Perioral Dermatitis

Perioral dermatitis is a relatively common facial rash that typically affects young women ages 15 to 40. As the name implies, the rash is commonly located around the mouth. It has a characteristic appearance with groups of tiny bumps surrounded by intense redness. There is also a distinctive zone immediately around the mouth with normal skin coloration. Perioral dermatitis looks a bit like acne, but it is not acne. It looks a bit like dermatitis, but it is not dermatitis. It seems to be an entity all its own.

While we are not completely certain what causes perioral dermatitis, it appears to have an association with fluctuating hormones or stress. Unfortunately, the most common cause of perioral dermatitis is the doctor. Using a topical cortisone that is too strong for the face or using a milder cortisone for too long a duration, causes the skin to develop a steroid dependence. Application of the medicine will help the rash slightly, but after a few days the eruption begins to worsen. If the ointment is stopped, within days the rash explodes, becoming much more red and angry-looking.

Fortunately, the treatment of perioral dermatitis works in almost everyone. I have found that a course of an antibiotic, either tetracycline or doxycycline, will resolve almost every case of perioral dermatitis. The typical woman will clear in about six weeks. Sometimes a topical medication, such as Elidel or Protopic, will be given in order to help diminish the redness. If your rash was caused by a topical steroid, it may be more difficult to treat. You may also go through an initial flare of the rash, which can be quite dramatic. Unfortunately, you will not get improvement without experiencing at least a small flare. The topicals that will be prescribed can help a little, but the best thing to do is to accept the flare and work through it.

Sometimes, perioral dermatitis is recurrent. This happens every several years. If you experience a similar eruption beginning to develop, call the office and be seen quickly. Early treatment means an early cure.