Red rash around your mouth could be perioral dermatitis

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Perioral dermatitis causes a rash, which often looks like acne.

What exactly is perioral dermatitis?

If you have a rash around your mouth, you may have perioral (pair-ē or-əl) dermatitis (der-mah-tie-tis).

This rash often looks like small, red, acne-like breakouts in people with light-colored skin and skin-colored breakouts in people who have skin of color.

Whether red or skin colored, this rash can itch. Sometimes, the rash causes a burning sensation.

It’s also possible that you won’t have any itching or burning. You’ll likely have dry and flaky skin where you have the rash, though.

While this rash often develops around the mouth, it can also appear around your eyes or nose. You may have the rash around your mouth and nose or your nose and eyes.

Some people get it around their genitals. If you have the rash around any of these areas, your dermatologist may say you have peri-orificial (pair-ē or-əh-fish-ul) dermatitis.

Peri-orifical dermatitis is actually a 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. That literally means peri (around) oral (the mouth).

Is perioral dermatitis contagious?

No matter where this rash appears, the mouth or even the genitals, you cannot catch this rash. It’s not contagious.

What causes perioral dermatitis?

It’s not entirely clear what causes this rash. Something may be irritating your skin, such as a skin care product or toothpaste. It’s also possible that you’re allergic to something that’s touching your skin.

Many people develop this rash when they apply a corticosteroid medicine to their skin for too long. That’s why it’s so important to follow the directions for taking medications. Be sure to follow the directions on medications that you can buy without a prescription and your doctor’s instructions for using all medications.

What can get rid of perioral dermatitis?

You may be able to get rid of this rash on your own. To clear perioral dermatitis, you must stop applying all corticosteroids, including hydrocortisone cream, to your skin.

This means that if you’re applying a:

  • Hydrocortisone cream without your doctor’s knowledge, stop using it.
  • Prescription corticosteroid, ask the doctor who prescribed it if you can stop applying it.

If your doctor tells you to keep using a corticosteroid, ask if you can use another medication.

When you stop applying a corticosteroid or hydrocortisone cream, the rash can worsen. If this happens, it can be tempting to start using the cream or ointment again. Don’t. Using it again will only bring temporary relief. Each time you stop applying it, the rash can flare.

Before you stop applying a prescription medicine, check with the doctor who prescribed it.

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It’s also possible that if you continue to apply the corticosteroid medication, it will eventually cause the rash to worsen each time you apply it.

How do dermatologists treat perioral dermatitis?

While this rash may clear on its own, some people need a dermatologist’s help.

To get rid of this rash, you may need to:

  • Stop applying all corticosteroids, including hydrocortisone cream, to your skin
  • Take an antibiotic, such as tetracycline or erythromycin
  • Change your skin care routine

Skin care can play an important role in treating this rash. You may need to switch to a mild, fragrance-free cleanser and be very gentle when you wash your face. You may need to use fragrance-free skin care products.

A dermatologist can examine your rash and create a treatment plan that’s right for you. While many patients receive an antibiotic, you may need a different medication.

In some cases, a patient may need to use a mild corticosteroid cream for a while along with other medication. A dermatologist can determine what approach will work best for you.

How long will it take to get rid of perioral dermatitis?

Expect gradual improvement. This rash tends to clear slowly. It may take a few weeks or a few months to clear completely.

If you’re having trouble getting rid of a rash, you can find a board-certified dermatologist by going to:

Find a dermatologist


Images
Image 1: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

Image 2: Getty Images

References
Chamlin SL and Lawley LP. “Perioral dermatitis.” In: Wolff K, et al. Fitzpatrick’s dermatology in general medicine (7th edition). McGraw Hill Medical, USA, 2008:709-12.

Nguyen V and Eichenfield LF. “Periorificial dermatitis in children and adolescents.” J Am Acad Dermatol 2006;55:781-5.

Rodríguez-Martín M, Sáez-Rodríguez M, et al. “Case letters: Treatment of perioral dermatitis with topical pimecrolimus.” J Am Acad Dermatol 2007;56:529-30.