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What Are the Different Causes of Perioral Dermatitis?

By C. K. Lanz
Updated Mar 03, 2024
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While the precise causes of perioral dermatitis are unknown, possible triggers include makeup and moisturizers, overuse of topical corticosteroids, and dental products that contain fluoride. Characterized by a burning sensation, this facial rash is usually limited to the area around the mouth but occasionally manifests around the nose and eyes as well. It is possible that this type of dermatitis is a form of rosacea, seborrheic dermatitis, or adult acne. A diagnosis usually involves only a physical examination of the affected area. Treatment typically begins by eliminating the irritant, but severe cases may require an anti-inflammatory drug.

In many cases, topical steroid cream applied to the face is one of the primary causes of perioral dermatitis. These creams are topical forms of corticosteroids. They are often prescribed to treat a rash, dermatitis, or eczema. When the cream is overused, the skin around the mouth can become irritated and erupt in the characteristic circular pattern of small bumps. In some cases, the condition will worsen when the steroid cream is discontinued, establishing a cycle of overuse and outbreak.

Other potential causes of perioral dermatitis are makeup, moisturizers, and dental products that include fluoride. Ingredients in the makeup and moisturizer or facial cream may be irritating the delicate skin around the mouth, eyes, and nose. Skin care products with a petrolatum or paraffin base are particularly suspect, as is using foundation in addition to moisturizer and night creams.

Those who are sensitive to fluoride in toothpaste and other dental products may develop perioral dermatitis. There may be some miscellaneous causes of perioral dermatitis, like hormonal fluctuations and oral contraceptives. A doctor or dermatologist may also order a culture for bacteria to rule out bacterial infection as the cause.

This type of dermatitis is treated much like rosacea. If simply stopping use of the irritant does not work, topical antibiotics often clear up mild cases. A severe case may require treatment with an oral antibiotic for several weeks. If the cause is related to overuse of steroid cream, taking a tetracycline derivative for several weeks may be necessary to get through the rebound outbreak.

It is thought that perioral dermatitis is actually a form of adult acne, seborrheic dermatitis, or rosacea. The eruptions that characterize perioral dermatitis are very similar to those associated with rosacea. The difference between perioral dermatitis and these other skin conditions is that the former usually clears up permanently with treatment. The other conditions often reoccur.

Whatever the causes of perioral dermatitis, it primarily affects women. Women aged 20 to 45 years account for approximately 90 percent of cases. It is thought that the number of male patients will increase as men change their cosmetic habits. This condition does occur in children, but is rarely diagnosed.

There are some natural treatment options for this condition in addition to simply discontinuing use of the irritant. Omega-3 fatty acids have anti-inflammatory properties and can help relieve skin inflammation and rashes. These fatty acids are found in fish oil and flaxseed. Some studies have shown that chamomile creams also help relieve dermatitis in general. Any treatment plan for perioral dermatitis should be discussed with a doctor.

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