How Do You Treat Perioral Dermatitis?

Treatment of perioral dermatitis depends on the extent of the disease and the underlying cause.

Perioral dermatitis (POD) is a rash that involves the skin around the mouth. The rash of POD is bumpy and scaly in appearance. There may be itching and pain, along with the discharge of clear fluid from the rash. POD mostly occurs in women and children. 

The exact cause of perioral dermatitis is not known. Long-term use of steroid creams and ointments for minor skin conditions of the face can possibly lead to perioral dermatitis. 

The underlying cause of perioral dermatitis is not always known. Factors that may trigger perioral dermatitis include the following:

• Drugs: steroid creams, ointments, and inhalers 
• Fluorinated toothpaste 
• Skincare lotions and creams, especially those containing petroleum jelly, paraffin base, and isopropyl myristate 
• Sunscreens
• Makeup products
• Certain scented skincare products
• Ultraviolet (UV) light
• Heat
• Dust
• Wind
• Certain infections
• Oral contraceptives
• Hormones
• Vitamin B12 deficiency

Common signs and symptoms of perioral dermatitis include:

• Redness and bumps around the skin of the mouth
• Itching may be present
• Burning sensation
• Dry, flaky skin
• Crusting
• A tightening sensation on the skin around the mouth
• Watery discharge from the rashes
• Rash may involve the eyelids, nose, forehead, and genitals

Treatment of perioral dermatitis depends on the extent of the disease and the underlying cause. Steroid creams or ointments should be discontinued. Treatment options include:

• Praziquantel cream
• Pimecrolimus cream
• Antibiotic creams 
• Oral vitamin A analogs
• Oral antibiotics
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Avoid the use of cosmetics, cleansers, and moisturizers during the treatment
• Avoid strenuous physical exercise until the skin heals

When the exact cause of perioral dermatitis is not known, there are no specific strategies to prevent it. Following precautions may help avoid episodes of perioral dermatitis:

• Avoid using steroid creams and ointments unless prescribed by your doctor
• Avoid using harsh cosmetics and fragrances 
• Protect your skin from strong sunlight
• Keep your face clean with water and gentle cleansers
• Minimize the use of makeup
• Consume a healthy diet

• The diagnosis of perioral dermatitis usually does not require any tests. 
• Your dermatologist or physician can diagnose it by visual examination of your face. 
• They may ask you about the use of steroid creams and ointments apart from other relevant histories.
• Swabs may be collected to perform skin culture for ruling out a possible infection. 
• In rare circumstances, your doctor may take a sample of the affected skin and send it for a skin biopsy. This is done when the standard treatment regimen is ineffective.
• Blood tests may be used to rule out nutritional deficiencies.