The condition is more common in women and relatively rare in men. However, its incidence among men appears to be increasing, likely due to the increased use of skincare products and cosmetics. Women between the ages of 16 and 45 are most commonly affected, representing 90% of the patient group. Perioral dermatitis is rare among children. The condition is harmless, self-limiting, and does not leave scars. However, many individuals find it bothersome and seek treatment.
The rash typically appears as red, inflamed skin with bumps around the mouth. Often, there is a clear zone of normal skin closest to the lips. The rash can also appear around the chin, cheeks, nose and eyes. If the rash is primarily located around the eyes, it is often referred to as periorbital dermatitis.
The skin becomes red, and a pimple-like rash with small bumps can be observed. These bumps are usually two millimeters or smaller. Some bumps may be filled with yellow pus. Flaky skin may also be present.
The rash can cause a burning and tingling sensation. It is usually accompanied by minimal itch and no pain.
The diagnosis is based on clinical examination. There is rarely a need for biopsy (tissue samples), bacterial tests, or other diagnostics.
The cause of perioral dermatitis is likely a disturbance in the normal skin bacterial flora and sebaceous gland function, leading to irritation and the subsequent development of the rash.
Several risk factors can trigger or exacerbate the condition, including the use of corticosteroid creams, oily facial creams, and cosmetics. In addition to corticosteroid creams, the use of corticosteroid-containing eye drops, nasal sprays, and inhalers can also increase the risk. Furthermore, sunlight, heat, and birth control pills may play a role. Some women experience worsening symptoms in the week before menstruation.
The condition is not related to allergies.
The most important aspect of treatment is to identify and eliminate the triggering and exacerbating factors. Corticosteroid creams should not be used. Ideally, all types of facial cosmetics, such as makeup, cleansers, moisturizers, night creams, foundations, etc., should be avoided. The face should only be washed with lukewarm water as long as the rash is present. Sunscreen should be thin and liquid-based (gel/fluid).
Although perioral dermatitis is generally self-limiting, some patients experience a more prolonged course. Some may also have noticeable and bothersome rashes. If needed and desired, treatment can involve prescription creams or low-dose antibiotics for one to three months. The treatment aims to restore the normal bacterial flora and reduce irritation.
The prognosis is good, and the skin will normalize. However, relapses can occur, especially among women who use many skincare products and cosmetics. There are treatment regimens available that can prevent such relapses.
Perioral dermatitis can resemble acne, rosacea, and seborrheic dermatitis, but it can often be distinguished from these conditions based on the characteristic distribution of the rash. Perioral dermatitis does not have comedones like acne or facial flushing and telangiectasia like rosacea. Seborrheic dermatitis rarely presents with small bumps and is usually localized to other areas of the face.
