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Perioral dermatitis is a common skin condition that mostly affects young women, although men and children may occasionally be affected. Perioral refers to the area around the mouth, and dermatitis indicates redness of the skin. Common characteristics include redness, small red bumps, pus bumps, and mild peeling, accompanied by mild itching and/or burning. Sometimes the bumps are the most obvious feature, and the disease can look a lot like acne. In fact, perioral dermatitis is a combination of both acne and dermatitis (eczema). The areas most affected by this condition include the region from the nose to the sides of the lips, as well as the chin. There is also frequent sparing of a small band of skin that borders the lips. Occasionally, the areas around the nose, eyes and cheeks can be affected.
If left untreated, perioral dermatitis may last for months to several years. When properly treated, this condition does not normally return, although recurrence is possible.
The origin of perioral dermatitis is unknown. Some dermatologists believe it to be a form of acne rosacea or sunlight-worsened seborrheic dermatitis. Others feel it may be related to the fluoride in toothpaste, or even certain types of make-up and moisturizers. Strong corticosteroid creams applied to the face may also initiate this condition. Once perioral dermatitis develops, mild corticosteroid creams appear to help, but the disorder reappears when treatment is stopped. In fact, perioral dermatitis usually comes back even worse than it was before the use of steroid creams.
There is no guaranteed way to prevent perioral dermatitis. Do not use strong prescription strength corticosteroid creams on the face. Your dermatologist may have suggestions about the use of moisturizers, cosmetics, and sunscreens and may advise against using toothpaste with fluoride, tarter control ingredients, or cinnamon flavoring.
In most cases, no tests are necessary to diagnose perioral dermatitis. A dermatologist can usually make an accurate diagnosis by simply examining the skin. Sometimes, scraping or a biopsy of the skin is performed, and occasionally blood tests are ordered to eliminate other conditions that can look similar.
Oral antibiotics, such as tetracycline, are the most common treatments for perioral dermatitis. Treatment may be needed for several months in order to prevent recurrence. For milder cases or when treating pregnant women, topical antibiotic creams may be used. Occasionally, your dermatologist may recommend a specific corticosteroid cream for a short time to help your appearance while the antibiotics are working.
Most patients improve with two months of oral antibiotic use. If corticosteroid creams were used for treatment, there may be a brief flare-up when the creams are stopped. If antibiotic treatment is stopped too early however, the problem may come back.