Perioral Dermatitis Overview

Perioral dermatitis is a common inflammatory skin rash

Perioral dermatitis in a child who had a habit of licking their lips

James Heilman, MD / Wikimedia Commons / CC BY-SA 4.0

Perioral dermatitis is a chronic rash that most often appears around the mouth. The rash is usually scaly and red rash and may be mildly itchy. It can also spread to your nose and around your eyes. This condition is seen in both children and adults.

Causes

If your child has a rash caused by irritation, and you treat it with a steroid cream, they can develop perioral dermatitis. While steroids can help the rash get better, the rash can get worse over time and will eventually stop responding to the steroid cream.

If you or your child are using a steroid cream and think perioral dermatitis has developed, stop using the steroid cream. It's important to note the rash will get worse once you stop using the steroids, but then will gradually get better.

Beyond steroid creams, inhaled steroid sprays can also cause perioral dermatitis. If your rash is caused by steroid spray, it will most likely improve once you stop using the spray. If you need the spray long-term, speak to your doctor about alternative medications or delivery methods.

Heavy face cream, irritating makeup, or fluoride toothpaste can also cause the condition. Having rosacea also makes you more likely to have perioral dermatitis.

Perioral dermatitis can affect children of any age; however, it is most common in women between the ages of 19 and 40.

Diagnosis and Treatment

If you think you have perioral dermatitis, see a dermatologist. There is no test to diagnose the condition. Your doctor will make the diagnosis based on the appearance of your rash.

Your doctor may recommend discontinuing a steroid cream or spray as the first step. If you or your child have perioral dermatitis, skip heavy face washes and cream and opt for a gentle facial soap while your rash heals.

Sometimes a topical or oral antibiotic is also needed to help perioral dermatitis go away. Common treatments for perioral dermatitis might include oral azithromycin (an antibiotic), Elidel or Protopic topical cream (medications commonly used for eczema), and discontinuing your use of steroid cream.

Other Possible Diagnoses

In most cases, especially after discontinuing the use of steroid cream, perioral dermatitis goes away on its own. If you or your child's rash does not subside, see a dermatologist rule out other similar conditions, including:

  • Impetigo: This highly contagious skin infection is common among school-age children. If your child has red, oozing sores around their nose or their mouth, they may have impetigo.
  • Seborrheic dermatitis: If the rash extends into the creases around your child's nose and causes flaking behind the ears and eyebrows, they may have seborrheic dermatitis.
  • Angular cheilitis: Inflammation at the corners of the mouth can be associated with iron deficiency.
  • Lip licker's dermatitis: Kids often suck their lower lip with their upper lip or simply lick their lips, especially during the winter. As the skin around their lips gets dry and irritated, your child may develop a rash. If treated with steroids, it can progress to perioral dermatitis.
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Article Sources

  • American College of Osteopathic Dermatology. Perioral Dermatitis. 2017.