Perioral Dermatitis Treatment, Marylebone, London 

Perioral dermatitis is a facial skin condition characterised by red, bumpy rashes that typically appear around the mouth but can also affect the nose and eyes. Despite its name, perioral dermatitis is not related to eczema, though it shares some similarities. This condition predominantly affects women aged 20 to 45, although men and children can also be affected. We’re now seeing a lot of perioral dermatitis to do with the high number of products and therefore chemicals that people put on their skin, which affects the skin barrier and may cause a change in the skin microbiome. So, how can you identify perioral dermatitis and what is the best way to manage it if you are suffering from the condition? In this blog post, I discuss everything you need to know.

What is Perioral Dermatitis?

Perioral dermatitis, or skin inflammation around the mouth is just that – a rash of tiny flat-top bumps concentrated around your mouth. It can also sit just underneath the nose, in the crevice down to the nasolabial folds, and looping around the chin area. In some cases, it can also appear in the eye area. While it can cause a burning sensation, it’s also possible to experience no discomfort at all.

What does it look like?

The condition can show up as small, sometimes pinhead-sized, fluid or pus-filled bumps. It can also appear as a bright red rash, which may look purplish or brown on darker skin, with inflamed areas that seem almost burnt. Under the nose, it may resemble the raw, irritated skin that comes from frequent rubbing during a cold. The skin may sometimes become scaly, though this isn’t always the case. Occasionally, it can appear as a combination of acne, rosacea, and eczema, all in one.

What causes Perioral Dermatitis?

The exact cause of perioral dermatitis is unclear, but several factors can contribute to its development:

  • Topical Steroids: The use of steroid creams or inhaled steroids is a well-documented trigger. Even accidental transfer of steroids from hands to the face can initiate or exacerbate the condition.
  • Cosmetics and Skincare Products: Products containing fragrances, preservatives, and certain chemicals can irritate the skin, leading to perioral dermatitis.
  • Fluorinated Toothpaste: Some studies suggest that fluoride in toothpaste can worsen the condition.
  • Hormonal Changes and Stress: These can also play a role in triggering or aggravating perioral dermatitis.

Symptoms include clusters of red bumps around the mouth, which may contain pus, and skin that may be dry, flaky, or itchy.

How is it diagnosed?

Diagnosis typically involves a physical examination by a healthcare provider, who will assess the affected area for signs of redness, inflammation, and scaling. In some cases, additional tests like a skin biopsy may be conducted to rule out other conditions such as rosacea or acne.

How can Perioral Dermatitis be treated?

Treating perioral dermatitis effectively requires a multifaceted approach:

Discontinue Steroids

If steroid creams are the cause, they should be stopped immediately. However, this might initially worsen the rash before improvement is seen.

Simplify your skincare

Strip back to a basic skincare routine, avoiding heavy creams, makeup, and any products with fragrances or preservatives. Use gentle cleansers and lightweight, non-comedogenic moisturisers to help heal the skin barrier.


Both topical (e.g., metronidazole, clindamycin) and oral antibiotics (e.g., tetracycline, doxycycline) are commonly prescribed. This helps reduce inflammation and bacterial load, although improvement might take several weeks to become noticeable.

Avoid Triggers

Identifying and avoiding personal triggers, such as certain foods, cosmetics, or stressors, can help manage and prevent flare-ups.

Lifestyle Changes

Incorporate stress management techniques and maintain good skin hygiene. I also recommend avoiding fluorinated toothpaste and chewing gum.

In more severe or persistent cases, consulting a medical skin health professional such as a dermatologist or dermatology nurse is crucial for personalised treatment plans, which might include advanced therapies such as photodynamic therapy or specific skincare regimens.

Perioral dermatitis can be a chronic and frustrating condition, but with proper management and treatment, it is possible to achieve clear, healthy skin. If you suspect you have perioral dermatitis, seek medical advice to get a proper diagnosis and treatment plan tailored to your needs.