An Itchy Rash on the Lips: Perioral Dermatitis Explained

Perioral dermatitis is a common inflammatory skin rash

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Perioral dermatitis (PD) is a scaly, itchy rash that often appears around the mouth. It may also spread to other areas of the face and body, and it can affect both children and adults.

Also called periorificial dermatitis, this condition causes symptoms such as:

  • Red bumps
  • Flaky skin
  • Clear fluid discharge
  • Inflammation

This article explains the causes of perioral dermatitis. It will also explore how this rash is diagnosed, as well as available treatment options.

Rash around child's mouth.
James Heilman, MD / Wikimedia Commons / CC BY-SA 4.0

What Causes Perioral Dermatitis Lip Rash?

The causes of perioral dermatitis are not well understood. The condition is thought to be related to the use of prescription steroids. Irritants found in skin or oral care products have also been linked to PD.

Steroids

Steroids are a type of anti-inflammatory medication. Their use, especially long-term, has been closely linked to perioral dermatitis. This is true for topical steroids and for steroids that are inhaled through the nose or mouth.

If you or your child are using a steroid cream or steroid spray, especially for long periods of time, watch for symptoms of PD.

Personal Care Products

The use of heavy face creams and moisturizers may also cause perioral dermatitis. Those that contain certain ingredients, like paraffin and petroleum jelly, may be particularly problematic.

In children, high sun protection factor (SPF) sunscreen may contribute to lip rash.

Makeup, especially foundation, may also cause PD.

Some cleansers and shampoos contain sodium lauryl sulfate (SLS). This compound is known to irritate sensitive skin, which may lead to perioral dermatitis.

Finally, a few case reports have suggested a link between fluoride toothpaste and PD. Tartar control ingredients used in some toothpastes may also play a role.

Some doctors consider perioral dermatitis to be a type of rosacea. This is because of overlapping symptoms and triggers. Other experts, however, have concluded that the two are separate conditions.

Risk Factors for Perioral Dermatitis Rash on Lips

Females are more likely than males to develop PD. The condition is also most likely to occur in people between the ages of 19 and 40. Children can also develop PD.

Use of certain products and medications also puts you at risk. This is especially true for steroid-containing creams and inhalers.

People experiencing hormonal changes or problems with the immune system may also be at risk. 

Symptoms of Perioral Dermatitis Lip Rash

PD appears as a red rash around the lips. The rash may consist of small, red bumps called papules. You may also have dry, flaky, or scaly skin and a clear fluid discharge.

The rash may itch or burn. In some cases, it can spread to other parts of the face, such as the nose and eyes. Rarely, it may appear around the genitals.

How Is Perioral Dermatitis Diagnosed?

There is no test to diagnose PD. Your doctor can diagnose it based on your symptoms.

PD may go away on its own. Stopping steroids is a good first step.

If you or your child still have the rash, it's best to see a dermatologist. This is a skin, hair, and nails specialist. They may rule out other similar conditions, including:

  • Impetigo: This skin infection is common among school-age children and is easily spread. Symptoms include red, oozing sores around the nose or mouth.
  • Seborrheic dermatitis: This rash is usually seen in the creases around your child's nose. It may cause flaking behind the ears and eyebrows.
  • Angular cheilitis: Iron deficiency and teeth issues can lead to inflammation and flaking at the corners of the mouth.
  • Lip licker's dermatitis: Kids may suck their lower lip or lick their lips, especially during the winter. As the skin around their lips gets dry and irritated, your child may develop a rash.

Perioral dermatitis is commonly diagnosed in children of any age and in women between the ages of 19 and 40.

What is the Best Treatment for Perioral Dermatitis Rash on Lips?

As a first step, your doctor may recommend that you stop using steroid cream or spray. It's important to note that the rash may get worse before healing.

Other common treatment options for PD may include prescription medications and lifestyle changes.

