for Managing It at Home
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Do not apply steroid creams to the face unless specifically told to
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Use a gentle cleanser and stop heavy or occlusive creams
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Be patient — clearing can take several weeks
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Expect a short flare after stopping steroids; keep with the plan
When to Call Your Provider
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No improvement after several weeks of treatment
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The rash spreads to the eyes or becomes severe
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Significant burning, swelling, or discomfort
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You're unsure whether it's this, acne, or rosacea
Sources & further reading
The information in this handout is based on general dermatology guidance from the reputable organizations below. These links are provided for patients who wish to read more from trusted sources.
American Academy of Dermatology (AAD). Perioral Dermatitis. https://www.aad.org/public/everyday-care/skin-care-basics/rosacea/perioral-dermatitis
DermNet. Perioral Dermatitis. https://dermnetnz.org/topics/perioral-dermatitis
MSD/Merck Manual. Perioral Dermatitis. https://www.msdmanuals.com/professional/dermatologic-disorders/acne-and-related-disorders/perioral-dermatitis
This handout is for general education and does not replace advice from your own provider. Always follow your provider’s specific instructions.
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