Perioral dermatitis

Definition

Perioral dermatitis is a skin disorder characterized by tiny red papules (bumps) around the mouth.

Causes, incidence, and risk factors
Perioral dermatitis most commonly affects young women. However, it may sporadically affect men. While its exact cause is unknown, it may appear after topical steroids are applied to the face to treat other conditions.

Symptoms

Perioral dermatitis is usually characterized by an uncomfortable burning sensation around the mouth. Itching is not a common symptom.

Most often, patients are primarily concerned with the cosmetic appearance of skin lesions.

In most cases, discrete papules (bumps) and vesicopustules (fluid- or pus-filled bumps) are seen around the mouth. Rarely, a similar rash may appear around the eyes, nose, or forehead.

Signs and tests
Your physician will likely diagnose perioral dermatitis based upon the appearance of your skin. A culture for bacteria may sometimes be needed to eliminate the possibility of infection.

Treatment

Generally, steroid creams should not be used to treat perioral dermatitis. Your physician may chose to treat these lesions with other topical medications, such as metronidazole, erythromycin, benzoyl peroxide, tacrolimus, or pimecrolimus.

In more severe cases, oral antibiotics (such as tetracycline, doxycycline, minocycline, or erythromycin) may be required.

Expectations (prognosis)

Perioral dermatitis is a difficult condition to treat effectively, often requiring several months of treatment.

Recurrences are not uncommon, particularly if topical steroids are reapplied to the face.

Calling your health care provider
Call your physician if you notice persistent red bumps around your mouth.

Prevention
Avoid using any topical steroids on your face, unless specifically directed by your dermatologist.

Johns Hopkins patient information

Last revised: December 5, 2012
by Potos A. Aagen, M.D.

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