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That Pesky Rash Around Your Mouth? It Might be Perioral Dermatitis

June 3, 2021 //  by Dr. Robert Paull, MD//  Leave a Comment

Think back 15 months, to when pandemic wasn’t yet a household word. When stay-at-home orders were initially issued, many of us thought this would all be over in a couple of weeks. We might even have approached it like an unexpected but welcome break from our daily routines.

But very quickly, the unsettling reality set in.

The relentless stress that followed manifested in all sorts of different ways. For Elizabeth Denton, it wreaked havoc on her skin.

“In my case, that meant a flare-up of perioral dermatitis (PD), a scaly red rash, to the right of my mouth,” she writes in an essay for Allure. “It’s something I had never even heard of and definitely was not the run-of-the-mill dry skin I assumed it to be.”

Perioral dermatitis is a condition where you develop red, sometimes pus-filled bumps around the mouth, chin, or nose. Less commonly, they can also develop along the outer part of the eyelids and on the cheeks.

Denton posted about her diagnosis on her Instagram Stories. Multiple people messaged to say they had it, too, which reassured her. Less reassuring: They all had different advice about how to treat it.

That Pesky Rash Around Your Mouth? It Might be Perioral Dermatitis

What Causes Perioral Dermatitis

While common, it’s still unclear what causes perioral dermatitis. There’s no shortage of theories, though, and they range from the use of topical cortisone creams to heavy skincare products. And stress.

“My red bumps aren’t fluid-filled, but I did have a small rash under my nose before it popped up by my mouth,” Denton says. “Sometimes the area even burns and feels tight and uncomfortable.”

Her experience is in line with most. The rash can be accompanied by itching or burning, or it may appear without any sensation at all. Again, we’re not really sure why.

What Treats it

Treatment, at least, is more straightforward. Beauty bloggers recommend skipping exfoliation until the rash begins to clear up, using a gentle cleanser to wash your face, and avoiding products that contain fragrances and dyes. But the only proven way to diminish perioral dermatitis and keep it from coming back is to use a prescription medication.

That said, try an over-the-counter treatment first. And give it two to four weeks. If your rash doesn’t show any signs of improvement, schedule an appointment with a board-certified dermatologist. Metrogel and Soolantra, which decrease redness and swelling, are commonly prescribed in such instances. Oral antibiotics are also sometimes given to help relieve inflammation.

Denton was prescribed Metrogel, which, she says, rid her of her rash “within a week.”

“In the meantime, I started checking the ingredients in my skincare more often,” she says. “I’ve noticed products with fragrance, especially products that aren’t rinsed off, such as night creams, make my PD worse.

“I’m also trying to take better care of myself in general … ,” Denton continues. “That means eating real meals (popcorn doesn’t count), getting some physically distanced fresh air, and going to bed earlier.”

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