Prescription Medications

Your doctor may prescribe oral or topical medications to help treat your rash. These may include:

Lifestyle Changes

Stopping the use of steroid medications may help your rash heal. However, it is important to talk to your doctor before stopping or starting any new medication.

Other lifestyle changes may also improve your symptoms. Use a gentle facial soap while your rash heals. Stop using facial products like creams, moisturizers, and foundations. Switching to dental products that don't contain fluoride may also help.

Recap

Prescription medications, including topical creams and oral antibiotics may help clear up your rash. It is also important to discontinue the use of irritating facial products.

Coping with Perioral Dermatitis Lip Rash

PD can be a long-term condition. You may go through periods of flare-up and periods where you have no symptoms. Without treatment, the condition may recur. 

What Triggers Perioral Dermatitis Rash on Lips

Use of topical and inhaled steroids is the most common trigger for PD flare-ups. Certain skin care creams, foundations, and sunscreens may also be triggers.

Researchers believe environmental conditions like heat and wind may also play a role. Other potential triggers may include:

  • Oral contraceptives
  • Hormone fluxuations
  • Fluoride and tartar control toothpaste

Long-Term Outlook

For some people with PD, symptoms will resolve after a change in skincare routine. Discontinuing the use of triggering products may be enough to clear the rash.

Some patients have success with topical antibiotics and other creams. In more extreme cases, patients may require an 8 to 12 week course of oral antibiotics. A few patients may need to take oral antibiotics for longer periods of time.

Unfortunately, PD may recur. For some patients, long-term management of the condition may be necessary.

Preventing Perioral Dermatitis Rash on Lips

If you are prone to PD and you use prescribed steroid medications, talk to your doctor. You may need to discontinue these medications to prevent flare-ups.

You can also help prevent flare-ups by avoiding the use of heavy creams, moisturizers, and foundations. Switching to a non-fluoride toothpaste and avoiding high SPF sunscreen may also help. 

Recap

For some people, perioral dermatitis is long-term. It may recur after treatment. You can help prevent flare-ups by avoiding triggering products.  

Summary

PD is a red, bumpy, flaky rash that typically shows up around the lips. It may also be found on other areas of the face and body. Children and women tend to be diagnosed most often with this rash.

While there isn't a medical test to diagnose this rash, a dermatologist will be able to identify it based on your symptoms. They may offer treatment suggestions such as:

  • Taking an oral antibiotic
  • Using a topical antibiotic
  • Stopping the use of any steroids and/or fluoride products

A Word From Verywell

There is strong evidence that PD may be related to the use of prescription steroids. This includes both topical and inhaled steroids. Still, you should always talk to your doctor before changing or stopping the use of any prescription medication.

PD may take a while to clear up. It is also possible that it may recur. Talk to a dermatologist about the best treatment options for you. Working closely with your doctor will give you the best chance of successfully clearing your rash.

Frequently Asked Questions

  • What causes rashes on lips?

    Lip rashes can have a number of causes, including bacterial infections, nutritional problems, and skin irritants. Perioral dermatitis is a specific type of rash linked to steroid use and irritating skin and oral care products.

  • How do you treat a rash on your lips?

    Many lip rashes can be treated by simply discontinuing the use of irritating products. Some rashes need to be treated with prescription medications, like antibiotics.

  • How do you heal a rash on your lip fast?

    If your lip rash is caused by a skin product like moisturizer or foundation, discontinuing use of that product could be a fast way to clear it up. If your lip rash doesn't go away after taking this step, see a dermatologist.

  • What does lip dermatitis look like?

    Lip rashes may consist of small bumps. Your skin may be red, dry, and flaky. You may also have sores that ooze or discharge of clear fluid. Some lip rashes also burn and itch.

  • Why do I have small itchy bumps on my lips?

    Lip rashes are often caused by skin irritants. Lip licking, bacterial infections, and skin conditions like eczema can also be culprits. The best way to find the cause of your lip rash is to see a dermatologist.

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