Perioral Dermatitis- A Puzzling Eruption That Localizes Around the Mouth

Out of nowhere it seems crops of small bumps develop around the mouth that can also be associated with dryness, scaling and redness.

While initially inconspicuous, the number of lesions can increase on an ongoing basis until a point is reached that the breakouts are distracting and uncomfortable.

The initial reaction that you usually notice is the appearance of small bumps that you probably think will stop and that the condition will clear up on its own, but as time goes by, you notice that the bumpy areas persist for weeks or even months despite trying a variety of home remedies.

Eventually, you might end up like many individuals with this type of eruption in a dermatology office.  After an evaluation and examination, the diagnosis of perioral dermatitis is usually made right away due to its very unique features and appearance.

One of the quirky things about Perioral Dermatitis is that not only can it cause you to get red bumpy areas around the mouth and chin, some of the same type of lesions can mysteriously appear around the eyelids.

This condition occurs almost exclusively in females and has been suspected to be related to an ingredient in cosmetics, dental products, or even fluoride in water but no absolute proof of this causative connection has been proven.  On rare occasions it can develop in kids which is even more difficult to explain.

However, it is known that the prolonged usage of topical steroid medications (or cortisone creams) can lead to the development of perioral dermatitis.  Prescription strength topical steroids that are fluorinated would be the ones that would usually cause you to experience this type of reaction, but it can also develop due to over the counter 1% hydrocortisone cream which is not fluorinated.

So, what happens after the Perioral Dermatitis  diagnosis is made?

Well, most dermatologists will have you immediately stop the usage of any potent topical steroid creams, and prescribe a short course of oral antibiotics mostly in the tetracycline family.  Over a four to eight week period of taking the antibiotic, the condition oftentimes improves significantly or even disappears completely.  Topical antibiotics such as sodium sulfacetamide or azelaic acid might be used as well or in place of the oral antibiotics depending upon the severity of the eruption.  If you have an unusually stubborn case of this condition, your treatment might have to be continued as long as three to six months before the problem resolves.

Other conditions that can cause eruptions around the mouth that might mimic perioral dermatitis include contact dermatitis due to foods or beverages, localized versions of rosacea, or even acne.  However, perioral dermatitis has a pretty distinctive appearance so usually you will pretty much know that you have it or you don’t.

One of the common tendencies for individuals who have this condition is to spend a lot of time trying to determine a cause and despite the association with topical steroid creams, we really don’t know why this eruption occurs and localizes to the area around the mouth and chin.

So, if you find yourself with lingering areas of bumpiness, redness, or irritation around the mouth and chin, see a dermatologist to get evaluated and treatment for relief.